Dr. Kelley Gillroy, DPM, Midwestern University, Glendale, AZ, completed her undergraduate education at Northern Arizona University and obtained her doctorate from Des Moines University, College of Podiatric Medicine and Surgery, in Iowa. She then completed a three year surgical residency program before beginning practice. She practiced as an associate in private podiatric practice in Sun City West, Arizona for a few years before accepting her present position at Midwestern University in Glendale, Arizona where she serves as assistant professor for the Arizona School of Podiatric Medicine and is a clinician at the Foot and Ankle Clinic at Midwestern University. She is also director of CME for the podiatry department at Midwestern University.

Dr. Gillroy is interested in all aspects of foot care but has taken a keen interest in trauma and in surgery of the foot and ankle. We were fortunately enough to take a few minutes out of Dr. Gillroy's dayfto ask her about footwear and how it can make a difference in the health of your feet.

Doctor, most people do not seem put a lot of thought into their choice of footwear. What kind of long-term effects does this have on the health of your feet and what do you recommend as far as footwear choices are concerned?

Dr. Gillroy: Well, as far as long-term effects of wearing shoes that are not supportive enough, most people over-pronate when they walk and there's usually not appropriate stability or arch support in the shoes which can lead to a lot of problems like plantar fasciitis, tendonitis, stress fractures and a lot of overuse type symptoms as time goes on.

Do you think that's a matter of misinformation?

Dr. Gillroy: Not necessarily. You can walk into some high-end athletic stores and assume what you find there will be appropriate. You can not trust a brand name now with the new trends in minimalist shoe wear and barefoot running trends. I think if it's on the shelf at these stores, people think automatically that they're purchasing something that's a good fit for their feet.

I do have a few tests that I usually like to tell patients to use to test their shoe wear before buying it to evaluate it for stability. First, you take the shoe and you try to fold it in half. The only place the shoe should bend is at the toe area where you're going to get a natural bend in your toes when you walk. If it folds up in the arch, you know that it's not stable enough because your foot does not fold there. So your foot is going to be doing a lot of extra work trying to be stable inside that shoe.

The second test that I have is to try to wring out the shoe or twist it side to side. You should not be able to do that. The sole of the shoe should provide significant resistance to that and then, the third test is trying to pinch the heel together. There should be resistance. It should not just collapse. That's to make sure that there's a nice heel support in the shoe. If the shoe passed those three tests, usually you're okay in regards to stability and then, you need to think about the arch support inside the shoe.

Most shoes are manufactured flat because they do not know what type of person is buying the shoe. If that person has flat foot or higher arches the will not like the fit of the insole so you have to take the lining out that comes in the shoe and supplement it with something that fits your arch better, which is usually a custom device if you have foot problems.

The next question is geared more towards women. Is it really possible for somebody to maintain foot and spain health and still wear stylish shoes?

Dr. Gillroy: Yes. They're definitely getting better as time goes on with what's available on the market for women. There are a lot of companies that are trying to produce different kinds of sandals, and flip-flops, and dress shoes that are less bulky and more pleasing that actually do fit appropriate guidelines for a stable shoe, but they are not as easy to find. A lot of high heels on the market, depending on the height of the heel, are very unstable for the ankle and if you wear heels a lot, you can risk spraining your ankle or develop tightness or contracts on your Achilles tendon just from always being on your toes.

You can get problems in the ball of the foot like a Morton's neuroma or pain under the metatarsals. There are shoe stores available now that carry sandals and dress shoes that you can wear to towork that are a little bit better. Look for a heel with more width or a platform for more stability. There are even orthotics made now to fit inside dress shoes.

Do you recommend different footwear for somebody who is on their feet all day as opposed to someone who is more sedentary?

Dr. Gillroy: Well, absolutely. The person who is more sedentary can get away with wearing less stable shoes because they're not constantly on their feet, whereas someone who's on their feet all day would need more shock absorption in their shoe and better arch support. That all transfers upwards and can even lead to knee pain and back pain if they're on their feet all day.

What do you feel is the biggest misconception that people have about footwear?

Dr. Gillroy: I know a lot of people have brands that they try and they feel like if they are spending their money on a brand like Nike or New Balance or something like that they are automatically getting the right shoe which is not the case. There are so many different brands out there and it's kind of a whirlwind to try to decide what to buy, each brand has six or seven different types of shoes.

So just buying a Nike for example, does not mean you're getting the shoe that's right for you because they have minimalist shoes, they have shoes for runners, hikers, people who over pronate and people who have high arches. There's a lot of more to the anatomy of a shoe than just pulling it off at the shelf and a lot of people do not understand that.

Doctor, to wrap this up, how should someone go about choosing a Podiatrist?

Dr. Gillroy: Well, that's a tough one. Historically, Podiatrists have had different levels of training, for example, in the past not all podiatrists were surgically trained. Some of them specialized more in general podiatric medicine and palliative foot care and others focused on diabetic foot care and wound healing. The training is more uniform now. Every podiatrist that graduates now has 3 years of surgical training in addition to the general podiatric training. So now that it's more uniform, you can trust that your podiatrist can help with your foot problem and see you through to complete healing.

So in other words what you're saying is that the training and the curriculum is now pretty standardized. If you get someone who is a podiatrist that is licensed in the last 10 years they're going to have that training. Is that correct?

Dr. Gillroy: Yes. Most importantly, I just think you need to find someone that you have a good relationship with you so that if you do have a chronic problem then they are someone that you can trust. Look for a podiatrist that has good bedside manner and who spends time explaining things to you.

Sure, absolutely. When people are dealing with a situation where they're going to have to come back to the doctor again and again, you're right, it does turn into a very personal relationship. They're going to want somebody who they're comfortable with.

Dr. Gillroy: I would just encourage people to be proactive with treating their foot pain. What I come across more often than not are patients who ignore their symptoms when the injury first happens and wait for 2-3 months thinking the pain will go away on its own. Now, the injury has become chronic and more scarred which makes treatment more difficult and often leads to more problems from compensation. I encourage people not to ignore symptoms and seek treatment right away. It's better to find out that it's something minor rather than to try and backtrack through 2 or 3 months worth of pain which often leads to surgery.

Great advice. Dr. Gillroy, thank you so much for taking the time out of your day to answer a few questions about proper footwear. I certainly appreciate it.

Dr. Gillroy: You're very welcome.

Kelley Gillroy, DPM, Midwestern University, Phoenix can be reached at her office at 623-537-6160. She provides medical treatment for conditions such as bunions, heel pain, ingrown nails, foot pain, diabetic foot concerns and deformity correction.