The Link Between Shoes, Feet, Comfort & Pain

Foot Pain is Part of Our History

I recently listened to an episode of the podcast Freakonomics Radio called “These Shoes Are Killing Me!” In it, the host Stephen Dubner and his guests discussed the economic and social history of footwear. As an ankle and foot specialist, I found it fascinating. I know a thing or two about the structure and physicality of the human foot. However, thinking about feet in the context of evolution and socioeconomics gave me some new perspective, and at the same time reiterated my medical opinion about shoes and foot health. Our shared experience with pain and comfort offers a telling story about humankind as its an indicator of our overall health, far beyond our feet.

Tens of thousands of years ago, we walked, ran and hunted without shoes. And we were mostly fine, all things considered. However, according to National Geographic, a 40,000-year-old human fossil with delicate toe bones indicative of habitual shoe-wearing, provides us with evidence that we’ve relied on an accessory to protect or otherwise encase our feet for a significant percentage of the time modern humans have walked the earth. Love them or hate them, shoes aren’t going anywhere. And they have the potential to advance us and set us back at the same time.

Rooted by Our Feet

Those of us who count our daily walking steps for the sake of fitness know that the benchmark to hit is 10,000. If we’re walking an average of 3,650,000 steps annually, and we’re wearing shoes most of the way, the connection between foot health and footwear is undeniable. When our feet aren’t healthy, our entire body is affected. Beyond the impact on gait, balance, stability, and range of motion, when our feet are happy and healthy, the rest of our joints and skeletal system benefit. And when we suffer from injury, deformity or pain, it’s tough to participate in everyday activities, especially if our shoes are worsening or causing the problem.

Shopping Safe

When shopping for shoes, our options seem endless. If you conduct a generic search on the shoe retail website simply for “women’s shoes,” nearly 155,000 items are available for purchase. So how do you know where to start? How do you know that your shoe purchase isn’t going to cause problems for your feet and your overall health?

Harvard Medical School offers solid advice: “Stand barefoot on a piece of paper or cardboard and trace the shape of each foot. Now take your shoes, one by one, and place them on top of the drawing. If you’re like most people, your ‘comfortable’ shoes will closely match the outline of your own feet.”

My challenge for anyone reading this blog post is to create your personal foot outline and compare your footprint perimeter to every pair of shoes in your closet. Then sort your shoes into two piles. One pile is for the shoes that closely match the outline of your foot, and the other is for the shoes that do not. Are you willing to get rid of the shoes that do not? Or are you willing to reduce how often you wear them? My professional advice is yes, that you should.

What to Look For When Seeking Comfortable Shoes for Painful Feet

When shopping for new shoes, ask yourself the following questions:

  • Are the soles sturdy? Will they protect you when you step on sharp objects?
  • If the heel is elevated, is your weight evenly distributed and is your ankle secure?
  • Don’t rely too much on size, which can be inconsistent from brand-to-brand. Try the shoes on and walk around the store or your living room and pay attention to how they feel. Let your personal comfort be your guide.
  • Are you at a higher risk of tripping or falling?
  • Does the footbed of the shoe match the shape of your foot?
  • Make sure the arch support suits the structure of your foot. How do your other joints feel when you are walking?

The bottom line is to use common sense. If your answers to any of these questions are negative, select an alternative pair of shoes.

The Price We Pay for Vanity

A quote that really struck me in the Freakonomics story was from Dr. Howard Osterman, a podiatrist for the Washington Wizards and the Washington Mystics. He noted, “There isn’t anybody who wears a six-inch heel into my office who doesn’t know that it is detrimental to their health.” I couldn’t agree more with Dr. Osterman. I understand vanity. It’s part of our human condition. But when we knowingly damage our health for the sake of fashion, it’s a shame. And it’s painfully preventable — pun intended.

The Cleveland Clinic ranked shoe types against different foot conditions and concluded that overall, pointy stilettos are the worst shoes for your feet. If you insist on wearing toe-pinching, incredibly high heels, please do yourself a favor and limit how often you wear them and avoid them altogether when you know you will be standing or walking a lot while they are on your feet.

What I like about the Cleveland Clinic article is that it recognizes the fact that we as medical experts are never going to convince the general public to trash their high-price, high-fashion footwear in exchange for frumpy orthopedic alternatives. It’s not going to happen. But what we can do is educate people about foot health and foot conditions and advocate for moderation and personal mindfulness when selecting shoes.

One Foot at a Time

We are all built differently and are challenged with our own personal circumstances. Quite literally, foot health cannot be prescribed with a one-size-fits-all solution. As an example, flip-flops should not be worn as an everyday shoe, but if you suffer from a hammertoe, it’s a good option that can provide temporary relief. Other factors matter too, like managing your weight and skincare.

If you’re suffering any type of foot pain or discomfort, always contact your physician. The foot is one of the most complex structures in the human body. And your feet impact and are impacted by all the other joints in your body. Be sure not to ignore pain, just hoping it will go away. Pain is your body’s way of telling you that something is wrong. The solution could be as simple as changing your footwear, or something far more complex. Let’s talk about your footwear questions and concerns.