By Dr. Steven Gershman, DPM
Tennis shoes are generally another name for athletic shoes or sneakers, styles that can be worn for active use. Good tennis shoes have more functional features built in them than dress or casual shoes and are especially designed for active activities. Their purpose is allowing activity while protecting the feet from the forces that accompany the actions taken by the person. For the most part, a casual shoe will be made from leather but will lack extra motion control features, while an athletic shoe will have added features to control foot motion in all directions.
Diabetic tennis shoes (diabetic sneakers or diabetic athletic shoes) are specifically designed for the diabetic foot during activity. Why are they different than regular tennis shoes? The diabetic foot is different and requires extra protection.
Diabetic feet suffer commonly from lack of normal sensation which can lead to blisters or open wounds such as ulcers from constant rubbing which the person doesn't feel. Additionally, there is often poor circulation which can lead to more severe ulcers, infections and poor healing. Therefore, preventing wounds or ulcers is critical. Many diabetics suffer from dry skin due to nerve damage in the feet which makes the skin easier to break down. There can also be bony deformities such as bunions and hammertoes which are easy to irritate with poor shoes or shoes that aren’t wide enough.
What are the best diabetic sneakers?
The best tennis or athletic shoes for diabetics will accommodate any bony deformities and not irritate them. They should include the following features:
- Extra depth in the toe box area
- Multiple widths from medium all the way to extra extra wide
- Round shape toe box to allow unrestricted toe movement and a pressure free environment
- Soft uppers or stretch fabric uppers that conform to contours of the foot
- Seam free interior that doesn’t rub against the skin
- Foam padding of the shoe interior for added protection
- Biomechanically designed to fit the average foot based on the last (3-dimensional wooden or plastic mold upon which a shoe is constructed)
- Extra shoe depth to accommodate a well-made insole that cushions and contours the foot or if required, a custom orthotic
- Anatomical arch support
- Cushioned footbed to absorb shock forces
Many "regular" athletic shoes have narrow or poor depth toe boxes. They may look sleek but are dangerous to a diabetic. They lack proper room in the toe box to avoid rubbing on bunions which are bumps on the big toe side of the foot or on the little toe side. Lack of enough width in the toe box with these deformities in a diabetic can lead to open wounds over the bumps which are hard to heal and can become infected. Without enough height /depth in the toe box and toe deformities such as hammertoes, regular athletic shoes often rub on the toes, especially on the tops leading again to ulcers and infection. Also, if the shoes aren't wide enough there can be ulcers between the toes on the sides of the toes where they are squeezed together. These are often quite difficult to heal in diabetics.
The best tennis shoes for diabetic feet include all the features listed above and are built to control motion such as pronation which generally means rolling in and supination which means rolling out. Pronation in diabetics leads to increased motion in the foot causing bony deformities to develop or become more severe. Also, the foot tends to flatten and widen as it pronates. This can cause rubbing and irritation if the shoe isn't wide enough. Supination, if uncontrolled by the shoe, can lead to sprained ankles and calluses on the bottom of the feet which in diabetics can cause ulcers. Shoes with built-in orthotics, such as the ones developed by Orthofeet, offer optimal arch support, minimize excessive pronation and protect the diabetic foot during athletic activities.
The best diabetic athletic shoes will have a removable well-made insole that can reduce the risk of bottom of the foot calluses. Orthofeet shoes are designed especially for sensitive diabetic feet and approved under the Diabetic Shoe Bill. The orthotics that come inside the shoes are constructed with high grade foam that cushions the foot, absorbs shock forces and over time shapes to the contours of the foot for a comfortable fit. Moreover, the orthotics are removable and can accommodate more specific insoles, such as custom molded orthotics. Click here to view Orthofeet diabetic tennis shoes.
In general, the best shoe for diabetics or anyone is a shoe that is comfortable. Many studies have shown that most injuries occur when the shoe isn't comfortable. Try on the shoe and make sure it isn't rubbing anywhere, particularly the toes and front of the foot. You shouldn't see your foot bulging the toe box so that it is outside the outsole. If it is doing that it is either too narrow or a poor fit for you. You should have a thumbs worth of width from the end of the longest toe to the end of the shoe. It is best to try on the shoes later in the day when your feet are most swollen. If you have foot discrepancies and require two different sizes, always go with the larger foot. You can always insert spacers in the smaller foot to adjust the fit. You should be able to walk comfortably in your normal socks with the new shoes, so make sure to try them on with the socks you plan on wearing.
Replace your shoes often, at least once per year if you wear them regularly. Shoes stretch and warp over time allowing abnormal motion and forces on the foot which in a diabetic can be dangerous. When in doubt, REPLACE THEM. Better to throw away a shoe too soon then seeing your feet damaged. The best diabetic tennis shoes should enable you to stay active, but always check with your medical provider before you start a new exercise program. And of course, don’t forget to see your podiatrist for regular foot exams. A minimum of every 6 months is suggested.