Health Watch By Steve Mullenix

The North Jefferson News



The science of shoe fitting, called “Pedorthics,” is centuries old.

The first documented history of shoe fitting dates back to 1324 AD when King Edward II of England decreed that one barley corn would represent one full shoe size. Even with this declared standard, there were many arguments among cobblers. Many went back to custom fitting shoes to the individual.

The expense of custom shoes was out of reach for most commoners, so a standard never really caught on.

Although we’ve worn shoes for thousands of years, our current sizing methods are a mere century old. In 1880, the first uniform shoe sizing method was introduced by Edwin B Simpson of New York.

Simpson’s method defined each incremental shoe size as one-third and each half size as one-sixth. Simpson defined the heel to ball measurement and the first proportional relationship between length and width of shoe.

Everyone has heard the saying: “If the shoe fits, wear it.” Well, is that really the best thing to say to someone? For some individuals with special foot issues, there could be nothing worse to say.

For many people, finding a pair of shoes that fit can be a frustrating and time-consuming process because so many people have subtle abnormalities of the feet. These abnormalities can make the process more difficult. Add to this the considerations of why someone is looking for shoes and the process is even more complicated.

For some individuals, style is the only concern, for others it may be function, still for others comfort is the major concern. All these issues come into play when looking for that perfect pair of shoes.

When purchasing shoes, it is always a good idea to have the salesperson measure both feet because there can be differences in the size of your feet. If there are notable differences in the size of the feet, buy the size to fit the bigger foot.

Common conditions that can affect the way a shoe fits include:

• Planta Facitis (pain in heel or arch)

• Metatarsalgia (pain in the joint or the ball of the foot)

• Diabetes – A major concern

• Arthritis

• Pes Planus (flat feet)

• Pes Cavus (high arches)

Let’s concentrate on the concerns of the diabetic foot. Diabetic patients need to be particularly aware of the type of shoes they wear. This is especially true if they have poor circulation, numbness or loss of sensation in their feet (neuropathy).

Shoes should be purchased that have adequate room in the toe box area. The uppers of the shoes should be of soft leather with few or no seams. Extra deep shoes are available to meet the needs of the diabetic patient.

In many instances, Medicare will reimburse for one pair of shoes per year if the patient’s doctor recommends the extra deep shoes. Some pharmacies and medical equipment stores are able to provide custom fitting for these individuals. Make sure the individual fitting your shoes has been certified in shoe fittings and meeting the needs of the diabetic patient.

For the rest of us, let’s consider these general steps if finding a pair of properly fitting shoes:

• Always insist on measuring the foot.

• Use the “one finger test.” Once fitted, you should be able to fit one finger between the shoe and the foot at the back of the heel and at the top of the arch.

• Don’t forget to bring the socks or hose you normally wear when shoe shopping.

• If the shoe is right in length, but a little wide, use a tongue pad to tighten up the shoe.

• Avoid synthetic materials: Buy leather when possible.

• Look for shoes with rigid shanks. The shank of the shoe carries mechanical force out of the ball of the foot and significantly improves foot function.

• When considering sports shoes, look for one that is relatively rigid in the heel portion of the shoe.

Following these simple suggestions make may just make “the shoe fit” so you can “wear it.”

Steve Mullenix (R.Ph), co-owns The Pharmacy in Mount Olive with his wife, Sherry Mullenix (J.D., R.N.). They can be reached at 631-1201.