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Tuesday, April 5, 2011

Comfortable Dress Shoes - what to look for...

A general overview of what you're looking for in a comfortable dress shoe...

1. You need a thick rigid sole to limit motion across the forefoot and midfoot.

2. Depending on your foot type, you can wear heels - the trick is to wear a wedge heel so that there is no motion across the bottom of the foot. If you have a condition called Hallux Limitus (meaning limited range of motion across the big toe joint) you will be limited on the heel height or  you may not be able to tolerate a heel at all. 

3. No pointy toes!! Look for a dress shoe with a square-toe box because the "cockroach killer" pointy-toe shoe's are a little bunion factories. If you have more serious forefoot problems like bunions and hammertoes, you can get shoes that have an "extra-depth toe-box" or has a soft, stretchable material across the forefoot area. 

4. Very important - try to get a dress shoe that gives you some form of rearfoot control - whether it be with a strap or an enclosed heel. If you are not biomechanically controlling the rearfoot - you are forcing your tendons, muscles, joints as well as your knee, hips and lower back to work harder to stabilize your feet.  

5. Arch control. Sometimes this is hard to find in dress shoes but they are out there. If the dress shoe has a removable insole, you can often put in a over-the-counter or custom-molded insert. Sometimes the dress shoe already has arch support in the shoe. 

Special Note: It is a common fallacy to think that your foot needs freedom and motion. Your foot actually needs rigid biomechanical control. If you are walking barefoot or wearing flip-flops or a flexible/flimsy shoe - you will have more motion across your joints, which will cause more inflammation, pain, wear-and-tear (osteoarthritis and degenerative joint disease) that will not only put you at risk for foot problems but also knee, hip, and lower back pain. 

Remember, no matter what the shoe, this is what most patients will benefit from a dress shoe with:
1. Thick, rigid sole.
2. Firm arch support.
3. Wide toe-box.
4. Rearfoot control (strap or enclosed back).  

There are always some exceptions to the rules. For instance, older patients or patients with certain neurological diseases need to have a lighter shoe. Also, Dansko shoes, which are excellent for people who have to work on hard surfaces for long hours, typically do not work as well for patients who have "bumps" on their feet such as bunions, Tailor's bunions and extremely high arches. 

I hope this is helpful! 

I would love to hear any thoughts, feedback or comments...

Dr Cathleen A McCarthy 


Allison Hargrove said...

Thank you for posting this!! This will be really helpful and something I can follow to find the right shoe!! :0)

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

Your welcome and it's my pleasure!
Have a great day!

mom929 said...

Thank you for this post. I was just diagnosed with hallux limitus and told that ALL of the shoes I own won't work for me. And I'm not talking high heels, just basic sandals, hiking shoes and sneakers. So a shopping I go. Thanks for this list.

Casey Cook said...

Dr. McCarthy:

Quick question for you. I'm your only patient in maryland by the way!

I came in for tibial tendonitis. You diagnosed me with funtional hallux limitus. I went through all the possible shoes I could buy with you, you suggested the ridgid sole, and MBT's seemed to be where I was going. I'm back in MD, and I went to foot solutions. They sold me on Chung Shi shoes. Are you familiar with them? I have 2 weeks to bring them back. Don't know if I made a mistake, but would love your input. Thanks again for your great work!

Ken Casey Cook

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

Hi Ken!
The Chung-Shi is a good shoe - it's a more aggressive version of the MBT. I personally prefer the MBT or the Sketcher Shape-Up. The Chung-Shi isn't good for anyone having ankle instability or ankle hypermobility. I would try on the MBT, the Sketcher Shape-up and the Chung-Shi and purchase whichever one feels the best. They are all excellent shoes but the acid test is how it feels on you! Make sure you wear a good over the counter insert or a custom molded insert with them. All three of these shoes do need arch support.
Hope all is well!

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

Hi Ken,
Oops, I forgot to answer you actual question! Yes, the Chung-Shi should work very well with your conditions as it off-loads the 1st toe joint.

