Choosing comfortable athletic shoes is important for everyone. However, individuals with diabetes have to be especially careful because ill–fitting athletic shoes can lead to a variety of complications including bunions, ulcers and other foot conditions.
Primary considerations when selecting athletic shoes include:
- Control of foot motion
Experts recommend that individuals who participate in a particular sport a minimum of three days a week choose athletic shoes designed specifically for the sport. The American Orthopaedic Foot and Ankle Society (AOFAS) has identified seven categories of athletic shoes:
- Running, training and walking
- Court sports
- Field sports
- Winter sports
- Track and field sports
- Specialty sports
- Outdoor sports
In addition, the American Diabetes Association offers tips on footwear for water activities and skateboarding.
Many experts recommend that diabetic patients buy two pairs of athletic shoes and alternate them each day. This helps keep feet dry, and prevents blistering and skin ruptures. Individuals can take several steps to ensure the selection of proper–fitting athletic shoes. For instance, when trying on athletic shoes, people with diabetes should:
- Try on shoes after a workout or at the end of the day, when feet are largest
- Measure both feet first
- Wear sports socks
Types of athletic shoes
Experts recommend that individuals participating in a particular sport at least three times a week select athletic shoes designed specifically for the sport. Factors to consider when shopping for any type of fitness footwear include:
Not every sport is appropriate for all individuals. People with diabetes should consult their physician before beginning a sport or exercise program.
The American Orthopaedic Foot and Ankle Society (AOFAS) has identified seven categories of athletic shoes:
- Running, training and walking. Running shoes should provide flexibility, extra cushioning, good heel control and maximum shock absorption. Walking shoes should have a soft, comfortable upper, smooth tread, extra shock absorption and a rounded or “rocker” sole design. It is important to note that although running shoes may be used for walking, walking shoes should not be used for running.
Cross–training shoes are most appropriate for beginner and intermediate athletes. They should be less flexible than running shoes, yet able to adapt to various applications, such as walking and aerobics. There are several types of cross–trainers (e.g., for running and walking, for running and hiking). Individuals should select cross–trainers designed for the specific activities in which they engage.
- Court sports (e.g., tennis, racquetball, handball, squash, basketball, volleyball). Athletic shoes for these activities should have good traction and stiff, durable soles designed to withstand the heavy abuse that often occurs when individuals make sudden stops and shift their weight forward, backward and from side to side.
- Field sports (e.g., soccer, baseball, football, lacrosse). Shoes for these activities rely on cleats, studs or spikes imbedded into nylon soles for added traction.
- Winter sports (e.g., ice skates for figure skating and hockey, boots for skiing). Ample ankle support is the most important consideration when selecting new footwear for winter activities.
- Track and field sports. Shoes for track and field sports vary by activity. For instance, runners and sprinters may have different footwear considerations than pole vaulters. The AOFAS recommends consulting a coach or athletic trainer to determine the proper shoe for various track and field events.
- Specialty sports. Dance, golf, bicycling, bowling and wrestling all have activity–specific shoes. For example, some bicycling shoes clip into the bike pedals to improve pedaling efficiency.
- Outdoor sports. This category includes boots and shoes designed for outdoor recreational activities such as hiking, hunting, fishing and boating.
In addition, the American Diabetes Association (ADA) recommends that people with diabetes wear water shoes to protect the feet from injury during swimming, water aerobics and other aquatic activities. Sandals are generally discouraged as diabetic footwear because straps chafe, raising the risk of blisters that can lead to serious wounds. In addition, wearing sandals or going barefoot exposes the feet to puncture wounds, burns and wounds caused by drying and cracking of the skin.
The ADA also suggests that those who enjoy skateboarding buy special skate shoes that grip the board or wear flat-bottomed shoes that cover and protect the feet.
Choosing the correct socks for athletics and other uses is also a concern for diabetic individuals. It is best to avoid socks with constrictive elastic bands or seams.
Finding the perfect fit
People with diabetes are predisposed to foot problems because diabetes can damage the nerves (diabetic neuropathy) and reduce blood flow to the feet. For diabetic individuals, well–fitting athletic shoes can mean the difference between a workout that is enjoyable and beneficial and one that results in complications, such as bunions, ulcers, skin infections and osteomyelitis (bone infection).
Many experts recommend that individuals with diabetes buy two pairs of athletic shoes and alternate them each day to help keep feet dry and prevent skin ruptures and blistering.
Shopping for athletic shoes can be overwhelming. However, individuals can take the following steps to ensure the selection of proper–fitting footwear:
- Match athletic shoes to the appropriate sport.
- Try on shoes after a workout or at the end of the day, when feet are largest.
- Measure both feet before trying on shoes. Foot size and width typically change four to five times during adulthood. Individuals should therefore have their feet measured every time they buy shoes. Many individuals have one foot that is slightly larger than the other. Select athletic shoes that fit the larger foot to ensure that toes are not cramped.
- Wear sports socks while trying on athletic shoes to ensure that the shoes are not too small or too narrow.
- Individuals who wear shoe inserts (the American Diabetes Association recommends using air or silica gel midsoles in athletic shoes) or orthotics (devices that are placed into shoes to alleviate discomfort) should bring them along to test them in various shoes.
- Try on and compare the fit of at least four pairs of shoes before deciding on a pair.
- Lace both shoes and walk or jog around the store to ensure a comfortable fit. Shoes that are too loose, too tight or do not fit properly in the heel area can cause blisters, calluses and even ulcers. Shoes should feel comfortable immediately and allow the feet to “breathe.” Individuals should not attempt to break in uncomfortable shoes.
- Select athletic shoes that are built with a soft, flexible upper material that matches the shape of the foot (e.g., flat foot, high–arched foot) and a smooth interior without any seams that may rub and cause blisters.
- Select shoes with sufficient toe space. The ball of the foot should rest comfortably in the widest part of the shoe, allowing plenty of wiggle room for the toes. Individuals should allow 1/2 inch (about 1 centimeter) between the tip of the shoe and the longest toe. Patients with deformities such as hammertoes (a condition common to people with diabetes and characterized by toes curling under the feet) may require custom–made shoes with extra depth and additional toe space.
- Choose shoes that bend in the toe area. Shoes that bend in the arch or midfoot area put extra pressure on the Achilles tendon and heel, especially during high–impact activities such as running.
- Select shoes with thick soles. Thick soles cushion the feet during physical activity. This additional protection is especially important for individuals with impaired circulation, a common condition in diabetes.
Researchers have found that many patients with diabetic foot wounds have incorrectly sized shoes. Patients who have difficulty finding shoes that fit well or who have foot conditions may benefit from consulting a pedorthist, a medical specialist who fits shoes.
Questions for your doctor on athletic shoes
Preparing questions in advance can help patients have more meaningful discussions with their physicians regarding their conditions. Patients may wish to ask their doctor the following questions about choosing athletic shoes:
- What qualities should I look for when buying athletic shoes?
- Do you recommend any particular brand of shoes for me?
- Do you recommend that I wear any shoe inserts?
- How often should I alternate shoes? How many pairs do I need?
- Should I get specialty shoes for my favorite activities?
- Will Medicare or other insurance pay for any special shoes I need?
- Is it OK for me to “break in” a shoe?
- Is it OK for me to wear sandals or go barefoot for any of my activities?
- If I have foot problems or have trouble finding shoes that fit well, would I benefit from seeing a pedorthist or other specialist? Will Medicare or other insurance pay for this service and any special shoes or inserts I need?
- What should I do if a shoe is causing a blister or other problem? At what point should I seek medical attention?
- What about work shoes and dress shoes – what should I look for when buying them?