by Carl R. Littmann, originally written 8-18-2004; revised, simplified and expanded after that, and also to discuss heel pain. Last rev. 4-2013

Problem and Digest:
Click for ‘Sketch for a type of shoe repair’; but also see ‘Cautions’ in the below main text of this article, before deciding whether to attempt repair.  Similarly, reader may click ‘foot-Stretches for Plantar Fasciitis’ heal pain; and ‘Heel-cup & arch support--one type’; but also note cautions adjacent sketches and in main text. 

Overview:
Some expensive athletic ‘sneakers’ and non-athletic shoes have many fine features; but they develop problems with wear, or even have certain problems when new.

Sometimes shoes do not provide long service for some individuals who have, historically, tended to wear-down shoe soles very unevenly; or just the heel-sole region much faster than region near the toes.  Sometimes, even rather new shoes, without noticeable wear, seem to capsize to one side, like an unevenly loaded ship or a material that is too fatigued to be as supportive.  In that case, even persons of the same weight, but who transfer their weight differently, may find that the shoes work for only one person, or perhaps neither. 

But the sad result of either above problem is that a person’s ligaments likely stretch in inappropriate ways; and pain arises and often escalates!  With much experience, testing and study; many people could probably make drawings of where the pain is in their foot, knee, or leg versus the likely specific worn regions of their shoes causing it.  And/or, perhaps, other causes.  And determine whether screwing #10, #8, #6 and/or #4 sheet metal screws into the shoe heel or sole would restore some spacings and firmness.  And if that helps, for how long?  And/or determine if it would help by applying several layers of white adhesive tape to the ‘removable shoe Pads’ (provided inside most new shoes by most manufacturers).  And if so, how much tape, how many strips, where, and the details? 

But especially for complicated cases; I strongly recommend readers get the expert advice of good doctors, podiatrists, and specialists in custom shoe making and significant alterations.  Podiatrists might recommend and prescribe custom-made special ‘orthotics’, for example.  One complication these days seems to me -- that some shoes manufacturers build in their own single ‘version’ of ‘orthotics’ effect into their shoes -- which may ‘clash’ with a Podiatrist’s custom made prescription.  I suppose that is like a computer operator using too many similar anti-virus vendors to protect their one computer; and they clash in hopeless confusion.  

Repair Details and cautions:  Click for Sketch

I now outline a general guide that I have used to extend the useful life of many of my shoes.  It likely has to be varied depending on unique problems, and in some cases will not work at all!  Note all precautions already mention above, and also those after my ‘General Guide’ section. 

General Guide for Repairs: 
Generally, after I have used my shoes a month or more; my foot, knee or leg begin to feel less comfortable, maybe even with some strain or pain.  I take my shoes off and notice where the shoe sole may be getting worn down.  And where the internal cushion pad (a hopefully removable one provided in the new shoe by the manufacturer) may be getting ‘fatigued’ or less supportive.

I might attempt to fasten #6, #8, or #10 sheet metal screws into the heel, say near the perimeter of the heel (in a ‘reverse horseshoe-like pattern) that contacts the ground. Sometimes their heads’ thickness partially compensates for the worn-off material.  If the soles are made of relatively soft rubber, those screws may have to be 3/4 inch long, minimum, to remain in securely.  Of course, make sure there is at least that much thickness rubber material for safety and to avoid getting one’s foot ‘stabbed’.  And I would be reluctant to use less than 1/2 inch long screws even in soles made of tougher rubber. 

((Sometimes it may be helpful to carefully use an ice-pick to start a ‘pilot’ hole in the shoe (of course with foot removed from shoe) and to mark the hole’s location with a pen -- before attempting to screw in the screws.  Occasionally, Elmer’s glue, ‘Stix-all’ or ‘Stix-on’ glues might also help keep screws in place, especially if the hole’s integrity is compromised.))  Note, in the shoe-sole regions far away from the heel, such as near the ‘ball of the foot’, that sole material may be very thin, so that typically a size #4 by 3/8 inch long screw length or less might have to be used there, to keep the foot from being stabbed – see later in the article. The extra spacing resulting from the thickness of screw-heads can be increased even more, if needed, by adding flat washers below screw-heads.  Or still more by adding strips of adhesive tape over the screw-heads and nearby regions, but that option may impede appearance and often require replacement. 

On the shoe’s internal pad (usually on its upper surface); strips of healthcare style ‘adhesive tape’ can be applied to also ‘build up spacings’ and support.  Near the region of the pad where the ball of the foot rests, that tape might be added, perhaps to the lower surface, as well as the upper surface of the pad.  I have occasionally even used a patterned cut or configured thin (magnetic) rubber strip, by affixing its adhesive side to the pad’s lower surface to build up the heel spacing. Usually, in that case, I first cut it in a ‘horseshoe-shaped’ pattern, and then apply it near the heel region near the pad’s perimeter.  Cases vary and approaches vary.

