Indians traditionally used to walk around barefoot but these days everyone wears shoes. It is good because we now walk on hard surfaces, not on grass or mud. Our feet have not evolved for this. Their natural cushioning is not sufficient. Our roads are tarred or cemented and our floors made of concrete, granite, marble or tiles. Standing and walking barefoot on hard surfaces even in the house is not a good idea. It can lead to pain in the heels, ankles and the balls of the feet.

What we choose to wear on our feet is very important. While the Hawaii chappal or flip-flop is very popular, it is ideal only for use on sandy beaches, not for everyday wear. Children wear black shoes as part of their uniform. Many of these are made of faux leather or hard plastic. This can change the child’s gait.

Children’s feet grow fast, so fast that shoes may have to be bought every six months. Buying expensive shoes so often is a financial burden so parents may buy shoes that are too large or not replace them soon enough. The foot floats around in large shoes and there is no grip or stability. In small shoes, the bones of the growing feet of a child can get crowded, causing pain, change in gait and permanent foot deformities.

Fashionable shoes for both men and women may have pointed toes. They can squeeze the entire front of your foot, leading to callouses and bunions. The bones and nerves become squeezed together causing severe pain and blisters. The shape of the foot can change.

If you wear heels, especially more than two inches, it can shift your centre of gravity forwards, leading to a constant backache. The unnatural position of the foot can cause a painful bump on the back of the heel. The ankle becomes unstable and can lead to sprains or fractures.

Keep these things in mind when shopping for shoes:

• Footwear should be made of natural materials such as leather, canvas or cloth.
• They should not be rigid or unyielding.
• Buy shoes in the evening as feet tend swell at the end of the day. (It may be a size bigger).
• If you are planning on wearing socks, try on the shoe with socks.
• Many people have feet of slightly different sizes. Therefore try out shoes on both feet and walk a few steps. If either foot is uncomfortable, do not buy the shoes. Salesmen will tell you that the shoe will “loosen out”. It will not.
• If the toes are pointy, make sure your foot ends before the shoe narrows. Wiggle your toes to make sure there is enough room.

The writer is a paediatrician with a family practice at Vellore and the author of Staying Healthy in Modern India. If you have any questions on health issues, please write to yourhealthgm@yahoo.co.in