February 19, 2002


Experts say the size of your shoe can affect your health


New shoes beckon: The narrow, open-toed, three-inch fire engine red heels, or a flatter, wider, shorter pump?


First, think of the feet as soldiers on the front lines. Would you rather send them into battle wearing Kevlar or chiffon?

Thought so.

But selecting a proper shoe is rarely a hop, skip and jump away; even settling with a proper size is more difficult than it might seem.

Just ask The Foot Nurse, Patti Glick. The wrong pair of shoes - too short and wide - spelled trouble for her aching dogs in the form of a neuroma, irritation of the nerves between her toes. Only after settling on a longer, narrower shoe did true foot comfort become hers.


"Picking a shoe is one thing. Picking the right size is another and it's not always that easy," says Glick, a Cupertino, Calif., based registered nurse who conducts wellness seminars and promotes foot safety throughout her community.

"We kind of guess what's best, but the problem with guessing is if you pick a shoe that's too small, your feet and the shoe will not bend in the same spot."

Too often, say Glick and Hagerstown podiatrist Todd Harrison, shoe shoppers are off the mark on footware fit.

Unless visiting a specialist, such as shopping for running shoes at a store with attendants trained to properly measure the foot, shoes are liable to be ill-fitting and either exacerbate existing foot problems or create new ones.

It doesn't help, Glick says, that foot size today will not necessarily remain the same throughout adulthood. Adults can expect their foot to change size and shape four or five times as the body grows older. And children's feet will grow and change 26 times leading up to maturity.

Pregnancy can wreak havoc with feet. So can weight gain, which forces feet to bear more stress and subsequently flatten feet.

"Our tendons and ligaments gradually relax during the aging process, so our feet tend to spread longer and wider," Glick says.

"If they look in the mirror, their body changes but they don't think their feet change," adds Frederick, Md., podiatrist David Levine. "Gravity has a way of bringing things down."

Because feet can swell as the day goes on, sometimes up to half a size, Harrison suggests purchasing dress shoes at the time of day they will be worn.

Playing tennis in the afternoon means shoes should be bought in the afternoon. Similarly, dress shoes should be bought at the end of the day to take the swelling into account. Otherwise, shoes can feel tight and uncomfortable by the end of the day.

One trick is to trace the outline of both foot and shoe on a sheet of paper. If the foot outline is larger than the shoe, odds are footwear is improperly sized.

"Some people will feel like they're wearing a big enough shoe," Harrison says. "They don't really believe you until you trace it out and show them."

Levine owns the Podiatry & Footwear Center, a one-stop shop where people can see Levine and visit his walk-in shoe store. What most people don't realize, he says, is that foot problems are not relegated to below the ankle. A problem in the foot has the potential to radiate upwards, even causing back pain.

Where Glick and Harrison disagree is in discussing which brand of shoe to buy. Glick says no company creates product lines that are all risk-free, and that bargains are not automatically ill-suited for wearing.

But Harrison says, as in the case of running shoes, major athletic shoemakers pump a lot of cash into research and development and that care can be seen in higher-priced options.

Back to the shoe store dilemma: Heel or pump? Unfortunately, not enough people know what to look for in order to make a wise, foot-friendly decision.

"I don't even think they're aware of it. Most people just don't have any idea," Glick says. "You really have to take the time to look a little bit and be a selective consumer."

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