THE VALUE OF GOOD SHOES: MOULD THE SHOE, NOT YOUR FOOT
If anything is going to carry you into a healthy future, it’s your feet. If you treat these marvels of engineering well, they are likely to age beautifully and will even be able to walk you to your final resting place. By the age of 50, the average Australian has walked a good 120 000 km. Yet apart from having lost some padding underfoot, he or she is still likely to be the owner of a pair of fairly pristine feet.
Hereditary conditions and systemic diseases aside, the single most significant factor that will determine the condition of these feet is footwear. Because feet are made up of many small bones and ligaments, they are highly adaptable and therefore susceptible to reshaping. Over time, shoes can remould them. Consider pointy shoes. They assume the foot is kite-shaped and are designed as if the third toe were the great toe and the first and fifth were both little toes.
A foot that spends too long in such a shoe is subjected to constant deforming pressure that disrupts both its muscle action and its biomechanics. Its soft tissue is damaged too, and corns, calluses and pump bumps (hard skin at the back, above the heel) appear, along with structural deformities such as bunions and hammer, mallet or claw toes.
Once toes are clawed, they no longer exert the same amount of useful pressure on the ground. The excess pressure is either absorbed by the ends of the toes, causing nail damage, or transferred up the foot, causing other problems.
Wedge-shaped shoes currently may look clunky but they follow the natural shape of the foot: what you lose in elegance, you may gain in comfort. With age, padding under the ball of the foot and the heel is lost. This can be remedied with extra padding or off-the-shelf insoles.
Although nothing further need happen to the foot, in Western societies much more usually does happen because of long exposure to ill-fitting footwear. In barefoot and sandal-wearing populations foot shape is retained into old age. But in our society heel size commonly remains unaltered while the forefoot splays and the toes become funnelled. The foot gradually takes on the form of the shoes it has been wearing.
Most feet can be rehabilitated with simple exercises, straightening out bent toes, remobilising painful, stiff joints and improving muscle control. But some – particularly the feet of women with a history of wearing high heels – are beyond rehabilitation.
It’s noteworthy that while women gave up wearing body-distorting corsets decades ago, they are still trying to maintain the illusion of small, narrow feet. Men, on the other hand, often wear shoes that are too big. In a study of aluminium-smelting industry workers, these men were offered a choice of metal-capped boots of varying lengths; the researchers selected one size – size 9 – and examined all the feet wearing this size.
At one smelter they found the length of feet in size 9 boots varied from 250 mm to 286 mm. This difference of 36 mm is equivalent to five traditional length-based sizes. Those with short feet in long boots had wide feet and straight toes. Those with long feet in the same boots had narrow feet with bent toes. The boots took no account of width or other dimensions.
The ideal shoe should follow the natural shape and inherent dynamics of the foot, at least approximately.
Thirty years ago the footwear industry concentrated on making shoes match within one-sixteenth of an inch. For every size available, there were at least 30 different fractional fittings.
For a size 9 shoe, there were two lengths – a straight 9 and a 9,5. These came in 10 widths ranging from AA to EE and were available for high- or low-arched feet. Shoe shops carried huge quantities of stock and had back rooms with shoe boxes stacked from floor to ceiling.
In those days a pair of men’s shoes cost a week’s wages, but they lasted 15 to 20 years. They were inherently stable in shape because they fitted at the time of purchase, were made of non-stretch leather, polished every day and resoled from time to time.
Since then, the industry has been rationalised; now there are more styles but shoes don’t fit as well and are not expected to last. Thirty years ago, when we had all those options, our population was predominantly Anglo-Saxon and foot shape was fairly standard. Now no-one is catering for the wide range of foot shapes associated with our diverse ethnic mix.
Today, more than 95 per cent of available shoe types in Australia offer standard lengths and a half-size that refers to a higher instep but offers no extra width. Consequently, there is a tendency to ‘stretch’ new shoes and an expectation that in the first month they will be tight, that by the second they will fit and that a few months later they will be overstretched.
The notion of using your foot as a stretching device is unsound. Rather, take better care finding a shoe that matches your foot shape or alter it inside to improve the fit.
This can be done with simple cheap fillers.
Orthoses are routinely overprescribed and usually not worth the $300-$600 they cost to have custom-made. In some cases they can even be harmful. Orthotics is a medical treatment that may have medical side effects. In some situations, orthoses that are supposed to compensate for weak muscles result in classic foot deterioration such as increased muscle weakness, joint stiffness and reduced control.
This orthotic de-conditioning is a well-recognised consequence of using back orthoses. Twenty years ago orthoses (braces) were used for a wide range of back problems in all ages. But overall, people became worse and grew dependent on the bracing.
Astonishing claims are made about the general benefits of orthotics. Consider flat feet. Perhaps 5 per cent of the population inherit them. These usually cause no problem. In addition, after a history of wearing ill-fitting shoes perhaps 20 per cent of adults have some muscle weakness that results in a flattening of their natural arch height. As acquired flat feet are caused by muscle weakness or altered action, it may be better to strengthen the muscles and retrain the foot rather than rely on orthotics. Exceptions would be the feet of the infirm elderly and those with serious permanent damage.
*117\105\2*
