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If you’re old enough, you may remember how many types of athletic shoes were available before the fitness boom. That would be approximately two – all-purpose sneakers and sneakers with high tops. People who jogged, played tennis, basketball or most other sports, headed out in one of these and didn’t think twice about it – even if their feet hurt.

Now that more and more folks are out on the trails, courts and ball fields, the selection of athletic shoes has exploded. In the 1970s the number of types had grown to about five, while today there are more than 3,000.

That may be a few more than necessary. Wearing shoes that fit your feet and your sport is important, but for people without pre-existing foot problems, choosing a shoe may be easier than you think. Most people should wear moderately supportive to supportive athletic shoes. For example, for sports where you cut laterally quite a bit, such as racquet sports, basketball and football, you need a higher shoe with more ankle support.

Runners and walkers need less ankle support but good cushioning for shock absorption. The American Orthopedic Foot and Ankle Society (AOFAS) recommends that shoes for both of these activities should also be lightweight and flexible to accommodate the natural roll of the foot.

There are limits to “lightweight,” though. People should be cautious about wearing the newer, minimalist shoes for running. Known as barefoot running shoes, they may be totally flat or have heels that are a few millimeters thick. This can work for some sports, such as weightlifting. But many people have ended up with injuries after running in these shoes. Research is conflicting about health benefits, but at least one shoe company settled a class-action lawsuit to pay for refunds for its shoes.

People with foot problems such as very high, stiff arches or flat feet, may need shoes with more specific areas of support. The same goes for older adults, who may have balance problems that can be exaggerated by wearing the wrong shoe. Some walking shoes have cushioned heels that are very high, which forces people to walk without much ankle flexion. That can lead to tightening of the Achilles tendon, making them vulnerable to falling.

With so many variables, the best way to choose the right shoe may be to get expert advice. If you know you have foot problems, or if you have had trouble finding shoes that fit, you may benefit from checking with your doctor. An examination of your feet and your gait, and a look at the wear pattern on the soles of your current shoes, can help diagnose foot problems. With information about your favorite sports and activities, your doctor may be able to recommend a good shoe for you. In some cases, orthotic inserts to provide better support can also help.

People with normal feet can often get the advice they need at a good sporting goods store. People who work there are often passionate about their sport and their footwear, and they have good insight into what will work for you.

Once you determine which type of shoe is best for your activities, you need to get one that fits. Poorly fitting shoes can cause problems such as blisters, corns, bunions, stress fractures, plantar fasciitis and more. The AOFAS recommends these tips:

  • Measure your feet each time you buy shoes – foot size changes over time.
  • Buy shoes late in the day, since feet swell somewhat during the day.
  • Wear the same type of sock that you use for your sport.
  • Re-lace the shoes before you try them on, using even pressure for each eyelet.
  • Try on both shoes. It’s not uncommon for one foot to be bigger than the other – buy the size that fits the bigger foot.
  • Stand up in the shoe and check that there’s at least 3/8 to ½ inch space between your longest toe and the end of the shoe. Your index fingertip is a good measure. The end of the shoe, called the toe box, should also be tall enough for your toes.
  • Walk or run a few steps to check for fit and comfort. Feel for raised seams or lumps inside the shoe that could rub. Make sure the heel is snug with minimal slippage when you walk.

Don’t buy tight shoes and hope that you’ll break them in. They should fit the first time you put them on.

Even with the best-fitting shoes, you may wind up with foot, ankle or knee pain from some activities. Issues like shin splints, plantar fasciitis and tendinitis can become chronic if they are not addressed. They can be treated, but the sooner the better. If pain gets in the way of what you like to do, you should get it checked out.

A good pair of athletic shoes can seem like your best friend. But eventually you’ll need to buy a new pair. The AOFAS says that if you’re moderately active, that will be in about six months to one year.

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The Family Health column is written by Shawn Lake for Community Medical Center.

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