Footwear Assessment
Reviewed by Andrew Schox, BSc(Hons) PGradDipPod MPod, October 2026
A footwear assessment is a structured check of the shoes you wear and how well they suit your feet and your health. It aims to find shoes that don't fit before they cause pain or wounds. Your podiatrist measures your feet, tries on your shoes, and checks the toe space, heel, width, fastening and wear. For people with diabetes, it is one part of a foot check that sorts each foot into low, moderate or high risk. The result can lead to advice on better shoes, closer follow-up, or special footwear from an orthotist.
What is it?
A footwear assessment is a careful check of your shoes. Your podiatrist looks at how the shoes are made, how they fit, and how well they suit your feet and any health conditions you have.
It is more than a quick look. Podiatrists often use a checklist so nothing is missed. The checklist covers things like fit, the general features of the shoe, how it is built, how much it controls foot movement, and how well it cushions your foot. Some checklists also look at wear marks on the shoe.
For people with diabetes, it is one part of a wider foot check. It sits alongside checks of your skin, blood flow, feeling and foot shape.
Why is it done?
Shoes that don't fit properly are one of the most common causes of foot problems. They can cause pain, rubbing, blisters and sores. They can also squash the toes and, over time, change the shape of bones and joints.
For people with diabetes, the stakes are higher. Poorly fitting shoes are linked to foot ulcers (open sores that are slow to heal). Poorly fitting shoes can also raise the risk of falls and injury.
The aim is to find the problem early. Your podiatrist can then help you change your shoes before they cause harm.
Who needs it, and how often?
Everyone with diabetes should have their footwear checked as part of a foot check when they are diagnosed. After that the check is usually repeated every year. At each check, each foot is sorted into low, moderate or high risk of ulcers. Some services recheck low-risk feet every 2 years.
People at higher risk are seen by a podiatrist more often. Depending on the risk group, that is at least every 3 to 6 months, or at least every 1 to 3 months. Your podiatrist will tell you which applies to you.
You may also want a footwear check if:
- you are buying new shoes and want your feet measured
- you have foot pain, or you think your shoes may be raising your risk of falls or injury
- you can't find shoes that fit, even after trying wider-fit shoes
If you have diabetes and have lost feeling in your feet, have had a foot wound, or have a change in foot shape, ask a podiatrist to review your shoes. Don't rely on judging them yourself.
What happens?
The check is painless and usually part of a longer foot appointment. Here is what to expect.
Your shoes are looked at. Your podiatrist looks at the shoes you actually wear. They check how the shoe is made, what the sole is made of, how it fastens, and where it is worn. Wear marks on the sole and the upper part of the shoe can show how you walk and how the shoe has been used.
Both feet are measured. Most people have one foot slightly bigger than the other. Your podiatrist measures both feet and has you try on both shoes, preferably standing.
Length is checked. There should be about 1 cm between the end of your longest toe and the end of the shoe. A thumb's width is another way to judge this.
The heel is checked. The heel should feel comfortable and snug. You should still be able to slip a finger between the back of the shoe and your heel.
Width is checked. Your podiatrist compares the width of your foot with the width of your shoe. They may trace your foot, or use a ruler, callipers or a foot-measuring device. Width is harder to measure than length, so your podiatrist may take extra care here.
The shoe's design is checked. Your podiatrist looks at the heel height and the shape of the toe box (the front part of the shoe). They also check how the shoe stays on your foot.
The findings are recorded. If you have diabetes, your podiatrist records your foot risk category with the footwear findings. They explain your risk to you.
What do the results mean?
Your podiatrist compares your shoes with these fit and design points. Shoes that meet them are suitable.
- About 1 cm between your longest toe and the end of the shoe.
- A snug, firm heel that doesn't rub.
- A heel under 2.5 cm that is broad and stable.
- A firm lace or strap fastening, high across the foot.
- Enough width and length for your foot.
