If you have swollen feet finding comfortably fitting footwear can be problematic and buying shoes can end up becoming an ordeal. Many retailers offer mail order or online ordering, enabling you to try on footwear in the comfort of your own home, which can help to avoid some of the embarrassment of having to expose swollen feet in public.

Several important factors should be considered when choosing footwear, which should be safe as well as comfortable. It is important that your footwear does not aggravate or cause further problems for your lymphoedema. The following are some things to be aware of before you begin looking for and choosing footwear.

Considerations when choosing footwear

• Good fitting, supportive footwear can help in the management of lymphoedema. Footwear which helps you to walk with a good “heel-toe” action, enables the calf muscle to pump more effectively and improves lymphatic drainage. The opposite is true of poorly fitting, non-supportive footwear, which can compromise lymphatic drainage and cause lymphoedema to worsen.
• To maintain the shape of the foot and ensure the intricate bones of the foot and ankle are kept in alignment, supportive footwear is essential. Ill-fitting shoes offering no support, such as court shoes, flip flops or mules, can cause the foot to become misshapen, and can be dangerous when walking.
• Poorly fitting shoes, which cut into the delicate tissues of the foot, shoes which leave the feet exposed, particularly in winter, or shoes with seams, can all result in skin breaks, blisters, sores or chilblains, and can lead to possible infection.

Preventing complications associated with lymphoedema is especially important when choosing footwear.

Tips when buying footwear

• Many mail order and online retailers offer a wide choice of good shoes, some in modern styles, and usually with a range of options for wider feet. This reduces the need to visit the shoe shop (included at end of this post is a list of retailers with website addresses).
• Shoes which fasten securely are a better and safer option than those which slip on and off. Adjustable fastenings can be helpful if the size of your feet changes. Try looking for shoes with easy-to-manage fastenings, such as laces and those which open down towards the toes, which can be easier to put on. If getting down to do up laces is difficult for you, Velcro, hook and loop, or touch fastenings may be better. Or try shoes with elastic laces which slip on and off easily without the need to bend down to do up or untie laces.
• Look out for extension straps which are available from many shoe retailers, allowing flexibility in fit.
• A long-handled shoehorn is also a good investment, making it easier to put on and take off shoes.
• High heels cause instability and should be avoided. Flat or low-heeled shoes are a safer option, and soles with a good grip, which also allow cushioning, will add to the comfort of the shoe.
• Softer, stretchy man-made fabrics can allow for fluctuations in foot size, but leather may be harder wearing and is breathable.
• For foot measuring or trying on shoes, consider the best time of day: your feet are likely to be less swollen early in the morning than later in the day. The middle of the day may be the best time for shoe fitting. Always wear your compression garment as this will maintain the size and shape of your foot.
• If your feet are different sizes, or you have swelling in just one foot or leg, some outlets do sell odd sized shoes, and although there will probably be an extra charge for this service, it should still work out cheaper than buying two pairs of different sized shoes.
• For different sized feet, or for fluctuations in size, shoes with multiple innersoles are available from some retailers. One or more innersole(s) can be removed to accommodate the larger foot size (the list of retailers at the end of this post includes details of those offering innersoles)
• Alternatively, to accommodate different sized feet, or to avoid buying shoes which do not fit well and end up not being worn, made to measure footwear could be considered.
• Slippers should be chosen carefully, as those which offer little support to the foot can be dangerous to wear around the home, especially if you have stairs or steps to negotiate. Instead look for a good supportive slipper, or maybe consider having a second pair of comfortable shoes to wear indoors.

Socks for swollen feet

If you are wearing compression garments which completely cover your feet, you may not feel the need to wear socks as well. Socks or hosiery provide a barrier, helping to protect your feet against possible damage from your footwear, such as rubbing, chaffing or blistering. They also help to wick moisture away from the skin, preventing bacteria and sweat from transferring onto footwear.