Usually, if knee or leg discomfort is toward the inner side or back; that corresponding side or back part of the shoe is worn down or fatigued; and restoring the spacings or stiffness in that shoe’s region might be helpful.  Sometimes, however, if the outer part of one’s heel becomes uncomfortable; increasing the spacing and support on the opposite side – near where the inward side of the heel bone & arch of foot meet – improves the comfort.  (That is also often near the most elevated part of ‘orthotics’ support, and often effective at supporting ‘fallen arches’ -- to use the ‘slang’.  The integrity of the ‘Plantar’ ligament in one’s foot is highly involved in keeping the arch of one’s foot ideal; and, in turn, that is helpful in keeping the pressures against the various bottom regions of one’s foot ideally distributed and reasonably comfortable.)  Even increasing support of firmness under the ‘ball of the foot’ may sometimes relieve discomfort on the outer side of one’s heel.

Similarly, if pain occurs at on the bottom of the foot just before where the middle toe begins; a few strips of adhesive tape applied to the cushion pad at the ‘ball of the foot’ region may bring relief.  (It increases support there; and thereby relieves some of the pressure an inch or two beside it, by restoring a more even balance.)

Also, for some people, certain pains along the top of the foot may indicated that substantial additional ‘stiffness’ below the ‘ball of the foot’ must be provided.  And that may require a small screw (typically a #4 sheet metal screw only 1/4 to 3/8 long) be screwed into the bottom surface of the shoe-sole, where the shoe contacts the ground, i.e., located below the ‘ball of the foot’.  Of course, make sure the screw’s length and point is not so long as to puncture the ball of ones foot.

Incidentally, when prescribed orthotics are used; the podiatrist will likely advise that the original pads in shoes (the, hopefully, ‘removable ones that were provided in the new shoe) be first removed and not used; because then the prescribed orthotics will provides the arch support and other aid, and thus potential conflict is avoided. 

Sometimes, while waiting for new shoes or new orthotics; one can achieve temporary comfort by inserting a ‘pad’ of “4 or 5 sheets (segments) of 4”x4” soft toilet tissues” on the pad of the shoe, and let them extend from the back of the shoe to near the peak of the arch of the foot.  And replacing that pad each day.  And/or, for part of the day, replacing the pad of the shoe with a rather standard (‘generic’) ‘heel-pad--arch support’, as sold in most drugstores & supermarkets, and which are remarkably inexpensive, i.e., about $10-$20 at this writing -- 2010.  (I.e., compared to expensive ‘made-to-order’ orthotics.)

Cautions:
If any repairs are attempted, one should be experienced at using tools and hardware.  One should be circumspect in one’s approach; and approach the repair with a somewhat empirical attitude; be careful, and ‘take your time.’

Before considering the repair successful; make sure the shoes do not tend to skid (unsafely).  And that any fine floors, that one might use those shoes on, are not scratched by the shoes.  One should inspect the repair every day to make sure the screws are not becoming loose; and that any strips of adhesive tape or affixed strips are not ‘creeping’ away too far from there original location.  If those above parts hold in place reliably; perhaps inspecting every other day is OK.

One should not, even at best, expect the repairs I have outlined to extend the shoe-life extremely long.  When further repairs only result in a very short time of further use before discomfort arises again, and further repairs are again needed; that is a sign that one definitely needs new shoes. 
Note, one proceeds at their own risk, if one decides to repair, and uses my suggestions.  (I.e., even with my cautions, etc... -- I can only talk about what seems to have work well for me.)

OPTIONAL, (Can be skipped) Miscellaneous Comments and Opinions:
What have so many shoe manufacturers been doing, and for so long?  (Somewhat similarly for most clothes manufactures who seem to have forgotten the purpose that the particular garment is supposed to serve!)  There is a general ‘natural’ shape of the foot, and I wish most shoe manufacturers would stop trying to avoid fitting that natural shape!  (That is the sad impression I get, at least.)  For example, the toes of the natural foot do not point inwardly toward a point, nor does the foot naturally conform to ‘high heels’; and I don’t think shoes should force feet to do so.  Although not as damaging as the old discredited Chinese practice of ‘foot binding’; I think that many shoes sold for the last 50 years have been damaging; and that future pain, limitations, and sometimes the need for corrective surgery or other medical protocols have resulted. 

For a long time, cigarettes manufacturers have been required to provide a warning label on their products.  And I think for many shoes styles; the maker should also provide one.  It might state: “Caution, this shoe may be fashionable, but its fit or traits may be adverse your foot’s health!”  Or “Caution, this is principally a ‘running shoe’, or ‘long-walking activity’ shoe, but for other time-consuming activities, other designs may also be appropriate.” And that type of ‘directive’ should have been added long ago.  (Also, socks that elastically squeeze the skin near the ‘calf’ are rather common.  But I think that may lead to more future vein and circulatory problems than otherwise, especially if the squeeze tends to leaves an ‘impregnation’ on the skin.)

