Footwear has protected feet for thousands of years, with stylish, fashionable shoes made of expensive materials socially reserved for exclusive populations. Only relatively recently has footwear been adopted by all classes in the Western world as integral apparel. Traditionally constructed from natural leathers, shoes have benefitted from material and design innovations enabled by modern technology. This expansion has increased choice but the problem of poor fit persists, with many wearing ill-fitting shoes. Footwear advice for problematic feet lacks solid evidence and relies heavily on individual practitioners, limiting effectiveness. While protecting and adorning feet across societies, footwear’s past exclusion and present universality reveal tensions between fashion and function. Ongoing improvements in marrying style with biomechanical optimisation can promote foot health for all.
Characteristics like toe box width, sole hardness, and heel height influence pain. Habitual constriction from shoes can cause long-term foot deterioration. Though essential for function and identity, the style and fit of Western footwear accelerate deformity and pain. Narrow toe boxes restrict forefoot motion while fastenings limit metatarsal expansion, increasing stress. Proper fit is disregarded, with shoes often too narrow. Therapeutic footwear is shunned for aesthetics despite its benefits. Choices are influenced by fashion, identity, activity, and fit. Given links between shoe characteristics and pathology, understanding footwear selection reasoning in those with pain can enable effective rehabilitation. Currently, the connections between foot pathologies and everyday footwear choices are poorly understood. We use interdisciplinary methods to investigate these links.
Our work on young women’s footwear revealed purchases were driven more by activity needs, style, and self-image than long-term foot health. Research comparing older adults’ preferred shoes to off-the-shelf medical-grade shoes found that medical shoes reduced dorsal foot pressures and discomfort versus non-medical shoes. This demonstrated that medical-grade shoes can provide benefits over regular shoes and serve as a viable alternative to custom prescription footwear. Overall, our studies have shed light on factors influencing footwear selection across generations and quantified impacts on biomechanics and perceived comfort. The findings highlight opportunities to promote foot-health-conscious choices through education and improved retail options catering to activity demands without compromising well-being.
Ongoing work will further elucidate footwear decision motivations and effects to guide evidence-based recommendations.
Current Projects
Previous Projects
Effectiveness and cost-effectiveness of prosthetic and orthotic interventions
Effects of Foot Orthotics on Kinematics and Kinetics
Ankle Foot Orthoses-Footwear Combinations
The relationship between arch height and foot length: Implications for size grading
Hill M, Naemi R, Branthwaite H, Chockalingam N. Appl Ergon. 2017 Mar;59(Pt A):243-250. doi: 10.1016/j.apergo.2016.08.012. Epub 2016 Sep 14.