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Everyday footwear: an overview of what we know and what we should know on ill-fitting footwear and associated pain and pathology
HelenBranthwaiteNachiappanChockalingam
The Foot; 17 January 2019
Highlights
•Research evidence on the effects of ill-fitting footwear is limited and often based on assumptions, indirect association and mythology.
•Footwear advice to direct people to healthy footwear needs to be individualised as there is no definition of an ill-fitting shoe.
•Footwear choice can alter gait and inappropriate fit can create pain and pathology.
•The direct mechanism of ill-fitting footwear contributing to pathology needs to be explored further.
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Footwear has been used to protect feet for millennia with socially exclusive population adopting stylish and fashionable shoes with expensive materials. In terms of historic timeline, only more recently footwear has been worn by all classes in the western world as an integral part of their apparel. Traditionally, footwear has been constructed from natural materials, mainly leather, but has recently benefitted from the flexibility that technology has provided with a plethora materials and new design innovations. Although it has expanded the availability for a variety of consumers, the choice and fit continue to be problematic with many individuals wearing shoes that are ill-fitting. Provision of specific footwear advice for problem feet is poorly evidenced and is heavily practitioner dependant limiting its efficacy. There is limited understanding as to the changes that can occur from regularly wearing footwear that is unsuitable in shape, style and construction which is referred to as ill-fitting. Current research on the effect that everyday footwear has on foot function and pain focuses mainly on women’s shoes, particularly high heels. Defining what is a good fitting shoe, that does not damage the foot or mechanics of walking, may need to be individualised, but best fit is based on loose historical parameters rather than research evidence. The aim of this overview is to highlight aspects of current research, establishing what we know about the effect’s shoes have on the feet as well as exploring the mythology around footwear fit and advice that is often historical in nature.
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