Listen to Your Patient’s Shoes


Podiatric physicians all share the goal of giving patients the best possible care and ensuring good outcomes for lower extremity disorders. At the Institute for Podiatric Excellence and Development (IPED) this is a topic we encounter among our members over and over. From our more experienced podiatric practitioners we’ve heard that examining a patient’s shoes, in addition to his or her feet, can enhance diagnosis of foot conditions. Here are some insights to be gained from shoes:

  • If the shoe fits…it’s a fact that the vast majority of patients are wearing shoes that are too small for their feet. Squeezing toes into narrow, pointy shoes or shoes that are a size too small encourages ingrown toenails and deformities and exacerbates many existing conditions. Encourage patients with shoes that don’t fit to get their foot professionally measured and to buy the correct size shoe to help eliminate painful foot problems.
  • What’s the wear pattern? In patients that tend to over or under pronate, the proof may be visible in the wear pattern found in their shoes. Other gait or foot structure issues may also be revealed by the wear pattern.
  • Risk reduction. For diabetic patients with neuropathy it’s particularly important that the podiatrist examine the inside of the shoes to check for foreign objects (such as small pebbles or pins) and rough stitching. These can cause an irritation or injury to the feet that the diabetic patient may not perceive until it has developed into a threatening wound or infection.
  • Odor alert. Shoes with a foul odor may signal the accumulation of bacteria that can cause athlete’s foot.
  • Self padding. If your patient has over-the-counter inserts or do-it-yourself padding inserted in their shoe, it tells you that they are experiencing pain or discomfort of some sort. Asking about the reason for the insert can lead to an important diagnostic discussion about foot pain.
  • Broken backs. In some patients shoes you will see a broken heel counter or overly stretched out slip on shoes, which are the sign of someone who doesn’t like to take the time to properly put on and take off shoes. This is an opportunity to educate patients about the importance of ankle and foot support and to suggest a lace-up type of shoe to prevent injuries and chronic foot conditions.

At IPED, giving podiatric professionals the opportunities and forums for sharing information is what we’re all about. To learn more about why becoming a member would be advantageous for you, contact our Executive Director Ruth Ann Donahue at: