Men will probably have no appreciation of the difficulties women have in finding shoes that are comfortable and fit well. In fact, many shoe manufacturers do not consider the shape of the average woman's foot when creating the newest fashions. Many foot problems seen by podiatrists and orthopaedic surgeons are caused by improperly
fitting shoes.

This problem was highlighted in a study done by the Council on Women's Shoewear of the American Orthopaedic Foot and Ankle Society. This study reported on the feet of 356 women. The width of the bare foot was measured while each woman was standing. The authors of the study found that:

  • 88% of those studied had shoes that were narrower than the foot by at least 1cm.
  • 80% of the studies reported some foot pain.
  • Almost 80% of the women had some major forefoot deformity (bunions, hammer toes, calluses under metatarsals or small toe bunions).
  • The average width of the foot ranged from 7-11cm.
  • These statistics cause concern because it makes one believe that there is a large portion of women who are wearing shoes too narrow,
    causing foot pain and deformities.


Facts about women's feet

The front portion of a woman's foot (forefoot) will spread after the age of 20 years, and the size of the shoe usually goes up during that period. As the forefoot spreads, the heel stays the same size because the heel is only a single bone. This creates a problem in fitting shoes; if you fit the forefoot, the heel slips off, and if you fit the heel the forefoot is squeezed into the shoe.

Common problems and deformities

These are some of the more common foot deformities and problems that are directly related to women wearing shoes that are too small and heels that are too high. The most common is a bunion. A bunion is a swelling on the inside of the forefoot. Bunions are caused when the great toe veers to the outside of the foot, and the bunion veers to the inside. Bunions are more common in shoe-wearing cultures. The pain is caused by pressure on the actual bunion and most bunion pain can be relieved by wearing shoes that are wider and deeper.
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Many women get Calluses under the front portion of their feet by jamming their foot into a shoe that is too narrow. Most of these calluses can be alleviated by changing to a wider, deeper shoe and/or by placing metatarsal pads in the front part of the shoe to redistribute the weight.

Other problems

Some women get hard corns on the tops of their toes that are often associated with hammer toes or claw toes. The toes become permanently bent, crooked or cocked up from being in the same position, especially in tight high heels. Many of these problems can be alleviated by wearing a wider, deeper shoe with flatter heels.

Some women complain of intermittent burning pain in the foot. They often have to stop and remove the shoe or rub the foot. This is typical of neuroma pain. This condition is a pinched nerve in the foot between two bones in the forefoot. It is really like a callus along the nerve from excessive pressure inside the foot rather than a tumour. Relief can be obtained by widening the shoe and lowering the heel.

These conditions can be seen without shoes, but there is no doubt that they can be caused and aggravated by improperly fitting shoes.
Here are some guidelines for shopping for proper fitting shoes:

  • Measure your foot with your full weight on it. Then take a six-inch ruler with you and measure the shoe.
  • Shop at the end of the day, when whatever swelling is present usually will be there.
  • Avoid seams on painful areas
  • Exercise shoes should be as wide as your widest foot. Often boys or men's shoes are cut more generously.
  • There is no standardisation for sizes in women's fashion, so you must measure the shoe you are trying in the store.
  • Don't buy shoes that are too small and expect them to break in.
  • Wear a heel that is reasonable but fashionable.

Thanks to Dr Martin Sullivan for the information in this Pamphlet.

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