Modification Tips: Making Sure The Shoe Fits

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Q: Fitting shoes can often be an issue to patients. What are some of the tricks you use to assist in a shoe fit when the precise size is just not available?
“Proper shoe fit is a ‘feel,’ not a size,” says Dr. Sol. He says a size like an 8-C varies among lasts, models, styles and manufacturers. Even with the increasingly rare assistance of knowledgeable fitters, consumers will continue to assess proper fit “based upon how they’re used to ‘fit’ feeling,” points out Dr. Sol.
Dr. Sol says the subjective criterion for shoe fit varies among individuals. To help people visualize “fit,” he asks them to remove the insoles from their shoes and simply stand on them. “This simple maneuver can save consumers both time and money in the selection and purchasing process,” he says.
Dr. Wernick advises consumers to fit the bigger foot whenever possible and try to match the shoe last to the foot shape.
“Never fit short. It’s OK to fit narrow if the length is long,” says Dr. Wernick, who recommends matching the first met to the widest part of the shoe at the “ball” of the foot. Both he and Dr. Dananberg advise people to use tongue pads and half insoles (called “jimmies”) to help improve heel, toe and instep fit.
“Measuring of feet can be helpful, but I caution patients that fit of shoes varies from company to company,” says Dr. Dananberg. “There is value in understanding which of the two feet are larger, and then this is the shoe that needs to be fit via size.”

Q: Along the same line of thinking, how do you assist patients when they have two feet of different sizes?
For Dr. Wernick, it depends upon the patient’s size differential. He says usually a size difference of one to one and one-half sizes may require two different pairs of shoes. Usually, a shoe store will charge for a pair and a half and if it is one-half size different, then a cork “jimmy” in the forefoot will make up for the difference, according to Dr. Wernick.
Although shoes are made symmetrically, most feet are not, Dr. Sol reminds patients, and most of us have feet of two different sizes.
“The old adage is true: try on shoes later in the day and fit your larger foot first,” says Dr. Sol. “If the difference is one full size or greater, I recommend buying two pairs and refer the patient to the National Odd Shoe Exchange in Phoenix, Ariz. (480-892-3484).”

Dr. Dananberg (pictured) practices in Bedford, N.H.
Dr. Sol founded the Walking Clinic, PC and practices in Colorado Springs, Colo.
Dr. Wernick is Professor and Chairman of the Department of Orthopedic Sciences at the New York College Of Podiatric Medicine (NYCPM). He is also a Diplomate of the American Board of Podiatric Orthopedics and is the Medical Director of Eneslow Comfort Shoes and Langer, Inc.
Dr. Wernick also acknowledges Robert Schwartz, C.Ped, the Director of the Eneslow Pedorthic Institute and an Adjunct Instructor of NYCPM, for his assistance in his respones.

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