Bigger Shoes: Just What the Doctor Ordered
In 1996, twenty-year old Ray Allen entered the NBA as a fifth round draft pick. His shoe size: 13. After a series of ankle injuries that resulted in double ankle surgery in 2007, Allen reported that his feet always hurt and his shoes felt tight. In this his 16th season in the NBA, Allen now wears a size 15 shoe (with custom orthotics). As a 36-year old he’s playing his career best and holds the record for hitting more 3 pointers than anyone else in the NBA. He doesn’t have the same ankle problems or foot pain, and he feels that bigger shoes made all the difference.
I often have patients tell me, “Doc, I feel like my feet have gotten bigger. Is that possible?” Or just as often patients may not know that their feet have gotten bigger until they order therapeutic shoes from our office and we measure their foot a size and width bigger than they are used to wearing. To officially answer this question, yes, your feet may be getting both longer and wider. There are several scenarios where this is the case.
1. Pregnancy: During pregnancy your body releases a hormone known as Relaxin. Relaxin loosens the ligaments (the tissue that attaches one bone to another) in your body so that your ribs can expand to accommodate the growing baby. Relaxin is not selective about which ligaments it causes to relax, so the ligaments in your foot also relax, which can cause your arch to fall and your foot to get wider. The excess weight you carry during pregnancy can also exacerbate these changes. And you can expect these changes to last even after that you’ve lost that baby weight.
2. Barefoot Running: African and South American tribes which are “non-shod” (don’t wear shoes) have wider and sometimes longer feet than those in “shod” cultures like ours. Many people who practice barefoot running have noticed that their feet are wider and sometimes longer than before they picked up the sport. This is likely due to their foot using and building up muscles that people who wear shoes don’t usually build up. It could also have to do with a lack of support leading to stretching of the ligaments that support the foot.
3. Age: A 2006 study of 440 VA patients with the average age of 67 found that only 25% were wearing the right sized shoe. For a lot of people, after age 40 they gain a half shoe size every 10 years. This is because as we age, the tissues in the foot weaken like they do in the rest of the body. Muscle mass declines and ligaments lose some of their elasticity. As a result, the front of the foot widens, and the foot becomes longer due to the arch falling. Hammertoes and arthritis can make the foot taller too. The natural fat pads in the heel and on the ball of the foot get thinner, making walking barefoot (or even in shoes without adequate padding) uncomfortable.
The bottom line is regardless of why your foot is getting larger, there is one very simple solution- new shoes! A shoe that is properly fitted should fit the widest part of the your foot, which is usually the front of your foot. It should be supportive and have some good cushion. At Advanced Foot and Ankle Care all of our offices have therapeutic shoe stores with a wide array of styles. Therapeutic shoes have the added bonus of having styles that are wider in the front or “forefoot” but not the heel. They also feature a higher “toe box” to accommodate for hammertoe deformities. Orthotics also fit well into these shoes. It is hard to part with favorite shoes that have become too small, but having a medical reason to shop for new shoes is something to smile about!