If you wear socks as well as lymphoedema stockings, the following should be considered:

• Socks should fit well, and not cut in or cause constriction, which can impede circulation and worsen your lymphoedema.
• The top band on socks can be particularly problematic, so look out for socks with a wider, softer top-band.
• Some companies produce socks which are especially designed for swollen feet, with extra wide heels, increased depth over the instep and soft, non-restrictive tops, which may also be seam free.

Further recommendations for swollen feet

We suggest you see you GP or Health Care Professional for advice and possible onward referral if you need help with any of the following:

• Toenails should be manicured professionally to avoid skin breaks and the subsequent risk of infection. Nails left to grow too long will affect the comfort and fitting of footwear, and referral to a Chiropodist or Podiatrist is therefore essential if you have lymphoedema.
• You may be eligible for a referral to your local Appliance or Orthotics Department for made to measure footwear.
• Swollen painful feet can affect the way you walk, causing stress to your joints and problems with posture. If this is the case an Orthotist can advise you, possibly recommending special innersoles to help correct your posture and make walking more comfortable.

Please also remember: It is important to avoid anything which may worsen your lymphoedema or increase your risk of infection.

Suppliers

Clarks International (part of Clarks Shoes)
Provides an odd shoe scheme for its own brand products. Instead of having to buy two pairs, you can have one pair to fit both feet. There is a surcharge for this service, 25% for children and 50% for adults on top of the usual shoe price. It is recommended that both shoes should be tried on for suitability and advice taken from the staff before purchasing. For details contact your local Clarks branch. www.clarks.co.uk

Cosyfeet
Extra wide, deep footwear designed to fit swollen feet. If you have very swollen feet, Cosyfeet offer strap extensions on most of their touch-fastening styles. They lengthen the straps, giving you even more room.If you are chronically sick or disabled, you can claim VAT Relief on Cosyfeet footwear and products showing ‘without VAT’ prices.

www.cosyfeet.com

Duo Boots
Small company based in Somerset offering a choice of calf sizes in every style of knee high and over the knee boots; calf fittings range from a slim fitting 30cm through to a wide fit 50cm calf size and caters for foot sizes from a size EU 35 through to EU 43. They also stock shoes. www.duoboots.com

Reed shoes
Supplier of orthopaedic footwear to the NHS, but also available to the public. All footwear is supplied with 3 x 3mm inlays. 1 ^st trial fitting is free of charge and subsequent fittings may be charged for. Viromed specialist shoes Lymph shoe and sandals for swollen feet are also available. There is a list of stockists on their website. www.reedmedical.co.uk

Joya Shoes
Small swiss company producing comfortable shoes designed to help posture and support the natural walking process. Certain styles have with removable innersoles to increase depth and width of shoe. There are stockists across the UK. www.joyashoes.co.uk

ShoeMed
Award winning specialist retail shoe shop that provides personalised shoe fitting service. Stockist of wider fit shoes with removable footbeds and seam free interiors, including Joya shoes. www.shoemed.co.uk

Shuropody
Have an in-store team of experts including HCPC registered Podiatrists, qualified Foot health Practitioners and Foot Care Assistants. They work with several shoe companies and stock wider and orthotic ranges of shoes. www.shuropody.com

DB widerfit shoes
Specialist shoe retailer stocking wider, deeper shoes, plus orthotic ranges www.widerfitshoes.co.uk

Shoe Tailor & Ambrose Wilson
Extra wide shoes, available up to EEEEEE fitting, plus a helpful website. www.Ambrosewilson.com

About the author

Jeanne started her lymphoedema career in the early 1990s, setting up the lymphoedema clinic in Durham. She then moved into a specialist clinical role across South Durham, Teesside and North Yorkshire, and in 2013 set up the Lymphoedema Service based in Imperial Healthcare Trust at Charing Cross Hospital. Jeanne is now the Lymphoedema Nurse at St Teresa’s Hospice in Darlington, where her passion for education continues.