‘Comfortable’ shoes are not necessarily good for your feet

Clogs and Birkenstocks aren’t for everyone. Experts offer tips to find the right shoe for you.

SPECIAL TO THE WASHINGTON POSTNovember 17, 2013 

Buying from a store specializing in “comfort shoes” doesn’t guarantee that they will be comfortable for you.

What makes a shoe a “comfort shoe”? Generally speaking, it means cushioning under the foot and supportive features such as arch support. Birkenstock sandals have a molded foot bed with an indented heel cup and a bump under the forefoot — the metatarsal pad, which deflects pressure away from the ball of the foot.

“They’re a really comfortable choice for many people,” says Erika Schwartz, a podiatrist with DC Foot and Ankle in Washington.

For others, not so much.

A small study of people with osteoarthritis of the knee found that walking in clogs and so-called stability shoes was harder on the knees than walking barefoot or in flip-flops. This suggests that certain supportive shoes can alter your gait in a way that’s unhealthy for joints above the ankle, at least temporarily and in people with arthritis.

“What are the best shoes to wear? I hear this question 20 times a day,” says Selene Parekh, an orthopedic surgeon at Duke University Health System.

Parekh says to look for a shoe that’s supportive and comfortable — for you.

If you are having foot problems, the best thing to do is figure out the type of foot you have and how you walk. Do you rotate your foot so that the inner edge of the sole bears the bulk of your weight? How high or how flat are your arches?

When a patient comes in with foot pain, Parekh looks at the wear pattern on her shoes. If the inner part of the sole is worn, he’ll look for flat feet overloading that area. Outer-sole wear may indicate high arches. More wear on the heel or under the ball of the foot can show whether a person is a heel-striker or a forefoot-striker when he walks.

If you do have pain, a foot expert — either a foot and ankle orthopedic surgeon or a podiatrist — can help you understand shoe features to look for and to avoid. For example, if you have bunions, you want to look for a more box-shaped toe, Parekh says.

People with high arches are more likely than flat-foot types to roll an ankle in clogs, Schwartz says. That’s because arch height can affect which part of your foot bears the most weight as you walk.

Properly aligned ankles sit directly over the heels. Feet are pronated when the heels tilt out from the body and the ankles roll in — a characteristic that is often linked to flat feet. When heels tilt in and the ankles roll out, the feet are supinated; this often occurs with very high arches.

An orthotic insert that raise the outer edge of the foot can help stabilize a supinated foot within the clog, Schwartz says. Pronated feet can benefit from arch supports.

Orthotic inserts, whether purchased at the drugstore or custom-made, are designed to correct the alignment of the foot and ankle, which helps maintain proper positioning of the knees and hips and even the lower back.

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