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Thursday, August 23, 2012

Podiatrist Shoe Recommendations For All Day Comfort At Work.


Dr. Cathleen A. McCarthy

After I completed my first two years of Podiatry school where I basically sat all day in classes and then went home and spent more time sitting and studying, I was unceremoniously tossed into my third year where I was expected to stand on hospital floors for ten to twelve hours a day.
To make a long story short: I was in agony!
I finally understood why all those lectures on ‘Heel Pain’ were so important – and relevant! Throughout the third year, I had a recurring nightmare where I would wake up in the middle of the night convinced that an evil ogre was hammering a nail straight up into my heel and I desperately tried various kinds of shoes – searching for that illusive, magical shoe that would help me get through the day comfortably. 
Ironically enough, even though I was in Podiatry school, we spent most of our time learning surgery and medicine but I don’t remember a lot of lectures on what constituted a ‘good shoe’. Our professors did talk about advising patients to wear ‘good shoes’ but few ever specified exactly what that meant.
Once in private practice, I began to realize what a crucial role proper shoes play in a helping patients get better faster. I also realized that what works for one patient may not necessarily work for another patient with a very different foot issue. In other words, proper shoes for patients are pathology specific and depend on the patient’s biomechanical foot structure as well as history of previous problems and injuries.
I came up with some basic rules for picking comfortable shoes for all day wear on concrete floors and, although there are always exceptions to the rules, these rules work for most patients.
First, you should always look for a shoe with a thick, rigid sole. This is counter-intuitive because most people look for a ‘soft flexible’ sole thinking that it will be more comfortable. In reality, it’s the exact opposite! You need a thick, rigid sole with less motion and less flexibility so that it is more protective of the foot joints, muscles and tendons. Think of it this way, if you broke your wrist, your doctor would put you in a cast and you would instantly feel more protected and have less pain. Less motion equals less pain. 
Second, you should try to find a shoe with good arch support. Most shoes come with removable insoles so that you can replace it with either a custom-molded insert or an excellent over-the-counter insert that offers arch support. Ninety percent of people will benefit from arch support while ten percent of people cannot tolerate arch support. Proper arch support can help with knee, hip and lower back pain and decrease ‘tired-leg syndrome’ at the end of a long day on concrete floors.
Third, you need a wide, soft toebox. Avoid any shoes with pointy-toes as they can cause hammertoes, bunions, corns and calluses.
Forth, make sure that whatever shoe you choose has proper rearfoot control. In other words, your shoes should have no open backs. If your shoe doesn’t have rearfoot control, you are forcing your tendons, muscles, knees, hips and lower back to work harder to keep your foot in your shoe. This causes more ‘mechanical strain’, which leads to increased discomfort and chance of injury. 

Here are some specific shoe recommendations that are pathology specific:
For the young, healthy person with strong legs and no significant foot or ankle deformities, I would recommend the Dansko or Sanita Clog with rearfoot control.
For a young, healthy person with no history of balance issues, Achilles Tendonitis, nerve damage or weak legs, I would suggest you try the MBT, Sketcher-Shape-Up or the New Balance Rock and Tone shoe. Each of these are ‘rocker-bottom’ shoes, which can be extremely comfortable. I do recommend that you wear arch support with these shoes – whether it’s custom-molded or over-the-counter inserts.
For a person who may have more serious foot issues such as diabetes, nerve damage, balance issues or weak legs, I recommend trying the New Balance 928, which is an extra-depth shoe with a thick, rigid sole and a wide base. If you have trouble reaching your feet due to hip and knee replacements, you can get the NB 928 with Velcro-strapping. I highly recommend that if you do have these more serious medical issues, please consult your Podiatrist to make sure this shoe is right for you.
For virtually anyone, try the Crocs Rx clog and make sure to wear the strap to the back so that you get some rearfoot control. These are not for everyone but there is a reason why you see so many nurses and doctors in Crocs!
Let’s not forget the guys! For the man who is on his feet all day in tough conditions, my personal favorite is the p.w. Minor Hercules, which is an extra-depth boot with a hidden shank in the sole that is very protective and comfortable.
I hope this has been helpful!


Dr. Cathleen A. McCarthy


Anonymous said...

What about Crocs Specialist?

Bianca said...

