As a massage therapist, you know the ramifications of wearing high heels on the feet, knees, back and neck. Here are tips for buying shoes.

I once read that the two advancements in civilization that have contributed the most to our chronic physical pain are the chair and shoes.

Apparently, though, it is those evolutionary developments that have led to the chronic back and foot pain that society lives with now.

Since we are rapidly advancing toward covering as much of Earth in concrete and cement as we can, I don’t see the demise of shoes in the modern world any day soon—and that means we must take counteractive, preventative measures to keep our feet healthy and strong.

As a massage therapist, you know the ramifications of wearing high heels on the feet, knees, back and neck. I hardly think that I need to delve into the problems of habitually wearing a shoe with heels of more than one inch. Flip-flops and slides fall into the same category of “wear at your own peril.”

The Steps to Choosing the Right Shoe

When you wear shoes that don’t stay connected to your feet when walking, the grip needed to keep that footwear on your foot causes a chain reaction beginning in your feet and lower body:

  • The metatarsal heads and the distal phalanx of your toes are driven into the ground, creating higher-than-normal pressure. Think calluses, metatarsalgia, permanently contracted toes and risk of fracture.
  • The dorsal surface of the phalanges is driven up into the top of those cute slides. Think corns, permanently contracted toes and calluses.
  • Unnecessary muscle tension is created in the lower leg. (Try this: while seated, place your hands on the anterior leg muscles, and grip your toes hard. Or place your hand on the back of your calf while gripping your toes hard. Feel the muscle contractions in your leg?) Think plantar fasciitis/fasciosis.
  • In addition, wearing flip-flops when your arches are weak will eventually contribute to their further weakness and collapse. Again, think plantar fasciitis/fasciosis.

Here are some other points to consider when shoe shopping, including the most important part of maintaining pain-free feet:

  • The feet swell as the day proceeds, especially in warmer weather, so purchase your shoes at the end of the day.
  • Stand to measure your feet. The average foot expands by nearly two sizes when full body weight is put upon them. If the store you plan to visit does not measure its customers’ feet (as fewer and fewer do these days), then stand on a piece of paper before venturing out and have someone draw the shape of your feet for you to measure yourself.

(Don’t attempt to do on your own. You need your full weight on your feet to get an accurate reading.)

Take that drawing with you to the store and check the length and width of your drawing against the sole of the shoe you are interested in. Ensure that there is a little space between the edges of your foot measurement and the outer contour of the shoe.

  • Most people’s feet are a little different in size. Buy your shoes with the larger size in mind.
  • Most women tend to wear shoes that are too small for their feet. The feet expand as we age, especially in width. This is due to years of gravitational pull on them, weight gain and the weakening of arches. Measure! Your shoe size at age 45 or 50 will not be the same as when you were 20 years old.

Since footwear is a major contributor to foot pain, take note of these points when selecting the shoes you plan to work in all day:

  • Don’t wear the same pair all day, every day. Doing so allows only some of the intrinsic muscles of the feet to gain strength, while others weaken from lack of use. Different shoes will ask different muscles to engage. At the very least, remove your workday shoes when arriving home and change into something else for the evening.
  • Inadequate support, either due to the design of the shoe or their age, causes the internal shock layers, which you cannot see, to lose their oomph. Replace shoes before the outer soles are worn down.
  • Inflexible soles will not allow the muscles of your foot to move through their necessary and natural dynamic of contraction and expansion. You should be able to take a shoe in your hands and bend it nearly in half.


Karen Ball, NBCR, LMT, is a board-certified reflexologist in practice since 1983. In addition to maintaining a clinical practice, she offers, through the Academy of Ancient Reflexology, trainings in conventional and Thai reflexology and related subjects throughout the U.S. and Canada. She is the current president of the Florida Association of Reflexologists.