Lydia said...

As far as other shoes go, like sandals or clogs for example, is it always necessary to have a back strap?

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

Hi Lydia,
In my opinion, controlling the rearfoot is crucial. The only exception is if you have a large "bump" (Haglund's Deformity) on the back of the heel that is aggravated by the strap. Please refer to my blog entry titled "The Basics" for more in depth explanation.
Hope all is well!
Dr Cathleen McCarthy

Lydia said...

Thank you. I believe what I am dealing with is Metatarsalgia. (I have a scheduled appt with a podiatrist just haven't been there yet) I had a sudden onset of pain under the 4th metatarsal on the ball of the foot. I was an avid cheap flip flop wearer and am on my feet all day. Since I had the pain and swelling I have been wearing my sneakers (the best shoes I have) all day long and the pain has significantly diminished. I would like to buy several pairs of really good shoes and just want to make sure I do the right thing. I am looking at the following brands...MBT, Dansko clogs and Birkenstock. Is there any others I should be looking at?

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

Hi Lydia,
Check out Jambu's for cute and casual dress shoes, Allegria for a chunky casual look, the Wolky sandals for an excellent summer shoe. Also, look at my blog on "Top 20 Women's Comfortable Dress Shoes" and my blog on "Top 5 Walking Shoes" for more ideas.
Dr Cathleen McCarthy

Anonymous said...

I was trying to find a way to send you a message. I was in DSW the other day and found a new style of Crocs and wanted your opinion of them. They are called the Sexiflip. They are not as rigid as their clogs but would this be a good alternative to wear say at the pool or a BBQ, etc.? Thanks for taking the time to look. By the way DSW has a ton of shoes and I was lost as to what to buy but I found several pair that have a rigid sole. Thanks for doing your blog.

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

Hi Allison,
The Sexyflip Croc is not very good - if you want something like that but better - check out the Croc Cleo. It's not for all day wear but is good for light wear around the pool.
Hope all is well,
Cathy McCarthy

Anonymous said...

Thank you for this wonderful blog! I have hallux limitus, 3 years post-surgery. Love the top twenty list! As summer approaches (ever so slowly here in Maine) I'd love to see a similar top twenty list of dress and casual sandals.

Also, a shout-out to online stores that offer "free shipping both ways," which makes it possible for me to try shoes not available in the stores in my area.

Ann C

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

Hi Ann C,
Thank you so much for your kind words! I've been working on my top ten casual sports sandals for the last week and am so happy to finally get it out there. I see tons of Hallux Limitus in my practice and I really feel that proper shoes are crucial as it can prevent further damage not only to the 1st toe joint but to the knee, hips and lower back.
My next list will be for dressier summer sandals - I work on it in my spare time so hopefully I will have it out in the next several weeks.
Have a great summer!
Dr Cathy McCarthy

Claire said...

Hi, I'm confused about the dansko thing. My podiatrist insisted that dansko shoes are ok for my feet (I have bilateral bunions) and so I bought some and then now I'm worried they aren't right. How do I know if they are o.k.? I read that danskos are rocker bottom shoes... and that rocker bottom shoes are good for people with bunions

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

Hi Claire,
Thank you for reading the blog!
Yes, Danskos are great shoes but they are not for everybody. They aren't Rocker Bottom shoes (that would be MBT's or Sketcher Shape-ups, which and also great shoes also but not for everybody). Picking a shoe is very pathology specific - meaning what works for one person does not always work for another person.

If you don't mind answering a few questions - I may be able to give you more specific info. How big are your bunions? Are they mild, moderate or severe? Do you get pain on the bunion from the pressure against the shoe? Are you looking for a dress shoe for work or a walking shoe for exercise? If for exercise - what activities do you do (hiking hills, weights?). Do you have a history of Achilles Tendonitis?
So for all the questions, but I can be much more specific if I have this info...
Cathy McCarthy