Ashlee Williams, MD: Your shoes do more than complete an outfit. They're the foundation of your foot health, posture and comfort. But with endless styles and brands to choose from, how do you know which ones are actually good for your feet? Welcome to The Healthier You Podcast. I'm Dr. Ashlee Williams, and today I'm talking with Dr. Kristy Golden, a Board Certified Podiatric Surgeon here at Kaiser Permanente about what really matters when it comes to footwear. We'll discuss the four types of shoes every person should own. What to look for when buying new pairs and how the wrong shoes can cause long-term problems. Dr. Golden, thank you so much for being here.

Kristy Golden, DPM: Thank you. I'm excited to be here. Thanks for having me.

Host: Yes, it's an exciting topic. I need to know what shoes I need to buy. Okay, so Dr. Golden, why is choosing the right pair of shoes so important to overall foot health?

Kristy Golden, DPM: Yeah, I mean, that's a great place to start. So, your shoe is the interface between your body and the ground. It is what you can control about your shock absorption from the surfaces that you walk on, and it's also what you can change based on changes in your activity level and your weight. So, if you don't kind of evolve your shoe choices to match your current person and your lifestyle that you currently have; often the shoes will not provide the support that you need at this moment and lead to like a whole host of problems. Certainly not just limited to foot pain, but foot and ankle pain's probably the primary symptom that your shoes are not working for you, but also can lead to knee pain, hip pain, and lower back pain. And just early fatigue, calf cramping. There's lots of symptoms that can come from choosing the wrong shoe.

Host: So how can someone tell if their shoes are actually supporting their feet properly?

Kristy Golden, DPM: Okay, so there's a few things to look at when you are shopping for shoes. The first, let's talk about the sole of the shoe. So a sole has two parts. Okay? There's the floor facing sole; that should not be flat. Okay, so in other words, it should be a bit of a rocker to the bottom of the sole. You should be able to almost put your finger underneath the toe of the shoe and the back of the heel of the shoe in order to tell that there is a rocker to the bottom of the sole.

That's really important at decreasing foot fatigue and a whole host of other biomechanical benefits to a rocker soled shoe. Now, the other side of the sole is also important. This is the foot facing side of the sole, okay? You also don't want that to be flat, so you only can tell that by literally putting your hand in the shoe. If there is a rise in the arch of the foot facing part of the sole, that is a good shoe.

All right. So a rocker sole on the bottom and a high arch on the foot facing part of the sole. Those are like key elements to every good shoe. Also, you do not want flexible shoes. If you can take the shoe, and I'm going to use my hands here for, to show you if you can bend a shoe, if you're holding the toe and the heel of the shoe in your hand, you can bend a shoe, you can twist it; this is not a good enough shoe for your foot support because if you can do that with your hands, of course your foot is doing that when you're walking in the shoe, which leads to earlier fatigue and joint pain and other issues. So, that would be the main categories. Also, I would recommend kind of as a tertiary category of shoes; when you're choosing for shoes, the back of the heel, you don't want a squishy more collapsible back of the heel. You want the back of the heel of the shoe, we call it the shoe counter, to be rather stiff, to hold your foot straight in the back.

Host: So I gotta tell you I have a two and a 5-year-old, as you probably know, and one of the best new purchases that I bought for my 2-year-old is house slippers. She is obsessed with these house slippers. Can you, and I know it's important for everyone to have a pair, can you talk about the types of shoes that everyone should own?

Kristy Golden, DPM: Sure. Okay, so I always say there's four pairs of shoes that you need, and the fifth one is a bonus. Okay, so the four pairs of shoes are a house shoe. Your feet do not know where you are. They don't know if you're home. They don't know if you're doing laundry or if you're out walking or if you're at work.

It all feels the same to your feet, right? So a house shoe, very important. We do a lot of work in our homes. A house shoe, errands shoe. This is the shoe you slide on. Almost always it's kept by the door. It's almost always not a great shoe. And you go to the bank, you go to the doctor's, you go to the grocery store, you know, you go pick up your kid, you do all the things that you do in an errand's day, that shoe needs to be sort of named and made sure that it's the right shoe. Because you put a lot of steps in when you're doing your errands. And the third is a work shoe. So depending on your job, ideally you can wear a sneaker to work. I mean, that's the most ideal situation. But if you're not able to wear a sneaker to work, then there are a whole host of companies nowadays, we're very lucky, that make really supportive work style shoes.

Okay. And the fourth category is your exercise shoe. This is key. Not all exercise shoes are not all sneakers rather are good for your feet, right? There are some that are actually not good for your feet. So I would follow those categories of criteria for good shoes that I outlined before when you're picking out all four of these types of shoes.

And then I say the fifth shoe is a bonus, and this is like the Saturday night shoe. So if you're in the right shoe in your home, on your errands, when you're at work and when you're exercising, then you won't be preloading all this inflammation and pain into your feet through the week. And then if you want to go, let's say to church on Sunday or out to dinner on a Saturday night, it will matter a little bit less what style shoe you choose in those moments, because you're usually not putting a lot of weight on your feet, not doing a lot of walking in those environments.

