Shoes affect how you walk and your risk of falling more than you might expect. A shoe that looks good can actually be dangerous with Parkinson’s, so it is worth knowing a few criteria.
The sole should be somewhere in the middle
A sole should be neither too slippery nor too stuck to the floor. Slippery materials such as leather soles raise your risk of falling, while soles with too much grip, or thick heavily cushioned ones, catch your foot on the floor and actually make you trip. A thin rubber sole with a shallow tread is the balance point that prevents slipping and reduces catching. It is also worth knowing that thick, grippy soles in particular give the feeling of your foot catching on surfaces like carpet, which can become the trigger for the freezing of gait covered in When your feet freeze mid-step.
Check the heel, the back of the shoe and the toe box
A heel that is low and broad, 1 inch (2.5 cm) or less, is stable. Shoes with a firm heel counter that holds the back of your foot keep your ankle from wobbling, which helps your balance. The toe box should be roomy — you need that extra space for when your feet swell or your toes are hard to move. If your feet lean to one side or your posture is noticeably unsteady, custom orthotics, made to match your foot size and pressure distribution, may give your balance additional help.
Velcro is the easier fastener
Laces are a real nuisance to tie when your hands shake or fine finger movement is difficult. Switching to velcro or elastic laces makes putting shoes on and taking them off much easier. Slip-on styles with a velcro strap across the top of the foot are also a good choice.
Avoid bare feet and slippers indoors too
At home it is common to wear slippers because they are comfortable, or to walk around in just socks or barefoot — and this can actually be dangerous. Slippers come off your feet as you walk and are easy to trip over, and walking on wood or tile in socks alone or barefoot gives you no grip on the floor at all, so it is easy to slip. Indoors too, it is safer to wear non-slip socks or flat indoor shoes.
If you freeze often, laser shoes are worth knowing about
There are laser shoes and canes that project a laser line onto the floor to guide your steps. Some studies reported that freezing episodes fell by about 31% and falls and near-falls by 40% to 60%, but a more recent, larger study found no clear effect — so responses appear to differ from person to person. A practical first step is to talk with a physical therapist about alternatives such as the rhythmic cueing features on canes and walkers, or visual markers on the floor (tape and the like).
If someone helps you put your shoes on
When you help someone into their shoes, check whether their feet have become more swollen or changed shape. Feet sometimes swell as activity levels drop or posture changes; the person may not notice it themselves, but shoes that are too tight can make walking more unsteady. When you fasten velcro, leave enough room for a finger rather than pulling it too tight.
Break new shoes in first
Suddenly walking a long way in shoes you are not used to can change your gait and make you less steady. When you buy new shoes, wear them for short spells around the house several times and check that your walking feels comfortable before you wear them outdoors.
What you can do now
When you next change shoes, check the sole, the heel and the fastener before the way they look. If your walking or balance is particularly unsteady, a physical therapist can also recommend shoes or orthoses suited to your situation.
This article is not a substitute for medical diagnosis or treatment. If you are worried about your gait or about falling, please talk with a physical therapist.
