Shoe Selection

Shoe Selection

Smart choices need to be made while purchasing shoes in order to reduce the potential for foot and ankle problems.

Most errors stem from a lack of basic knowledge of factors such as shoe size, design needs and modifications offered.

Considered to be the gold standard for measuring feet, the Brannock Foot-Measuring Device is helpful in determining both heel-to-toe and heel-to-ball or arch length. This ensures that the shoe selected allows for adequate ventilation with a comfortable fit.

The correct shoe size can prevent majority of the problems associated with ill-fitting shoes such as calluses, hammertoes, metatarsalgia, corns, ankle sprains and neuromas. 

A shoe last is a 3-dimensional mold (wooden or plastic) based on which a shoe is constructed. When it comes to design, it is important to keep in mind that the ‘last’ determines the overall shape of the shoes; this could be either curved or straight.

In the case of a curved or crooked last, the midfoot area of the sole is cutout, limiting motion in the fifth metatarsal ray and increasing the risk of injury.

An enormously elevated heel causes an altered series of foot and body biomechanics, which could be detrimental in the long-term.

The outer most sole of high-heeled shoes taper in the middle where maximum midfoot support is needed. This causes a shift in body weight distribution, affecting the bursa under the calcaneus, ultimately resulting in heel soreness and pain.

In a Stanford University study published by the Journal of Orthopaedic Research in 2014, it was found that wearing heels that are three and a half inches high and above, can strain knee joints and lead to osteoarthritis.

The wearer’s activity level also plays a crucial role in the selection of appropriate footwear.

With an increase in people adopting active lifestyles, shoe companies are spending millions of dollars to produce the right kind of footwear for both, the athletic and non-athletic population.

Activewear with torsion control seems to be gaining popularity in the market, on account of its ability to limit impact forces and prevent hyperpronation.

However, a number of studies in the past have proven that the effect of such kind of footwear on the musculoskeletal system remains minimal.

The Integrated Multi-Axial Posture Theory™, applied in the manufacture and design of MASS4D™ orthotics, looks at establishing a foot posture which results in optimum neuromuscular efficiency, reducing the stress placed on the entire kinetic chain, so that tasks can be performed with the most amount of efficiency.

MASS4D® protocols examine the patient’s anatomy and capture the foot in its corrected closed chain posture. This is obtained by mimicking the patient’s healthy stance-phase gait in a specialised foam box to create a semi-weight bearing impression, which is used in the manufacture of the orthotics.

These custom made orthotics aim to respect an integrated multi-axial foot posture which results in optimum neuromuscular efficiency, reducing the stress placed on the entire kinetic chain thereby enabling tasks to be performed with the least amount of energy. 

Related Links


  1. Jenny L. Sanders (2011) When Patients Insist On Wearing High Heels. Podiatry Today: June 2011, Vol. 24, No. 6. Retrieved from
  2. William A. Rossi (2001) Footwear: The Primary Cause of Foot Disorders. Podiatry Management: February 2001. Retrieved from:
  3. Titchenal, M. R., Asay, J. L., Favre, J., Andriacchi, T. P. and Chu, C. R. (2015), Effects of high heel wear and increased weight on the knee during walking. J. Orthop. Res., 33: 405–411. doi:10.1002/jor.22775

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