I recall that some shoe repair tradesmen, 30 to 60 years ago, sometimes installed so-called ‘cleats’, i.e., a flat metal strip near the back of the shoe heel where it contacts the floor or ground.  That was not uncommon in those old days.  That may have accomplished some of what I have suggested in this article, although I have no personal experience with those old ‘cleats’. 

If a person is more comfortable standing with only their socks on - than with their new shoes on; that is a likely bad sign about the design of the new shoes.  And similarly, when walking. (And I’m not just talking about the refreshing feel of being ‘barefoot’ that most people naturally experience.)  Apparently and fortunately, some innovative foreign shoe designs have been introduced to supplement designs that have been popular in the Americas for the last sixty years.  The new concept seems to involve the sole associated with the heel bone area, and the design avoids having the center of one’s heel bone absorb the total weight or impact when standing, walking, or turning/twisting.  And the design actually requires less material, and emphasizes the perimeter of the heel to provide a stabilizing effect against rocking motions. 

When a person has two different types of shoes, both good makes; I think that the wearer should occasionally alternate between those different types, say, every few days or weeks, etc.  That is probably because it is good for most people’s feet to occasionally encounter slight variations in exposure, especially when slowly breaking-in new shoes.  A seemingly astute salesperson once advised me not to wear exclusively thick-soled athletic shoes.  It is likely, that the particular pressures that my foot exerts on flat ground deviates from the ideal or typical. Then, thick, somewhat spongy soles and cushion might just invite further non-balancing action, ligament extension or twist.  (So maybe that person’s suggestion was right for me, at least.) 

Incidentally, be very careful walking on smooth floors while wearing only socks, especially those socks with a significant polyether content. And be even more careful going down stairs.  One can slip and incur bad injury, even on non-waxed floor, and especially on waxed floors or the like, that are even more slippery!  (Even regardless of whether one is wearing shoes or not; it is a very good safety habit to keep one hand on the handrail provided with most staircases, or hopefully, even where there are only a few stair-steps.)

Optional--Closing Remarks:
I never cease to be amazed at how the slightest exceeding of very narrow body tolerances can cause great problems. And, yet, when a very able and perceptive doctor does catch subtle, but serious variances, and his/her advice is good, and obeyed -- great relief is often obtained.

I have seen cases where two slightly different sets of orthotics were made; and one gave just a little more support than the other did.  The visual difference was not noticeable to me, at least until the Podiatrist pointed it out.  And the one, with slightly less orthotics support, just did not do the job, but the one with slightly greater support (in a key place) did!  Similarly, I have found the ‘horseshoe-like’ indentation (depression) on the heel of orthotics very helpful for me, i.e., the subtlety made a great difference!  (Some heel-cup designs seem to appreciate that concept too.)

I have often seen even the slightest change in a previously satisfactory engineered product and other products lead to great improvement, or rendering the product almost totally useless – usually the sad latter!  So it is no surprise that the saying arose: “Never Assume…etc.”  (Or at least re-test, if at all possible, even after making seemingly inconsequential changes.)

And, by the way, what is it with most pajama designers?  I don’t need pajamas bottoms with one to five pockets, nor pajama tops with more than one pocket, i.e., I don’t sleep with ‘tools’ and big things in my pockets and don’t need the disruptive transitions and problems of many attached pockets.  What I would like, instead, is very loose, very light weight, very stretchable knit cotton (long legged) pajama pants.  With long sleeve shirt of similar material and ‘buttonable’ in front.  That is so I don’t dream that I’m too hot and can’t quickly remove my hot shirt -- and wake up and discover that, indeed, I can’t shed it promptly and I am too hot!

Speaking of loose-fitting, it greatly facilitates easy & effective breathing and sleeping for pajama bottoms to have the waist very loose.  And for some people - not even fastened at all!  For some people, who sleep on their side; it helps to put a supportive pad (such as new squashed toilet tissue roll) between their hip and mattress to relieve some excess weight, pressure, and movement-loss in the regions near one’s lower side ribs and toward one’s front, i.e., those regions that must expand & contract with breathing.  (The whole subject of where to put other supportive pads for a comfortable sleep would require a separate article, although most people are already familiar with positioning a spare pillow or pad between one’s knees -- as often used by people who sleep on their sides.) 

In my case, I find that my leg connective tissues do not fare well on some treadmills that utilize moving ‘belts’ to walk on.  And even less well, in my case, if the belt is slanted upward.  I do better when walking indoors on a stationary rug, or walking outdoors, if feasible.  A non-trivial amount of walking is very important to many people’s health.  So I am happy that there are still some good shoes manufactured and available.  And good ‘heel-cups’, tapes, and hardware.  And that good custom-designed and custom-made orthotics can be wisely designed, prescribed, and made, by quite a few good professional Podiatrists. 

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