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Older adults have a lot
to think about when it comes to being active—including their
feet. Deciding which shoes to buy is important for men and women
who have diabetes. What advice do the experts offer?
1. Fit
Timothy Kalla, a clinical instructor with the University of British
Columbia, says a professional fit is the most important shoe feature
for people with diabetes. There are four main risk factors for foot
problems for these individuals:
• Previous problems;
• Loss of circulation;
• Loss of feeling; and
• Foot deformity (hammer toes, bunions, calluses, limitation
of motion, etc.).
People are more likely to have foot problems when they have more
risk factors. So the person who fits the shoe must understand the
effect diabetes has on the feet.
2. Material
Footwear expert Phil Moore says shoes must be smooth on the inside.
It’s also better to have shoes with seamless toe boxes, often
with uppers made of heat moldable material or deerskin (as with
orthopedic shoes). Running shoes have more seams than is ideal,
but the mesh often stretches to make room for problem areas.
3. Size
Kalla says loss of feeling is the greatest risk factor for foot
trouble in people with diabetes. He says that people with feeling
loss typically buy shoes that are too small, because they can feel
the shoe. These people will complain that their shoes are too big
when fitted with the right size. But wearing shoes that are wide
and long enough can help prevent toenail injuries and reduce pain
in the front of the feet, says Moore.
4. Accommodation
Deformed areas are prone to rubbing, says Kalla. For instance, a
hammer toe may rub on the seam of a shoe. A pair of extra depth
(or “high volume”) shoes without seams and with a soft
upper is vital for someone with loss of feeling and foot deformity.
5. Protection
The skin around the foot thins with age, says Moore, so active older
adults need shoes with more padding. They also need socks that remove
moisture from the feet to cut down on blisters. Walking shoes usually
don’t have the support, fit or cushioning of a running shoe.
According to Kalla, people who have diabetes and feeling loss often
need cushioned orthotics (or supports) to protect their feet. Individuals
must keep orthotics in mind when choosing and fitting a shoe.
6. Grip
Loss of balance often goes with feeling loss. Shoes with low soles
and a wide, stable heel can help, says Kalla. Sometimes heels need
to be flared outwards for more support. The shoe’s sole is
also important, especially in wet climates. Many therapeutic shoes
have slippery soles, which are risky for people with feeling and
balance loss. Moore says that athletic shoes offer good gripping
outer soles. On the other hand, the outer soles of orthopedic footwear
often have no tread pattern. This smooth bottom may be good for
people who shuffle when they walk and trip easily in shoes with
thick soles, but it is risky in wet conditions. A fall may be worse
than the original foot problem.
7. Support
Dr. Jack E. Taunton, codirector of the Allan McGavin Sports Medicine
Centre at the University of British Columbia, says good shoes with
extra arch support, heel control and additional heel lifts are important
for the older person, as the aging foot loses strength and flexibility.
The International Council on Active Aging thanks Phil Moore for
providing this material. Moore has written the Shoe Update, a review
of footwear for the healthcare industry, since 1984. He also is
coowner of LadySport Ltd. (1983), a retail chain that sells athletic
shoes and fitness gear.
Disclaimer:
This information is not intended to replace a one-on-one relationship
with a qualified healthcare professional and is not intended as
medical advice. It is intended as a sharing of knowledge and information
from research. The ICAA encourages you to make your own health and
business decisions based upon your research and in partnership with
a qualified professional.
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