If you’re living with diabetes you need to pay careful attention to shoe selection and fit as your feet are highly susceptible to injury and poorly fitting shoes are one of the leading causes of foot wounds.
Here are some tips to help you select shoes that won’t damage your feet:
When you are shoe shopping, take the insole out of the shoe and stand on it. There should be a thumb width between your longest toe and the end of the insole. If any part of your foot is hanging over the insole the shoe is too short or too narrow for you (like the photo to the left).
Conversely if insole is showing under the edges of your foot, the shoe is too wide for you. People who have reduced sensation in their feet often choose shoes that they can feel, which means they buy shoes that are 1.5 to 2 sizes too short. Shoes that are this small put extra pressure on their feet they can’t afford to have!
If you look down at your feet past your shin and see your second toe, your foot is “straight”. This means you need to buy a shoe that is pretty much straight on the inside like the one shown in the photo to the left.
However, if you can see your third or fourth toe while looking down, your foot is “inflared” which means you should look for a shoe where the toe is turned in at the front. If you wear a “straight” shoe when your foot is “inflared” your fourth and fifth toes will hang over the side of the insole which will cause it to wear earlier on the outside and break down sooner than it should. I have seen people whose toes fall over the outside edge when they walk because their shoes do not support them.
In addition to looking for shoes that match your foot shape, you should pay attention to shoe construction. Flat seams are best as they will reduce irritation. Shoes that have right sides sewed together like pant seams (like the one shown below), will likely irritate your foot. Also carefully feel the heel to make sure there isn’t any extra fabric that will rub.
It is always advisable to shop for shoes later in the day when your feet are at their biggest. However, if your feet tend to swell or you find your shoes are too tight at the toes, look for extra depth shoes as they will provide your feet with the room they need.
Do not buy any shoes unless they feel comfortable when you first try them on. Shoes don’t need to be “broken in,” they should be comfortable from the start. To be extra sure your new shoes won’t injure your feet, start by wearing them a couple of hours a day and slowly increase the time they are on your feet. This is not to break the shoes in, but to confirm that they fit perfectly. If they rub or pinch they are going to give you an injury that may take months or possibly years to heal.
By Jim Pattison, C. Ped (C), Prince Albert, SK