My great-grandmother has horrible feet. She is diabetic and wears the wrong shoes (no rear foot control at all, little to no arch support, narrow toe boxes and exposes her toes). She recently suffered a foot injury and is now healing. All of us would like her to start seeing a podiatrist. Do you know of anyone in the Central Valley in California? And if not, just California in general? Thank you for everything Cathleen. Your blog has been so helpful for everyone in my family (that will listen...some just aren't ready to leave the dark side :] lol )

Doctor of Podiatry Discusses and Recommends Shoes. said...

Hi Anonymous,
Crocs Specialists are excellent!
The only thing that some patients don't like about the Specialists is that if you purchase the ones with no holes in the front, they tend to be hot. Please remember that I am in Arizona so that is a really important factor since our summers can reach 117 degrees! If you live in a cold climate, it should not be an issue.
make sure to wear the strap to the back!
Dr. Cathleen A. McCarthy

Doctor of Podiatry Discusses and Recommends Shoes. said...

Hi Bianca,

Unfortunately, I don't know any Podiatrists in the Central Valley in California. I would recommend asking your primary care physician who he or she recommends - they will know who is the best Pod to send her to!

Check out my article entitled:

"Shoe Recommendations For patients recovering from a Lisfranc's fracture."

That is an A to Z description of what she will need to do. If she doesn't want to do that - see if you can't get her into Crocs Rx or try an Easy Spirit "Traveller", which is very popular with the Medicare ladies. Or you can give her a gift of "Diabetic Slippers", which, if you can get her to wear them she will probably love!
It's a good place to start!

I am so glad the blog has helped you and I thank you so much for your kind words and for reading!!

Arch Support said...

Thnx Dr. Cathleen..

ricosta shoes said...

Brown shoes are generally worn with earth tones, khaki, blue, green, and others. But you also need a dress shoe in Black to go with black pants or white and cream colors.

dinosoles shoes said...

When shopping for back-to-school shoes, you may want one style and your child may want another. While your child may want the latest fashion, you should remind her that comfort is key when buying new school shoes.

Mabel said...

Hi Dr. McCarthy,

Do you have any recommendations for good ballet flats that are good for the feet? Thanks for all the great recommendations! Have a nice labor day weekend!


Doctor of Podiatry Discusses and Recommends Shoes. said...

Hi Mabel!
Finding a ballerina slipper/flat with a thick rigid sole is a challenge! Although I have not tried this particular shoe myself, try the Dr. Martens Christina ($70), which has one of the more thick, rigid soles I've ever found on a ballet flat. If you get them - I would love to hear how they work for you!
Good luck and thank you for reading!

Gail said...

Hi Dr. McCarthy.

Have you any experience with the Gravity Defyer shoes with the reverse trampoline technology?

My body/feet experience Metatarsus Adductus--'mild clubfoot', which has caused an Extremely high arch.

My body also has severe fibromyalgia, fatigue and such.

I am in the process of moving to a basement apartment with ceramic tile over concrete floors.

In searching for 'best shoes concrete floor' these Gravity Defyers were one of the first results.

I've been wearing lite hiking boots inside and out for over ten years for the added ankle support.

I am searching for the best of whatever can be found for hopefully less than $150/ or so.

And something which will accommodate orthotic/supports for the high arch issue.

HEre is a link to the Gravity Defyer website, in case you need it. I actually prefer boots, but their boots all look like they have some height of heel. which I prefer flat.


THANK YOU IN ADVANCE FOR your time and attention.

Many blessings to all on their proper foot nurturing adventures.


Doctor of Podiatry Discusses and Recommends Shoes. said...

Hi Gail,

I'm sorry about the slow response! I do like Gravity Defyer shoes. I especially like their 30 day money back guarantee so that you have a chance to see if they work out. I would also consider the New Balance 928, which will accommodate your orthotics. The Gravity Defyer shoes have excellent shock absorption and I have patients who have been very happy with them. They are more lightweight than the New Balance 928 but that also means they tend to wear out quicker.

I would recommend getting medical grade Crocs RX (and wear the strap to the back) for around the apartment - to wear until you can get into better shoes for all day wear.

As far as boots go - make sure that they have a thick rigid sole that has as little flex as possible. The more thick and rigid the sole - the more comfortable.

I hope this has been helpful - I would love to hear how it works out for you...