Many who know my feelings on shoes or those who follow my blog will understand my belief that our feet work best in their natural state and not relying on shoes or orthotics. With that said, there are times when we need to equip our feet with shoes to protect them.

Every sport creates a challenge finding a shoe that still allows the foot to work the way it was intended yet enables athletes to participate in their desired sport at the highest level they can without worrying about injuring their feet. While we can tell this story over and over again with every sport, I would like to share a recent case involving a soccer player.

A 17-year-old female soccer player presented with reoccurring subungual hematomas that were resulting in paronychias and loss of toenails. On one occasion, we had to avulse several nail plates to relieve her of pain. She has been playing soccer since a very young age and was without a doubt skilled enough that she was not “toeing” the soccer ball and creating trauma to the nail plates (though I still had to ask this question of her and the parents). It was pretty clear that her shoes were too tight.

“Soccer shoes are supposed to be tight,” the athlete told me.

“True but there needs to be room for your toes to move and function,” I explained.

This tightness she was referring to is a common thought that our society has when it comes to our feet. Think back to being a kid and being told to “pull your socks up” or “make sure your shoes are on tight.” We have grown to acquire a feel for shoes and socks that may not the best option for our feet and toes.

In the above example that I gave, this athlete was wearing shoes that were too tight and the constant microtrauma was the culprit for the recurring subungual hematomas. What felt “proper” for her was actually too tight. She tried a bigger shoe by switching to a men’s shoe, which was wider, but the problem still occurred. It is hard to break away from the “snug” feeling we were all brought up thinking was normal.

She made a comment to me that sealed the deal on her guilty shoes. She stated that her nails had a really sensitive feeling all the time and that they did hurt when she was playing soccer. She couldn’t wait to take off her soccer shoes after the game and put on her running shoes. “My toes don’t hurt in my running shoes after the game,” she said. We are still trying to solve this challenge of finding a shoe that works for her.

The point is she is not alone and that many of us in all sports face a similar challenge. It is hard to break away from the “snug” feeling we were all brought up thinking was normal. In my opinion, this is just another common misperception about footwear that we need to address with the athletes we treat.