The slipper is the problem, not the shoe you paid for

Live well

The worst shoe I owned was free, and it lived by the back door.

Backless slippers. Flattened sheepskin, older than my truck. Carol had been telling me about them for a decade.

I want to give today to shoes, because it is the advice people hear most and the evidence behind it is messier than a shop makes it sound.

Two halves again. One thing you can change tonight… and one thing you can stop blaming yourself for.

What your old shoes did and did not do

Hylton Menz and Edward Roddy asked 2,627 women, aged 50 to 89, what they had worn on their feet in their twenties and thirties.

Nearly half of them had foot pain in the past year, and about the same share had a bent big toe joint.

Narrow shoes in their twenties tracked with the bent toe. Once schooling was allowed for, the odds sat about two and a half times those of the women in the widest shoes. Merely wide shoes showed up too, until that adjustment washed it out. Heel height never showed up at all.

But here is the part nobody prints. The shoes those women wore back then had no link to the foot pain they had now. None.

So if you have been blaming a pair of shoes from 1974 for your heel, you can set that down.

Bear in mind what that study is. Recall, decades back, and people misremember shoes the way they misremember weather. The pain and the bent toe were both self reported too. But the shape of it holds. Narrow shoes bend toes. They do not appear to be why your foot hurts today.

The shoe that matters is the one on your foot now

Reviews of footwear and falls in older people keep landing on the same short list… and none of it is fashion.

A heel under about an inch and a half. A firm cup around the back that does not fold flat when you squeeze it. A sole with tread on it. Laces or a strap, so the shoe is held on rather than gripped on.

And the one that got me. In a lab in Melbourne, 30 women in their late sixties and seventies were balance tested and walked in three set ups. Enclosed slippers with a strap came out best. Plain socks came second. Backless slippers came last.

That is 30 women in one session, measuring sway and stride and not actual falls. So it is not proof that a slipper will put you on the floor.

But it makes sense once you watch yourself in a backless pair. The toes curl up to hold the thing on, every step, all day… and a foot busy holding a slipper on is not a foot that is standing well.

Insoles, honestly

Here the trials surprised me, and I had it the wrong way round in my head for years.

A review pulled together 19 of them, 1,660 people in all. In the first few weeks, insoles did nothing for pain. Nothing.

In the middle stretch, around two to three months, they did beat a dummy insole for pain. The size of it was small, and the reviewers said plainly they were not sure it was big enough for a person to notice.

Function never improved. Not at any point. By the long run the small pain edge had gone too.

Molded to your foot has not beaten off the shelf in head to head tests either. In one trial a contoured sandal did as well as a shop bought insole in a shoe.

So start at 20 dollars, not 200. If the cheap one has done nothing after six weeks, a cast of your foot is unlikely to rescue it.

Do not expect an insole to do the week's work for you. It changes what your heel stands on. It does not lengthen the band or build it, which is what Monday and Wednesday were for.

Anyway, mine went out in April. I am still faintly annoyed that Carol was right.

And I will say the quiet part. None of this is a cure for a sore heel. It is the floor you stand the rest of it on.

Here is to a shoe that stays on,
Walt