Host: Okay, so we've purchased our four shoes, plus or minus the bonus shoe. How often should we be replacing these shoes?

Kristy Golden, DPM: More often than you think. So, generally if the shoe felt really good at first and then six months later it doesn't, that it's time to replace the shoe. Now, if the shoe never felt good, it's probably not the right shoe, but, shoes are made of rubber and plastic materials, especially like the sole of the shoe gets warmed up by the warm environment of your foot and just the wear and tear that it takes when you're walking.

And so it lacks support after about six months. So, if you're wearing the shoe on an everyday basis, I would evaluate your shoes at least every six months.

Host: Okay. Does age impact the type of shoes? Like do life stages such as childhood, adulthood, or older age require different shoe considerations?

Kristy Golden, DPM: Absolutely. Yes. So, and I always say this to patients, the shoe that works for you in your forties is probably not the shoe that worked for you in your twenties. When you're younger, more flexible, less stiff, more kind of durable in terms of what your body can take without causing pain.

I think we all know that. And so as we age, as we go through the different stages of life, our feet tend to become more needy. And so we need to pay attention to that because although you still might like the same style of shoe, it just might not be serving you anymore. So I would evaluate that as time goes on in our lives.

Other times where it's really important to evaluate your shoe is during and after pregnancies for women. I've talked a lot about this before. I think in our previous podcast, but the thing about pregnancy is, you know, you weigh more when you're pregnant, so you're putting more downward forces on your arches.

You're just straining your musculature so much more. Plus, you're secreting hormones to prepare for delivery called relaxin, which don't just target the cervical hormones they target, or the cervical ligaments; they also affect your foot ligaments. Therefore, you know the, the ligaments in your foot become more relaxed, and with that added weight, your arch will lower.

So a lot of women owe it. They tell us after I had a baby, my shoe size went up, right? Your foot did not grow during pregnancy. What actually happened is your arch lowered as a response to the increased load during the pregnancy. And once it goes down, it doesn't go back up. Okay? So very important during the peri pregnancy, post-pregnancy time, to be very cognizant that you're supporting your arches.

And that is the case for anytime you have extra weight on. You know, if you've gained a little weight, you might notice that your foot and your ankle are more painful than they used to be. This is a time to evaluate your shoes, how much support you're getting from them, and increase that and optimize it.

Host: Totally agree. I can attest to the fact that my foot size has actually grown since having kids, and I also stretched out one of my favorite pairs of shoes while I was pregnant. Okay, so as a podiatrist, it's a real thing. As a podiatrist, what is one piece of advice you'd like to give listeners who want to start building a healthier shoe collection today?

Kristy Golden, DPM: Yeah, I mean, I would go through your shoe closet. I bet if I came to most of your shoe closets, I would have some words about your shoes. You know, I think we all need to be honest with the phase of life that we're in and our goals, which for most people are comfort, not just style, but we want to feel good.

We want to feel comfortable. Not be in pain. And so selecting the right shoe is, so much of that. We're lucky to be in a time when, there are a lot of companies out there making shoes that are, quote cute, that also are supportive. I'm not telling

40-year-old women to be wearing orthopedic shoes all the time. No, no, no. There are options out there, but you need to sort of evaluate what you have, how you feel when you're wearing the shoes that you currently have. And you know, say this shoe, although I love it, might not be right for me at this time.

I would also start thinking about exercise, you know, and how we sort of go as a population, up and down with our exercise routines, probably too much, you know, I wish they would be more steady, but on times when you're feeling like, yes, I'm motivated, I'm going to exercise more, the first thing you need to do is get yourself a good pair of sneakers to do that in.

Right? Otherwise you're going to start exercising and have pain and be like frustrated by that, you know? And I counsel patients around that a lot. So get yourself the right shoe, get involved in those healthy activities and, just kind of be honest with how you feel in the shoes that you have.

Host: Well, thank you. I will be going through my shoe closet tonight. I really appreciate this valuable information, Dr. Golden. I will call you. All right. Here are the key takeaways. One: shoes affect your whole body, not just your feet. The wrong pair can cause pain in your feet, knees, hips, and even your back.

Supportive features matter. Look for good arch support, cushioning, and a stable heel. Use the pinch fold and twist test to check for stability. Three: everyone needs four shoe types, supportive house shoes, work shoes, athletic sneakers, and casual errand shoes to cover daily activities, plus or minus an extra pair for when you go out.

Shoes wear out faster than most people think, often within six to 12 months. Worn out shoes lose cushioning and support, which can lead to pain and injury. And lastly, footwear needs change with life stages, kids require flexible, properly fitted shoes. Adults should choose shoes that match their activity levels.

Moms need an extra arch support, and older adults need more cushioning and stability. For more expert advice, visit kp.org and listen to more episodes of Healthier You wherever you get your podcast. If you found this episode helpful, don't forget to subscribe and share it with others. Thank you, and from all of us at Kaiser Permanente, be well.