“MS has many faces, and it affects people in very different ways,” says Glenn B. Pfeffer, MD, the director of the foot and ankle surgery program at Cedars-Sinai Orthopaedics in Los Angeles. “There are as many different shoes for people with MS as there are variations of MS.” The three biggest concerns related to footwear for MS are sensory issues, balance issues, and motor weakness, Dr. Pfeffer says. “How one is most affected in any of those areas will affect the shoes,” he says. Here are eight rules to keep in mind when you’re shopping for the best shoes for MS. RELATED: How to Keep Walking With MS-Related Foot Drop “I think comfort has to be paramount, even above fashion," he explains. “If someone is not comfortable in their shoes, they’re going to be miserable. The shoe has to fit not only the foot, but also the person and their needs, depending on their MS.” Look for styles you like, but “find shoes that fit comfortably right away,” Pfeffer advises. “Don’t assume that you can break them in and they’ll be comfortable after you’ve worn them a few times.”
2. Select a Tread That Looks Like a Tire
The tread — the pattern on the bottom of the shoes — is an important footwear feature to consider to help you avoid falls, particularly if you have trouble with balance. The tread should look somewhat like a tire, Pfeffer says, with some cushioning and some corrugation that can help prevent slipping and skidding. To prevent falls, wear shoes with firm, slip-resistant soles (such as rubber) both inside and outside your home. Avoid smooth, slippery leather soles and overly soft soles on slippers.
3. Select Thin or Thick Soles Depending on Your Needs
Thick soles or thin soles? It depends on your MS symptoms and your particular needs. Someone with MS-related balance, walking, and mobility issues may want a thicker-soled shoe that offers more stability. But thinner soles can be more beneficial for others. “If someone is having sensory loss, they often complain of not being able to feel the ground well,” Pfeffer says. “They may want to have a thinner-soled shoe so they can have a better sense of feedback.”
4. Check Shoes’ Weight and Flexibility
When looking for the best footwear for you, consider the weight and flexibility of the shoe. If you have muscle weakness and have trouble walking in big, heavy footwear, a shoe made of lightweight materials is the best bet. In a qualitative study published in Clinical Rehabilitation in April 2018, people with MS who had recently fallen cited clumsy, heavy, or nonfunctional shoes as a fall risk factor. Someone with stability issues, on the other hand, may benefit from a heavier, sturdier shoe with not too much flexibility. This helps provide a bit more balance to help reduce the risk of falls, Pfeffer says.
5. Skip High Heels and Backless Styles
Another important footwear feature to look for is the right heel height. Don’t wear anything with a heel higher than two inches, Pfeffer says, or your feet will hurt and you may have trouble walking. Also avoid any shoes that are backless, such as mules or slip-ons, which can slip off your heel. Flip-flops are a definite no-no. “All those shoes need a good sense of sensory feedback and toe strength to stay on,” Pfeffer says. “They become a danger because they can just fly off, and they add very little support.” RELATED: When Multiple Sclerosis Causes Skin Symptoms
6. Opt for Easy Fasteners or Elastic Laces
Shoes with laces are best if you’re able to tie your shoes easily. But if you can’t, try a style with Velcro fasteners or, if you like the laced-up look, a pair of elastic laces, suggests Kathy Zackowski, PhD, the senior director of patient management, care, and rehabilitation research at the National Multiple Sclerosis Society (NMSS). Shoe stores, drugstores, and sporting goods stores are all good places to look for a variety of types of elastic laces.
7. Test Out the Shank to See What Works for You
The shank is a flat piece of metal, fiberglass, or plastic in the sole of the shoe. It’s located under the arch of the foot and gives the shoe stability and structure. For many people with MS, a stiff shank — which reduces the flexibility of the shoe — can be a problem. “Walking in a stiff shoe is much harder,” says Dr. Zackowski, but others feel more comfortable in a stiff shoe. Try on shoes of varying flexibility to see what feels best on your foot.
8. Try on Shoes at the End of the Day
The right-size shoe is especially important if you have MS. “If your shoe doesn’t fit well, you have to use a lot more energy to keep the shoe on your foot,” Zackowski says. To get a good fit, Pfeffer suggests shoe shopping at the end of the day, when your feet tend to be swollen, and finding a shoe that is a half-inch longer than your longest toe when you’re standing up. When trying on shoes, wear the same type of sock you plan on wearing with the shoes. Walk around the store in the shoes for several minutes. If your toes touch the front of the shoe when you stand or walk, try a half-size larger. If your heel slides up and down in the shoe when you walk, try a half-size smaller.
