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Consider use, activity when buying shoes by Nathaniel Jackson Certified Orthotist/Pedorthist This week’s wellness column topic can be further explored in the Children’s Hospital lobby Wednesday, April 19, as part of the ongoing Wellness Wednesday series brought to you by the Employee Wellness Program.    When it comes to deciding what shoes to wear and which shoes are the most proper for your feet, there are a vast number of factors to consider. Ask yourself how much time you will spend on your feet; what surfaces you stand and walk on; do you need shoes with built-in arch supports or custom arch supports made for your foot type; and lastly, do you have a diagnosis that requires a particular type of shoe, insert, or custom molded insert (i.e., diabetes, plantar fasciitis, pes planus deformity/flatfoot, or pes cavus deformity/high arch)?   We’ve all asked ourselves one or more of these questions on several occasions for one simple reason. When our feet are comfortable, so are we.   Our feet take us everywhere and they succumb to whatever environment we present to them. Whether it’s the workplace, gym, social event, or dancing, our feet will adapt to the activity; however, feet have a funny way of retaliating once the activity has ceased and it’s time for us to relax; they start to hurt. Here are a few shoe suggestions for working, exercising, and socializing.   For starters, most people spend 70 percent of the workday in their work shoes. When deciding on work footwear, select a shoe that has the following: ample room in the toe-box so the toes aren’t pressed upon each other; good counter support around the heel to support the heel and limit the heel from rolling inward/outward, and make sure the shoes are made with crepe soling, not rubber soling. Crepe soling absorbs shock when walking on all surfaces and will decrease the shock forces on the ankle, knee, and hip joints. There are quite a few shoes made with crepe soling to provide comfortable footwear for a wide spectrum of occupations—custodial, housekeeping, maintenance, nursing, administrative, executive, and physicians. Shoes such as Steel-toe boots, New Balance, Rockports, SAS, and Florsheim offer crepe soling in a wide variety of styles.   Exercising causes a great deal of stress to your feet, however it’s a necessary activity to maintain a healthy lifestyle. If you are a runner, power walker, weightlifter, hiker, or weekend warrior, then it’s imperative that you wear the proper shoe for the activity. Since these activities require excessive foot motion, you should have your feet evaluated by a professional such as an orthopedic foot surgeon, podiatrist, or certified pedorthist to see if you require a custom made foot orthotic (insert) fabricated for your foot type.   A foot with a pes cavus (high arch) needs support from a custom insert so that it can function without the pull on the medial longitudinal arch (instep). A foot with pes planus (flat foot) needs support from a custom insert so that it can function with reduction of pull on the medial longitudinal arch.  Again, tennis shoes such as New Balance, Brooks, Asics, Nike, Addidas, and Reebok are made with crepe soling and provide the most comfort and shock absorption when your feet are properly measured and fitted with the correct size and width.   Conditions such as diabetes, neuropathy, severe pes planus/flat foot deformity, edema, and plantar fasciitis require evaluation and treatment from the aforementioned professionals.  Diabetes and neuropathy can result in severe foot problems when improper footwear is worn. These diagnoses along with edema and severe pes planus deformity can lead to callous formations, ulcers, and unfortunately amputations if feet aren’t routinely checked. Extra-depth shoes (most commonly called diabetic shoes) with diabetic inserts or custom-made diabetic inserts (if required) are recommended for people with diabetes and/or neuropathy because the shoes are made with a quarter inch more room throughout the shoes to provide an adequate toe box and support around the heel. Plantar Fasciitis, or heel pain syndrome, should be evaluated, diagnosed, and treated by a foot doctor. Stretching, cold therapy (applied on the bottom of the foot in the plantar fascial region (inside heel at the beginning of the instep), and custom foot orthotics can provide some relief from the pain associated with plantar fasciitis.   Shoes that provide your feet with adequate room, cushioning, shock absorption, and support will keep your feet comfortable and feeling good, keeping you comfortable, productive, and feeling good.   For answers to questions about proper footwear and custom orthotics call Charleston Brace Co. at 871-0600.     Friday, April 14, 2006 Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Island papers at 849-1778, ext. 201.