How Important is Footwear When Wearing an Orthotic?

Orthotics do not work without something to give it contact with the dynamic foot.  That is where the shoe comes into play.  With footwear, the orthotic becomes an extension of the foot (or at minimum a bridge between the foot and shoe). With that all being said, are shoes an important consideration when wearing orthotics?  Absolutely.

The Importance of Fit

The first thing to remember is that a shoe is only as good as the fit.  A $200 shoe that fits poorly has less value than a $40 shoe that fits properly.  You will benefit from having an expert select and fit your shoes.

Find a retailer that has a good selection of shoes, and has associates who are skilled at fitting and have a history of customer satisfaction.  It is best to find a retailer who has a certified pedorthist on staff or someone who has a good understanding of pedorthic concepts.  Once you have an idea of which retailers might meet your requirements, ask these questions.  Does the sales staff know their stuff?  Do they measure feet?  Are they listening to you? 

The Basics of the Fitting Process

One concept to remember is that shoe size is not foot size.  A person who has a size 9 foot may wear a size 9 shoe – or a size 10 – depending on the brand. Even within a brand you can find that different models can have fit characteristics.  The starting point in shoe selection and fitting is to be professionally measured with the Brannock Device.  This foot measuring apparatus measures the heel-to-toe length of the foot, the heel-to-ball and the linear width.  Using the Brannock Device not only indicates the foot size but helps to visually show foot expansion between non-weight bearing and weight bearing state.  It is also a great tool for help quantify a size difference between the two feet.

Shoe selection is very important and the general goal is to match the foot shape to a corresponding shoe shape.  If the foot is shaped like a loaf of bread, then look for a straight-lasted shoe.  If the foot is shaped like a banana, then look for a curved-lasted shoe.  An important consideration is the orthotic itself, as they will affect the effective shape of the foot.  As most orthotics tend to be more straight and full, often the best shoe options are those that are also straight and full.

When fitting the shoe, the professional should try and fit the widest part of the foot into the widest part of the shoe.  If that is achieved then the shoe will flex naturally along with the foot, enabling a more fluid gait and causing less irritation.  Beyond last shape and ball-of-foot placement, having adequate space at the end of the shoe is important.  In general, having at least 3/8^th of an inch of space at the end of the longest toe (which may not be the great toe).

Shoe Selection is Critical

Before buying shoes, it is best to assess your expectations.  Orthotics will not fit into all shoes.  In fact, they will fit into a minority of shoes found in a typical shoe store.  The shoe will need to tie, Velcro or otherwise be secured around the foot.  In addition, the shoe needs to have enough internal volume to accommodate the orthotic. Remember that any given shoe model might not be the best fit option for every person.  In addition, depending on your activity level, the shoe you need may not a running shoe.  A full-waisted walking shoe may be the perfect shoe or perhaps a casual oxford.  Instead of looking for specific styles of shoes, look for specific features.

Follow Up

Don’t be afraid to ask for a return visit so you can have your retailer check how the shoe fits and how it accommodates the orthotic.  It may take a little time for the orthotic to seat firmly into the shoe and start to feel comfortable. If you have any pain, you should go back to your retailer immediately to have them check that they have chosen the correct shoe for your foot type and your orthotics.



Information courtesy of Lamey Wellehan Shoes  •  Maine’s Shoe Store since 1914