As in the fairy tale, the same shoe does not fit all feet. Shoe size is of course critical, but there are a number of other factors that need to be considered when purchasing shoes. In this article I will discuss the function of the foot, problems that may occur, and how choosing the right type of shoe can make all thedifference to normal foot function.

Most people are familiar with the terms “flat” and” high arched” feet.  In medical terms the flat foot is generally known as a pronated foot and the high arched foot as a supinated foot. Variance in degrees of pronation and supination is common between people and may occur from one foot to the other. The terms pronation and supination also describe the variable position the foot travels through with normal weightbearing. As we walk the foot moves through varying degrees of pronation and supination to allow our feet to adapt to changes in terrain, and the position required as the foot moves from striking the heel on ground contact to pushing off with our toes as we take a step. Pronation allows the body to absorb shock when it lands. When running, the heel takes the equivalent of five times your body weight on heel strike. This force is dissipated throughout the body. Supination is required to lock the foot when pushing off. This provides power in order to walk and run faster.

Most people can adapt for minor differences from the ‘ídeal’ foot posture but from time to time we all

get sore, achy, tired feet. There are a number of factors that can cause pain around our feet.

Changes in foot wear, the surfaces we stand or run on and activity levels are common factors seen when reviewing problem feet. An excessively pronated foot means that various tissues within the foot may be placed under greater stress with resultant pain in the arch, heel or into the achilles area and may be a factor in the development of a “bunion”. Likewise an excessively supinated foot is less able to absorb load and may be a factor in foot pain. Our foot posture can also influence a number of other areas in our body.  Shin, knee, hip and spinal pain can result from alterations in foot posture and function.

Correct choice of footwear is important. As there are many so different types of shoes on the market today it can be very confusing when deciding on which shoe to choose. Sports shoes are available in control and neutral designs to accommodate different foot needs. It is important to get the right shoe for your foot posture to ensure the maximum support for your foot.  Talk to your Physiotherapist or sports shoe retailer about issues you may have, and get advice on which shoe is right for you. In some cases an additional insert or orthotic may be required to assist with alteration in foot posture.

Selecting the right shoe does not always mean you have to buy the most expensive model .Generally the

more expensive models tend to have more stability control which will make a significant difference if your foot requires that control. Shoes are also designed for different function and it is important that you use the correct shoe type for your activity. Running shoes need to provide control and stability in a different plane than a court or squash shoe. Your sports shoe retailer will be able to advise you on what shoe is best suited for your needs. If you experience foot or leg problems, seek advice from your physiotherapist or a good sports shoe retailer before selecting your next pair of shoes.

Duncan Drew is a Physiotherapist at the Oamaru Physiotherapy Clinic .He is a credentialed McKenzie Physiotherapist and has a special interest in Sports injuries and Spinal conditions. He has played Cricket at National level and was a member of the successful North Otago Team who recently secured the Hawk Cup 

Source:  Oamaru Physiotherapy Clinic written by Mike Stewart and Michelle Sintmaartensdyk


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