As a Podiatrist, I regularly talk to my patients about shoes and footwear fitting and every new patient that I see has their feet measured, so I am acutely aware that a large number of people, across all genders and age groups, are in incorrectly sized and poorly fitting shoes. A review of the evidence on shoe sizing and fitting published in 2018 in the Journal of Foot & Ankle Research confirmed that, ‘a large proportion of the population (between 63-72%) are wearing inappropriately sized footwear based on length and width measurements’. The evidence also demonstrates that, ‘incorrect footwear fitting is specifically associated with foot pain, poorer overall foot health, painful hard skin and even ulceration in older people with Diabetes’. There are also differences in the fitting issues between men and women, which I regularly see in clinic. Women are statistically more likely to suffer foot pain compared to men and whereas more women wear shoes that are too narrow (50% of women compared to 34% of men), men wear shoes that are too long (31% of men in comparison to 13% of women).
There are lots of reasons for being in an incorrectly sized shoe. Sometimes this is because of a lack of facilities to measure and fit shoes properly (such as a Covid-19 pandemic!), but it is also the case that footwear manufacturers often don’t offer enough range of sizes, especially half sizes in length and width fittings at the forefoot. This often means that it is necessary to go up in length to get more width or down in length to get a narrower shoe. However, this is hurting our feet and contributing to problems such as bunions, toe deformities, thickening of nerves between the bones of the forefoot, blisters and hard skin, some of which might not be correctable, therefore, knowing the true size of your feet and then getting a shoe correctly fitted around it is vital, especially for more active pursuits such as hiking and running.
Another aspect of shoe fitting is the function of the shoe. If your foot is sitting in the incorrect position in the shoe, the technology in the sole that is designed to stabilise, cushion, flex (or not flex) during a certain part of the step is not interacting with the correct part of your foot and, subsequently, the rest of your skeleton. The upper of the shoe or boot will also be interacting with the foot in the incorrect places meaning that more rigid or too flexible parts of the upper may either irritate prominent parts of the foot or allow the foot to move around in the shoe too much.
Therefore, here are my top tips for finding out your true foot size and getting into the correct shoe!
- Have your feet measured! The team at the Tallington Lakes Pro Shop have all the tools to do this and Podiatrists like myself will often measure feet as part of our practice. The Society of Shoe Fitters also has a register of qualified shoe fitters such as myself.
- Buy your shoes from a shop and not online if possible (especially for new models or types of shoes) – walking boots / shoes and trail shoes / running shoes should always be tried on. Only order online if buying exactly the same pair as what you have already
- For active shoes like walking boots and trainers, make sure there is a maximum of 15mm and a minimum of 10mm from the end of your longest toe to the end of the shoe. For less active shoes, this can be a maximum of 10mm and a minimum of 5mm
- Try to make sure the widest parts of your forefoot (the width from your big toe joint to your little toe joint) are not painfully compressed or spreading and falling over the sole of the shoe as this means the shoe is too narrow and you may need to get a specific width fitting
- Make sure your foot is not moving around in the shoe – when your foot moves, your shoe should move with your foot and not within it. If it does then the shoe is too big (either too long, too wide or too deep)
There are countless ways that I use shoe technology and fittings in clinic every day to treat pain and improve function, but the tips above are a great starting point and may prevent or relieve your foot pain!
BSc(Hons), MChS, MFPM RCPS(Glasg), MSSF