Thoughts About Footwear

Foot types vary dramatically and sometimes what your foot looks like when you are sitting will change when you are standing, walking or running.  A thorough analysis by a physical therapist will be beneficial for those who are serious about footwear or if you are having low back, hip, knee or foot pain, especially when active.

1. Orthotics.

This is a tough one.  I am not a fan of prescribing orthotics for everyone with pain, even if the foot/knee/hip is not in perfect alignment.  There are individual cases where orthotics are permanently necessary.  There are cases where they might be temporarily beneficial.  Seeing a licensed physical therapist will help you determine the cause of your pain or poor alignment.  With physical therapy the goal is to improve alignment through manual therapy, exercises, stretches and movement modifications.  There are many opinions on orthotics, I happen to like this article by the Sock Doc.

2.  Flip-flops or sandals.

I have had a few people make tremendous progress with physical therapy for various foot conditions and then they wear flip-flops on the weekend and return to my clinic with increased discomfort.  Wearing flip-flops for extended periods of time (hours of standing or walking around the Saturday Farmers’ Market) may not be a good idea.  If you must wear flip-flops (I admit, I have a pair), please invest in a quality pair.  My favorite brand, Chaco, seems to fulfill these criteria.  If you are wearing more of a sandal, then they should have straps around the ankle to hold your heel in place and again, a supportive foot bed. This is a fun visual for the case against flip-flops!

3.  Athletic shoes

Whether you prefer a more traditional shoe or a minimalist shoe, it comes down to what feels right for you.  Sometimes if you know your foot type, this can help you determine a good shoe type.  You might fall into one of 3 categories:  over pronator, under pronator or normal (neutral) pronator.  To determine your foot type, see your local physical therapist or check out this article from Duke Health for a DIY method.

4. Dress shoes

Ladies, just don’t do high heels!  If you must have a heel, keep it less than 2”.  Invest in good footwear, especially if you have a job requiring standing or walking.  Quality brands such as Privo or Clarks will give you support without making you feel like you are out of style.

5. Barefoot

For those of us who were raised wearing shoes, psychologically it can be challenging to ditch the shoes.  Barefoot walking on uneven surfaces may help strengthen our feet.   Just like with a weight lifting routine, if we stick to the same routine, day after day, certain muscles may get overworked while other muscles never “get turned on.”  This can create asymmetries and ultimately lead to injury and pain.  Occasionally walking barefoot in the grass, sand or on another uneven surface will help to strengthen the foot and ankle in a different way.  Know your feet and know your limits, but we promote connection of your feet to the earth!


Jessica Dufault is a licensed physical therapist, a certified athletic trainer and a co-owner of Mindful Motion Physical Therapy, LLC in Madison, Wisconsin. She earned her Doctorate in Physical Therapy from Emory University in 2006. 

These are the thoughts and opinions of the author and they do not constitute medical advice.  For advice on medical issues you should always consult your local medical practitioner.