# Footwear advice > Footwear advice is guidance on choosing and wearing shoes that fit and suit your feet, so they support your feet rather than strain them. It matters most for people with diabetes or rheumatoid arthritis, and it's a sensible, practical step rather than a proven treatment on its own. Guide in [Treatments](https://footanklelowerlimb.com.au/learn/topics/treatments), from Foot Ankle Lower Limb: https://footanklelowerlimb.com.au/learn/footwear-advice Reviewed by Andrew Schox, BSc(Hons) PGradDipPod MPod (Podiatrist) on 27 October 2026. Next review by 27 October 2027. - **It's guidance on choosing and wearing shoes** that suit your feet, so they support them rather than strain them. - **Fit comes first:** the right length, width and depth, room for your toes and a secure fastening. - **It matters most with diabetes or rheumatoid arthritis,** where you may need more than general advice. - **Break new shoes in gradually** over a couple of weeks. ## What is footwear advice? Footwear advice is guidance on choosing and wearing shoes that suit your feet, so they help keep your feet healthy and comfortable rather than adding stress and pressure [1]. It looks at fit (length, width and depth), a secure fastening, and features such as support and curved rocker soles. Shoes that don't fit properly are one of the most common causes of foot problems [2], and well-fitting, supportive shoes should make your feet more comfortable [3]. A podiatrist can check your shoes against your feet and explain what to look for when you shop. ## What is footwear advice used for, and does it work? The strongest case is for people with diabetes. Guidelines recommend teaching people at risk of a foot ulcer (a sore that is slow to heal) not to walk without suitable foot protection, and advise those at moderate to high risk to wear properly fitting therapeutic footwear (shoes designed to protect the foot). After an earlier ulcer under the foot, footwear that relieves pressure while you walk is advised to help stop it coming back [4]. The recommendation is strong, though the quality of the supporting evidence is low [5]. For adults with rheumatoid arthritis, therapeutic footwear is linked with less pain and better physical function than standard shoes, though the evidence is graded moderate to very low quality [6]. For other conditions, treat footwear advice as sensible practice rather than a proven treatment on its own. Poorly fitting shoes can make a foot problem hard to improve, even with podiatry treatment [7]. ## Is footwear advice right for me? General advice suits almost anyone, because properly fitting shoes help avoid foot discomfort and deformity [8]. If you have diabetes at moderate or high risk of a foot ulcer, especially after a past ulcer, you need a podiatrist's input and ongoing foot care, not general shoe advice alone [4][9]. Ill-fitting footwear is one of the most common causes of foot wounds in diabetes [1]. If you've been given prescription shoes, wear only those and follow your podiatrist's or orthotist's instructions [9]. If you have rheumatoid arthritis with foot deformity, ready-made shoes can fit poorly and cause pressure areas, pain and skin damage, so ask for professional footwear advice. Shoes with space for the deformity may be needed [6]. ## What happens during footwear advice? It's mostly a fitting check rather than a course of treatment. Shoes should be the right length, width and depth for your foot, with an adjustable fastening such as laces, straps or velcro that holds it firmly [2]. Check for about a thumb's width beyond your longest toe, a snug heel, and enough depth and width for your toes [1]. It's good practice to have your feet measured before buying [10]. Fit shoes to your larger foot, and if you're getting insoles, take them along to try in the shoes [11]. Wear new shoes for an hour or two at first, then build up over a couple of weeks [10]. If you have diabetes, check your feet and shoes before and after each wear while you break them in; some adjustment is often needed at first [5]. > [!tip] Try this > Before you buy, take the insole out of the shoe and stand your foot on it. It should be as wide as your foot, with about a thumb's width beyond your longest toe [3]. ## What are the risks of footwear advice? The main problems come from shoes that fit poorly or don't suit you. They can cause pressure, rubbing, corns and ingrowing toenails [7], and raise the risk of falls or injury [1]. New shoes can rub. If new or prescribed shoes rub or cause redness, especially with diabetes or rheumatoid arthritis, stop wearing them for long periods and contact your podiatrist or orthotist [5][6]. Older people should be wary of very soft midsoles, which may worsen balance and raise the risk of a fall [12]. ## How does it compare with other options? The comparisons available are about devices and special footwear, not general footwear advice, and they come from different groups of adults, so they may not carry across between conditions. - **Diabetic foot ulcers:** non-removable offloading devices (such as a cast) are likely better for healing than other options [13]. Simple, removable offloading footwear may be a low-cost choice for preventing new or recurrent ulcers [14]. - **Plantar heel pain (pain under the heel):** orthoses (shoe inserts) weren't better than fake inserts or other simple treatment for pain and function in adults [15]. Ask your podiatrist which option suits your condition. If a device is suggested for diabetes, its benefits, risks and any reasons not to use it should be discussed with you first [5]. If you're given insoles, choose shoes with removable insoles so they fit [11]. ## When to see a podiatrist See a podiatrist if shoes rub or leave redness, a foot problem isn't improving, or you're unsure what suits your feet. If you have diabetes at moderate or high risk of a foot ulcer, or rheumatoid arthritis with foot deformity, ask about footwear suited