Shoes – are you among 88% of women wearing footwear, narrower than their feet?

Correct footwear fitting is acknowledged as being vitally important, because incorrectly fitted footwear has been linked to foot pathology.

A large proportion of the population wears incorrectly sized footwear, which is associated with foot pain and foot disorders such as lesser toe deformity, corns and calluses (63 – 72% of people are wearing shoes that don’t accommodate either width or length dimensions). Specific participant groups, such as children with Down syndrome, older people and people with diabetes are more likely to wear shoes that were too narrow (between 46 and 81%).[1]

Study of 356 American women (average age 42, range 20 to 60 years) found that 88% were wearing footwear that was narrower than their feet, with the average discrepancy being 1.2 cm[2]. Among these women, 37% were wearing high heeled shoes, 49% wore flats and 14% wore sneakers. This was followed by a subsequent study by the same authors, using the same methods, that recruited 255 American women (average age 41, range 20–60 years) and found that 86% of participants were wearing footwear that was too narrow, with an average discrepancy of 0.88cm[3].

Women are more likely to suffer foot pain compared to men[4] [5]. Furthermore, females suffer more foot pain while wearing shoes compared to men, most likely due to the narrower toe box of women’s shoes[6]. Women are wearing relatively smaller footwear compared to men.[7]

Footwear in people with diabetes

In terms of shoe width, there was evidence among a sample of 568 diabetic individuals with peripheral neuropathy that the forefoot of most individuals with diabetes is broader than the most common industrial shoe width references used by shoe manufacturers. A large proportion of individuals with diabetes may be selecting footwear that is correctly fitted for length, but are not considering, or are not able to acquire footwear of sufficient width[8].

Learn about your foot dimensions and appropriate foot size

High prevalence of incorrectly fitted footwear suggests that greater emphasis should be placed on footwear fitting education so people are more aware of their foot dimensions and appropriate foot size.

Footwear manufacturers should provide an appropriately large selection of shoes that can accommodate the variations in foot morphology among the population. In particular, a greater range of widths for each length sizing option should be made available in order to accommodate feet with wider dimensions.1

So, be sure you have footwear that fits you…. You don’t want foot pain and foot disorders, do you?

[1] Andrew K. Buldt, Hylton B. Menz: Incorrectly fitted footwear, foot pain and foot disorders: a systematic search and narrative review of the literature, published 2018,

[2] Frey C, Thompson F, Smith J, Sanders M, Horstman H. American Orthopaedic Foot and Ankle Society women’s shoe survey. Foot Ankle Int. 1993;14(2):78–81. doi: 10.1177/107110079301400204. [PubMed] [CrossRef] [Google Scholar]

[3]Frey C, Thompson F, Smith J. Update on women’s footwear. Foot Ankle Int. 1995;16(6):328–331. doi: 10.1177/107110079501600603. [PubMed] [CrossRef] [Google Scholar]

[4] Menz HB, Lord SR. The contribution of foot problems to mobility impairment and falls in community-dwelling older people. J Am Geriatr Soc. 2001;49(12):1651–1656. doi: 10.1111/j.1532-5415.2001.49275.x. [PubMed] [CrossRef] [Google Scholar]

[5] Munro BJ, Steele JR. Foot-care awareness. A survey of persons aged 65 years and older. J Am Podiatr Med Assoc. 1998;88(5):242–248. doi: 10.7547/87507315-88-5-242. [PubMed] [CrossRef] [Google Scholar]

[6] de Castro AP, Rebelatto JR, Aurichio TR. The relationship between foot pain, anthropometric variables and footwear among older people. Appl Ergon. 2010;41(1):93–97. doi: 10.1016/j.apergo.2009.05.002. [PubMed] [CrossRef] [Google Scholar]

[7] Menz HB, Morris ME. Footwear characteristics and foot problems in older people. Gerontology. 2005;51(5):346–351. doi: 10.1159/000086373. [PubMed] [CrossRef] [Google Scholar]

[8] Harrison S, Cochrane L, Abboud R, Leese G. Do patients with diabetes wear shoes of the correct size? Int J Clin Pract. 2007;61(11):1900–1904. doi: 10.1111/j.1742-1241.2007.01554.x. [PubMed] [CrossRef] [Google Scholar]


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