By Dr Helen Branthwaite, MSK Project Lead, College of Podiatry.
The rapid changes in shoe design and the increasing number of choices that occur in the footwear market might make a consumer with painful feet quiver at the thought of buying any new shoes. Yet, humans have been wearing shoes on their feet for thousands of years as protection against the environment. Problems have only been recorded in the last 600 years when shoes have been used more as a fashion statement as well as a status symbol. In fact, it was only considered normal for a western culture to wear shoes as standard after the first world war. However, it is well established that incorrect shoe choice can cause pain or injury yet the advice available about which shoes to purchase can be inconsistent. Within ARMAs campaign to heighten the awareness of the amount of pain that people suffer with MSK complaints, it is vital that the choice of shoes selected for painful feet are considered.
Currently, most people own many different pairs of shoes and choose what to wear based on the activity that they are planning to do. The choices are dominated by fashion and image with colour being considered before correct fit. Trends are set by celebrity endorsements and can often end up as a staple in everyone’s wardrobe. Think of the Ugg Boot®, designed in the first instance to be a slipper for surfers in Australia using surplus sheep’s wool. This boot initially rose to fame when Hollywood celebrities paired it up with the latest catwalk fashion but now Ugg® is a worldwide brand and the “boot” has many less than desirable imitations, all which have been correlated to causing pain. Footwear trends do come and go and sometimes the styling can help the wearer have more comfortable feet and other times they create a problem. The main complaint though from people who have painful feet, is working out what is best for them and what is the right choice.
Podiatrists frequently engage with patients about footwear choices and advise them on their selections. This can be as part of a treatment to prevent development of further complaints or can also be to improve the function of the foot to reduce pain. It is commonly thought that high heel shoes are really bad for users, but in some cases the use of a heel between 2-4cm can actually alter ankle movement reducing strain on the plantar fascia and Achilles tendon, two of the most common structures that cause pain in the heel and ankle. 
This is not the case for everyone though and for some people wearing a heeled shoe can increase the pressure on the front of the foot and cause problems with the digits and metatarsals. That’s why when issues like the equality act on high heel shoes for females was debated in parliament, the College of Podiatry presented the argument that heeled shoes should be the wearers choice and not a stipulation of uniform, as wearing high heeled shoes does alter mechanical function and is different for everyone.
The influence of marketing and trends can also be seen in the running community where scientific research and development aims to create a running shoe that can break world records, reduce injury, maximise efficiency and improve function. The rapid evolution of the running shoe leads to most active runners being in a state of bewilderment as to what is right for them. It also leads to governing bodies banning certain styles, as performance enhancement is considered.
With a drive to become more active in society to improve MSK health, where does this confusion leave the average park runner who is wanting to complete their 5k run in a quicker time, injury free?
I guess some of the answers lie in getting a full footwear assessment tailored to your individual requirements and needs. This should be in conjunction with an assessment and diagnosis of any pain you are suffering from. Provision of footwear rules and advice from a podiatrist can certainly make the scenario of purchasing new shoes more bearable and could possibly improve pain and function too. Don’t forget, that just by simply wearing shoes there are many changes that occur to the way you move and how you use your feet.