If the shoe fits.

What type of footwear is best for my ankles/feet?

This is one of the most common questions we field as physical therapists. The answer is not always easy, as “it depends!” Everyone’s feet and walking mechanics are different, therefore selecting the most appropriate footwear will vary from person to person. Rarely, if a person has chronic ankle and foot problems related to conditions that cause “too much motion,” ligamentous laxity, or has been diagnosed with severe “flat feet” or severe “over-pronation,” they may benefit from a shoe that offers significantly more stability and support (AKA the shoe may be stiffer or have more “substance” to it) as well as potentially orthotics. For people with “high arches” or a more “neutral” arch foot, a more “neutral” or more flexible shoe that moves with your foot is usually fine. People who have pain on the ball of the foot or heel may benefit from more “cushioned” shoes that offweight the painful area, while those who are working on foot/ankle strengthening may benefit from a more flexible shoe or one with less cushion (i.e. the foot feels “closer” to the ground underneath you) to allow for small foot muscles, joint and sensory receptors to more accurately and efficiently “feel” and adapt to the surface underneath them. 

Though we are not necessarily “shoe experts,” physical therapists can assist with evaluating your foot and ankle range of motion, strength, joint mobility, and walking mechanics in order to give you guidelines or certain shoe characteristics to look for, in order to help you select a shoe that is great for you! Overall, you want to look for a shoe that is supportive, comfortable, durable, and functional for the activity you are participating in. Also, you want to make sure the fit is proper. 

Some general guidelines for shoe fit:

1. Your heel should not slide up and down or side to side in the back of the shoe when you are walking

2. You should be able to “feel” or “sense” your heel, big toe, and arch of the foot when you are standing in the shoes

3. Shoes should be comfortable right away. If you feel like you need to “break them in,” they may not be the right pair for you.

4. The tops and sides of your toes should not rub on or hit the top or sides of your shoes while walking. If there is excessive friction or pain on the tops or sides of the toes when walking due to toes hitting the “edges” of the shoe, you may need a pair with a wider “toe box.” 

5. Your toes and balls of your feet are meant to “extend” or bend when pushing forward from heel to ball of foot while walking to help you propel forward. The top of the shoe or “toe box” should “bend” or be flexible to accommodate this natural motion.

6. Shoes should stay on your feet, especially if you have issues with balance, are at an increased risk for falls, or have decreased sensation in your feet. We like shoes with laces or velcro straps as opposed to “slip ons” or shoes that do not have a heel in the back. However, you should not have to tie shoes so tight that you need to sit down and untie them to take them off.