Footwear can play an imperative role in fall prevention through the improvement of balance and foot comfort. Read on to learn more about shoes and their inherent abilities in pain reduction and balance.
As we age our feet change. Not only do they get longer, wider and often flatter, but many of us will also suffer from toe deformities, such as hammer toes, mallet toes, bunions, hallux valgus and more. These deformities can make it challenging to find the proper fit and often will require modifications to footwear, such as stretching, cutouts and heating, to name but a few.
Other alternatives, such as extra depth footwear, are designed to increase space around the forefoot and thus help prevent friction and pressure that may result in blisters, sores or in the case of the diabetic foot, ulcerations (open wounds). With the introduction of nylon fabrics and the invention of the stretchable shoe, many shoes can now also be heat molded to reduce pressure where needed.
There are several options to help improve balance and stability through footwear. We recommend you choose low heeled footwear with outflares (soles that flare outwards), to decrease lateral (sideways) movement, and a base wide enough to accommodate your feet. With most shoes offering removable insoles, the best way to check that you are choosing the right width and length is to remove the insole and stand on it whilst in the shop. Your toes and feet should not overlap the edges of the insole and you should have at least a finger width of space at the end of the insole.
If dress shoes are needed for everyday use, choose shoes with a wedge, as opposed to an offset heel. If an offset heel is a must, be sure to select a heel with a wider base as opposed to a stiletto heel. This will ensure better support and prevent nasty ankle sprains. Also, stick to heels that aren’t higher than an inch, in order to prevent excessive pressures on the forefoot.
Arch Supports & Orthotics
In certain cases shoes may require custom-made or off-the-shelf inserts to reduce pressure on the plantar (bottom) aspect of the foot. They help prevent excessive inward or outward rolling of the foot and improve toe function that may be impeded by a collapsed arch. Preventing the foot from excessive side to side movements through the use of supports can also improve balance in individuals suffering from instability, Parkinsons, Charcot Marie Tooth disease or foot pain.
Arthritis can occur in any of our 300+ joints and feet are very often affected. Most often our clients will experience pain in their big toe joint, as well as the midfoot, ankle and toes. Much of the pain can be remedied through better footwear that helps prevent joint motion and thus reduces pressure on the area of discomfort. To prevent pressure on the big toe joint, in case of limited range of motion, we often recommend rocker soled footwear to help prevent flexion of the painful joint, thus preventing missteps that may lead to falls. Midfoot pain is usually best addressed through arch support.
In general we recommend that if the shoe feels comfortable on the first try, wear it.
About the Author
Christian Johannsen is a Certified Pedorthist at Foot Solutions in Ambleside (West Vancouver) and Kitsilano (Vancouver). For additional information or to schedule an appointment or home visit, please contact him at (604) 925-2282 or (604) 267-7463.