Footwear

L-W-O recommends you visit a Foot Health Practitioner, Chiropodist or Podiatrist on a regular basis.

I cannot begin to describe the anguish our members face when buying footwear. Those that have lymphoedema in their lower limbs, have swollen feet. Imagine the difficulty of finding the right footwear when you wear compression. Feet need support, they need comfort, and our support group members want to feel good. This is a challenge that should not be underestimated. Sadly, for those with lower limb lymphoedema fashionable shoes, shoes with heels, are often something they can only dream about.

I wish manufactures would listen and realise that we are not all the same, each foot is likely to be a different size and as we know shoes are sold in pairs. There is no consideration from manufacturers that feet could be so different. Standard width shoes, wide or even extra wide shoes may not fit someone who has swollen feet or wears compression. It is possible to buy single odd size shoes, but these often come at a hefty premium. You may be able to get a referral on the NHS to be referred to Orthotics for specially made shoes, speak to your GP, Physio, Podiatrist or Lymphoedema Clinic for advice.

Our members find that boots are a particular problem with ankle and calf sizes not being big enough for swollen legs. Some of our members will wear the largest pair of wellies they can find; this does not make for easy walking.

Buying Footwear

Regularly have your feet measured

When shopping for shoes most people will be drawn to the style or the colour but for someone living with a swollen feet/foot your biggest concerns will be 'Will it fit' and 'Will it be comfortable'.

The list below is intended to be a guide so please take sensible precautions.

When buying shoes for lower limb lymphoedema L-W-O Community suggests that you shop for shoes when your feet are swollen. The reasoning behind this is that you will not be trying to cram swollen feet into shoes that are not big enough. If you wear compression on your lower limbs, please do so when buying shoes or alternatively wear the same type of sock or stocking that you would normally wear.

You should always wear footwear both indoors and outdoors to prevent infection
Lower limb lymphoedema - wear well-fitting footwear for support and protection for everyday use
Do not walk around barefoot in case you step on something or stub your toe
Do not walk around barefoot as you are more likely to pick up a fungal infection
New shoes - break in before wearing for a special occasion
Shop for shoes when your feet are swollen
Feet are likely to be swollen late afternoon or the evening so this might be the best time to buy shoes
Shoes, sandals, boots should not leave indentations
Check the lining to see if it is smooth with nothing sharp or lumpy
Check out fasteners, laces can you reach them?
Velcro fasteners allow for when your feet swell or when the swelling decreases
Will you need strap extensions?
Make sure when buying shoes, you wear your compression on your lower limbs to make sure the fit is right
Be careful with heels. Can you walk in them? Nobody is saying you shouldn't wear heels; the choice is yours
Check insoles, make sure they are firmly in place
Cushioned insoles might be something you want to invest in
Especially in summer make sure your footwear allows your feet to breathe
Blisters can cause cellulitis

Breaking in New Shoes

L-W-O Community always recommends that when you buy new shoes before an event, allow yourself time to break them in. There is nothing worse than going out in a pair of shoes for a full day that you haven't had time to get used to. How many times do we buy shoes for a special occasion and by the end of the day come home with aching legs, sore feet, and blisters?

Cautionary tale

Someone I know went to a wedding, wearing new shoes for the first time. This person did not have lymphoedema but did develop blisters that turned to Cellulitis. Weeks of antibiotics, hospital visits followed and quite a long recovery time.

Break in new shoes

wear for around 30 minutes a day
increase time over next 7 -10 days
check for redness or swelling
check for signs of infection

All this can be done in the comfort of your own home, you are not likely to damage the shoes before that special occasion and you save yourself a lot of misery.

Damaged Feet

We should all take good care of our feet

Foot Hygiene is part of selfcare and skincare

Skincare will help prevent damaged feet.

You should check regularly for blisters, breaks in the skin and fungal infections.

Shoes that are too tight may lead to blisters that may lead to can cellulitis.

Made to Measure

Finding information on Orthotics has been patchy. This type of footwear is expensive but it is possible to get a referral on the NHS so speak to your GP, Physio, Podiatrist, or Lymphoedema Clinic for advice

There is a very good fact sheet from Oxford University Hospitals answering frequently asked questions.

Footwear falls into the following Orthotic Provision:

Custom Made/Modular footwear
Shoes raises and adaptations
Insoles
Fabric Supports

Boots

This can be a real problem if you love wearing boots, the real problem hear is not just swollen ankles but swollen calf swelling. Thankfully this is one were boots are changing with one online retailer adding a different range of calf sizes as follows:

standard calf extra wide fit
standard calf wide fit
super curvy calf wide fit
extra curvy plus wide fit
super curvy plus calf extra wide fit
curvy plus calf wide fit

Flip Flops

This is where I get into a lot of trouble from our members

I frequently advise our members about wearing flip flops. I've lost count of how many times I've been told, "I don't know what I'm talking about" or, "I'll still wear mine." Have you ever considered the complications that wearing flip-flops may cause for someone living with lymphoedema?

All I can do is give you the facts that are out there and suggest you do your own research so in brief flip-flops offer:

Little or no heel and arch support
Prone to injuries - if you stub your toe, twist your ankle, or may cause curled toes
Stress fractures or Plantar Fasciitis
Changes in the way you walk leading to back pain, hip and knee pain
Cause blistering between the toes, if the blister bursts you have open wound that will allow bacteria and infection to get in, this could lead to cellulitis
You are walking in the dirt, because of the thin sole, therefore, any break in the skin allows for infection
The skin will dry out quicker leaving it cracked and your feet more vulnerable to infection
Open to the sun so risk of sun burn

You can apply sunscreen to the top of your feet but do not apply to the bottom as it will make walking slippery making it hard to keep your footwear on.

VAT FREE

In the UK VAT on shoes is currently 20% but in certain circumstances you can get the VAT removed and several online footwear retailers have made this easier to do by adding ticking a box at checkout. On the high street ask if they will remove VAT.

Cosy Feet have a very good explanation sheet on VAT relief. There is also a helpful fact sheet on the Cosy Feet website that shows the conditions covered by VAT exemption and an explanation on each condition.

Links to Further Reading

Shoe Measuring Guide