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Footwear that is too big, too roomy or even too soft can be dangerous. JOAN CHEW finds out what elderly folk should and should not be wearing
 Do your shoes fit you exactly? Well, they should not. There should be one thumb width of space between the longest toe and the tip of the shoe.
Do not make the mistake of assuming the big toe is the longest either. Look carefully. There is a reason for the space, according to Ms Melissa Phua, a senior podiatrist at the Foot Care & Limb Design Centre at Tan Tock Seng Hospital (TTSH).
It is to reduce the chances of injury should the footwear hit a hard surface. This is particularly important for those who suffer from diabetes, as injuries to extremities can lead to graver consequences, such as gangrene.
Which also means that you should buy your own footwear, rather than let others buy them for you. It is not just a question of fit or avoiding blisters, to ensure that you do not, well, trip over your own feet.
More than half of the patients at Changi General Hospital’s (CGH) falls clinic are there because they were using footwear with an insufficient grip, said the hospital spokesman.
At National University Hospital (NUH), Dr Reshma Merchant, the head of general medicine and a geriatrician, said that 80 per cent of the patients at the hospital’s falls and balance clinic were using the wrong type or size of footwear.
It is not the footwear per se, Dr Lim Si Ching, a consultant at the department of geriatric medicine at Singapore General Hospital (SGH) stressed. But someone with multiple pre-existing risk factors such as poor vision and slower reaction times would do well to know the features of a good pair of shoes.
Mr Adriaan Erasmus, the principal podiatrist at NUH’s rehabilitation centre, said that shoes and sandals which are too big and loose are most certainly hazardous to the elderly who are more prone to falling when climbing up and down the stairs and when walking on uneven or wet terrain.
Yet, the elderly sometimes end up with footwear that does not fit them because the shoes may have been bought by family members without the elderly person being present.
Footwear that offers acupressure massage, which are popular among the elderly, are also not recommended by podiatrists.
These shoes have dozens of raised nodules in the insole. They claim to apply pressure to acupressure points on the soles of the feet and allegedly improve blood circulation. Podiatrists said that so far, there has been no scientific research to prove that they help to stimulate blood circulation.
Ms Phua said: “I will not encourage my patients to wear this type of footwear regardless of their age.” She explained that the elderly, who tend to have thinner skin, risk breaking their skin when they use these shoes.
Diabetics who have poor blood circulation may also be misled into believing that acupressure footwear is good for them.
Ms Phua said that some diabetics may have nerve disorders, such as diabetic neuropathies, and have lost the sensation in their feet and legs. Should the pressure from wearing such shoes hurt their feet, they will not be able to sense it.
Ms Jessie Phua, the principal podiatrist at Changi General Hospital, likened wearing these shoes to having a massage on the same spots constantly.
She has seen patients suffering from heel pain through the use of such footwear.
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