Dr. David B. Raynor, Best Foot Forward, 10/16/12

Many times I am asked for advice on purchasing comfortable shoes. I am asked by people who have a difficult time finding shoes, as I am a podiatrist and treat people with foot issues for the most part. 

Bunions, hammertoes, corns, calluses, arthritic bumps, bony prominences, loss of padding and swelling present problems for a number of people with these issues when they try to find comfortable shoes off the shelf. I tell people that there is no easy answer for off-the-shelf shoes when they ask. Finding a comfortable shoe for a person with a foot issue off the shelf is difficult and sometimes simply unrealistic. Comfort and orthopedic-style shoes are available, but are difficult to find sometimes and can be quite expensive. The lowest price one can expect to pay for a comfort or orthopedic shoe is about $120. Athletic shoes are more forgiving, but often people do not like their appearance. I do not recommend ordering shoes from a catalogue or online for the first purchase. Ordering a duplicate model of an existing, well-fitting shoe to save money from a catalogue or online is fine in my opinion.

SAS shoes are the closest to off-the-shelf orthopedic shoes, but only the men’s Time Out or women’s Free Time shoe families give foot deformities extra room for relief. Women have the advantage of being able to wear men’s versions to gain even more space. I can tell if a woman is wearing a men’s shoe, but I look at feet five days a week, and I believe most people would not know if a women was wearing a men’s SAS shoe. SAS are expensive, but are well made and made in the USA. PW Minor and Soft Spot are other shoemakers that make comfort or orthopedic shoes. These are more difficult to find, but pedorthists or orthopedic shoe stores carry them. These shoes most likely are not in stock and will need to be ordered when fitted by a trained professional, adding a delay.

Shoe shopping should be done in the late afternoon to obtain a realistic fit to take into account any swelling or inflammation issues. One should look for shoes not only with a wider toe box and a stiff heel counter, but shoes that look like the foot being fitted to. Some shoes, like Birkenstocks or Crocs, for example, are shaped like feet and will tend to fit well. Simply purchasing a longer shoe or wider shoe to gain space usually results in what I call “problem shifting.” If one has a narrow heel, purchasing a wider shoe to accommodate a bunion will usually lead to instability or a blister down the road, as the heel will now swim in the shoe because it doesn’t fit the heel. Look for natural — not manmade — uppers, EVA foam soles, sewn upper-to-sole construction, stiff heel counters, a wide heel base and as few seams as possible in the toe box. This final recommendation makes successful stretching by a cobbler much more likely if needed.

A shoe should feel comfortable upon first fitting. The shoe should not pinch or bind. It should feel stable. You should “test drive” the shoe in the store for at least 10 minutes. The shoe can not be expected to “break in” with wear if it is uncomfortable.

For difficult cases, I recommend standing on a blank piece of paper barefooted and having a friend or family member trace each foot. You now have a life-size copy of your foot you can take with you at any time. You can then remove the liners of shoes and place them over the tracings. Liners that extend beyond the tracing will accept foot deformities. Liners that lie within the tracing will not and will aggravate foot deformities causing discomfort.

David B Raynor. DPM, is a podiatrist in Inverness and can be reached at 352-726-3668 or at www.Advance

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