FOR FEET’S SAKE – What’s in a Shoe? 

FOR FEET’S SAKE – What’s in a Shoe?
Pete de la Pena, MD

A person walks 70,000 miles in a lifetime. So it is important to purchase the correct shoes. Have you ever wondered why people wear shoes? Do they wear this as part of protection, accessories or for fashion?

A shoe is an item of footwear evolved at first to “protect” the human foot and later, additionally as an item for decoration. Physical anthropologist Erik Trinkaus found evidence that shoes exist 40,000 years ago. The real modern shoe originated from Oregon in 1938. Footwear is an invention of necessity to protect us from the elements beneath. However footwear is under the influence of fashion. Purchase is dictated by: What style? What size?

But before you buy a pair of shoes, you must familiarize with the parts of a shoe.

Here are some of the guidelines in choosing a pair of shoes.

1. The Uppers – The material should be soft so as not to squeeze the feet and cause pressure blisters on the top and sides of the foot. The material should be durable – leather or rubber that is also stretchable.
2. Padded or soft tongue – This is to ensure a smooth surface over the top of the foot and prevent the laces or fastening of the shoe from damaging the skin of the foot.
3. Fastening methods – Laces or Velcro. This allows for a snug proper fit that is adjustable to the size of the foot.
4. Heel cup and Heel support– This will provide stability for the heel and control the position of the heel in the shoe. This should be soft and stable.
5. Innersoles – Closed shoes should ideally have removable innersoles to provide added cushioning. They should be removable for cleaning.
6. The arch support – In shoes for diabetic feet this should be built up slightly to provide greater contact area over the sole of the foot to distribute pressure more evenly.
7. Toe box and sideways space in the shoe. – There should be enough space in the shoe to allow the foot to expand during weight bearing by up to 1 to 1 Y2 cm. (see illustration below)
8. Sole of the shoe – The sole should be of a firm and durable material that is able to protect the foot from sharp objects and provide support for the foot by not being to flexible.
9. Heel height – Men shoes are generally from 1 to 1 Y2 cm. Women shoes are from 1 1/2cm to 5 cm in height.
10. Shoe size – Measure the shoes in the afternoon – to ensure that the shoes are not too tight and allow for any swelling of the foot during the day. Try the shoes on both feet, it is uncommon for the feet to be slightly different in size – always use the larger size.

So what is in a shoe? Of course your foot! Always remember that the human foot is a masterpiece of engineering and work of art. So please love your feet -these will lead you where you want to go.

Next topic: Devil wears Prada – The foot versus fashion design.


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The PCEDM is a sub-specialty society of the Philippine College of Physicians, a founding member of the ASEAN Federation of Endocrine Societies, and a member of the International Society of Endocrinology.

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