to your feet. With diabetes, reduced feeling means your feet may not warn you of problems, so daily foot checks matter [9]. Footwear advice should never delay getting help. See your GP or a podiatrist the same day if: - you have diabetes and notice a wound, sore, blister, colour change, redness, swelling or a hot foot [9]; - redness, heat, swelling or pus is spreading in your foot [16]; - you can't put weight on your foot after an injury [16]; - you have sudden severe pain or numbness in a leg or foot. For urgent advice when it isn't an emergency, call healthdirect on 1800 022 222 (24 hours a day), or go to a Medicare Urgent Care Clinic. Go to the nearest emergency department if you have diabetes and a foot infection that's spreading fast, with a fever and feeling very unwell [9]. See your GP soon if you have foot pain that is severe and isn't easing, pain at night that stops you sleeping, or a fever or weight loss alongside foot pain [16]. ## Common questions ### Are slip-on shoes or court shoes bad for my feet? They're fine for short periods, but not for most of the day. Slip-on and court shoes often don't fit well and give little support, and slip-ons can be held on by curling the toes, which can damage the toes or cause corns and callus. Shoes you wear most of the day should fit properly and be supportive. ### When should I replace my shoes? Check your soles regularly. Replace shoes when they show wear and tear that can't be repaired, such as worn, cracked or loose soles, which can reduce grip and raise the risk of a fall or injury. Go by the condition of the shoe rather than a set time. ### Are high heels harmful? Very high heels and pointed toe boxes can cause problems. A pointed toe box squashes the toes together and can change the shape of bones or joints, and a heel that's too high pushes your foot forward and crushes the toes. A rounded toe box with room for your toes is a better choice for everyday wear. ### Do insoles or orthoses replace good shoes? No. Insoles and shoes work together, so the shoes still need to fit well. If you're given insoles, choose shoes with removable insoles so there's room for them, and take the insoles with you to try in the shoes before you buy. Your podiatrist can show you how to use them. ## Further reading - [Footwear advice on Clindice](https://clindice.com/footwear-advice) - [Footwear advice](https://www.oxfordhealth.nhs.uk/wp-content/uploads/sites/47/2024/02/Podiatry-Footwear-advice.pdf), NHS - [The role of a podiatrist](https://www.healthdirect.gov.au/podiatrist), healthdirect - [Purchasing off-the-shelf orthotic aids and how to manage common foot pains :: Dorset HealthCare University NHS Foundation Trust](https://www.dorsethealthcare.nhs.uk/our-services-and-sites/physical-health/orthotics-insoles-braces-and-supports/purchasing-shelf-orthotic-aids-and-how-manage-common-foot-pains), NHS ## Sources 1. Footwear advice - NHS Lanarkshire · NHS Lanarkshire · 2020. https://www.nhslanarkshire.scot.nhs.uk/services/podiatry/footwear-advice/ 2. Footwear advice · NHS. https://www.oxfordhealth.nhs.uk/wp-content/uploads/sites/47/2024/02/Podiatry-Footwear-advice.pdf 3. Guide to buying footwear - information for patients | Right Decisions · NHS. https://www.rightdecisions.scot.nhs.uk/patient-information-leaflets/primary-community-services/podiatry-orthotics/guide-to-buying-footwear-information-for-patients/ 4. Guidelines on the prevention of foot ulcers in persons with diabetes (IWGDF 2023 update) · Bus SA, Sacco ICN, Monteiro-Soares M et al. · Diabetes/metabolism Research and Reviews · 2024. https://doi.org/10.1002/dmrr.3651 5. Australian guideline on prevention of foot ulceration: part of the 2021 Australian evidence-based guidelines for diabetes-related foot disease · Kaminski MR, Golledge J, Lasschuit JWJ et al. · Journal of Foot and Ankle Research · 2022. https://doi.org/10.1186/s13047-022-00534-7 6. A clinical practice guideline for the management of the foot and ankle in rheumatoid arthritis · Ramos-Petersen L, Reinoso-Cobo A, Ortega-Avila AB et al. · Rheumatology International · 2024. https://doi.org/10.1007/s00296-024-05633-1 7. Footwear | Podiatry And Orthotics · NHS. https://www.sussexcommunity.nhs.uk/patients-and-visitors/resources/patient-resources/footwear-advice 8. The art and science of fitting shoes · Janisse DJ · Foot & Ankle · 1992. https://doi.org/10.1177/107110079201300505 9. Diabetes and High Risk Foot Service · NHS. https://www.nhft.nhs.uk/foot-service/crc32/ 10. Footwear · Oxfordshire Podiatry. https://oxfordhealth.nhs.uk/podiatry/foot-health/footwear/ 11. Guide to buying footwear · NHS. https://royalwolverhampton.nhs.uk/wp-content/uploads/2025/06/Guide_to_buying_footwear.pdf 12. Footwear comfort: a systematic search and narrative synthesis of the literature · Menz HB, Bonanno DR · Journal of Foot and Ankle Research · 2021. https://doi.org/10.1186/s13047-021-00500-9 13. Effectiveness of offloading interventions for people with diabetes-related foot ulcers: A systematic review and meta-analysis · Lazzarini PA, Armstrong DG, Crews RT et al. · Diabetes/metabolism Research and Reviews · 2024. https://doi.org/10.1002/dmrr.3650 14. Basic Low-cost Removable Footwear for Diabetic Foot Ulcer Offloading: A Systematic Review · Sood S, Geng R, Mufti A et al. · Advances in Skin & Wound Care · 2026. https://doi.org/10.1097/asw.0000000000000385 15. Efficacy of foot orthoses for the treatment of plantar heel pain: a systematic review and meta-analysis · Rasenberg N, Riel H, Rathleff MS et al. · British Journal of Sports Medicine · 2018. https://doi.org/10.1136/bjsports-2017-097892 16. Foot and Heel Problems - South & West · South & West. https://southwest.devonformularyguidance.nhs.uk/referral-guidance/western-locality/musculoskeletal/foot-and-heel-problems --- This page is general information, not a diagnosis or a treatment plan for you. For advice about your own feet or legs, see a podiatrist or your doctor. In an emergency, call 000.