Some shoes are not suitable. Pointed toe boxes squash your toes together and can change the shape of bones and joints. Heels that are too high do similar harm. Slip-on shoes are often too small, or you curl your toes to keep them on, and both are bad for your feet.
For people with diabetes, the footwear findings go with your foot risk category.
- Low risk: no loss of feeling, no poor blood flow, no change in foot shape and no callus. You usually get a foot care leaflet and a recheck at the next scheduled interval.
- Moderate to high risk: you should be advised to wear properly fitting, accommodative footwear (shoes with enough room for the shape of your feet) that protects them. You will be seen by a podiatrist more often.
- A past foot ulcer on the sole: special footwear that reduces pressure under the foot while you walk is recommended to help stop the ulcer coming back. How much footwear helps prevent a first ulcer isn't yet clear.
- A current foot ulcer: this is active foot disease. You need to be referred to a diabetic foot clinic within one working day.
What happens next?
What happens next depends on what your podiatrist finds.
If your shoes don't suit your feet, you will get advice on better-fitting shoes. If you still can't buy shoes that fit, even after trying wider-fit shoes, your podiatrist may refer you to an orthotist. An orthotist is a health professional who can supply orthopaedic footwear (specially made or adapted shoes) if there is a clinical need. This is often for people whose feet have changed shape, or whose feet are at high risk of skin breakdown.
A footwear check is only one part of caring for your feet. If you have a foot ulcer, new shoes alone aren't enough. Your care team will take pressure off the ulcer with a special device, such as a boot that stays on your leg. This is the first choice. If these devices aren't available, well-fitting shoes with felted foam are the third choice. Covering and protecting the wound is part of this care.
Your podiatrist will also tell you when to come back. How soon depends on your risk category.
When to see a podiatrist
Book an appointment if
Book an appointment with your podiatrist if your shoes rub or leave red marks, you can't find shoes that fit, your feet seem to be changing shape, or you have foot pain. Book too if you have diabetes and your feet and shoes haven't been checked in the past year, or if you have lost feeling in your feet or have had a foot wound and haven't had your shoes reviewed.
Seek prompt assessment if
If you have a foot wound or infection and you also feel very unwell, with a fever, confusion or slurred speech, severe shivering or muscle pain, severe breathlessness, mottled or discoloured skin, or little or no urine, this could be sepsis: call your local emergency number. Call your local emergency number too if your leg, foot or toes suddenly turn cold and pale or blue, with pain or numbness, or if you have a foot sore and the skin around it turns black.
If you have diabetes and have a new wound or sore on your foot, or spreading redness, swelling or warmth, see your GP or another doctor today. If your GP can't see you today, go to an urgent care clinic or an after-hours GP. Until you are seen, cover the wound with a clean dressing, keep it dry and keep pressure off it.
If you are trying new or orthopaedic footwear and you find blisters, swelling, warmth, cuts or pressure marks that are still there 20 minutes after taking the shoes off, stop wearing them and contact your podiatrist or orthotist straight away. Do the same if new shoes cause redness from rubbing or pressure.
Frequently asked questions
How should I break in new shoes?
Wear them around the house for short periods at first, then build up gradually over a couple of weeks. Each time you take them off, check your feet for redness, blisters, swelling, warmth, cuts or pressure marks. If any of these appear, stop wearing the shoes and contact your podiatrist or orthotist.
Should I check inside my shoes?
Yes, every day, before you put them on. Look and feel inside for grit, stones, pins or other loose objects. This matters most if you have lost feeling in your feet, because you may not notice something sharp or hard until it has caused a sore.
Can I check my shoes at home?
You can learn to check shoe length with a short training session, and a partner or family member can help. Width is harder to judge and needs a professional. If you have diabetes, poor feeling in your feet or a past foot wound, get your podiatrist to review your shoes before you rely on checking them yourself.
Do my feet change size as I get older?
They can. Over the years your feet naturally change shape and can get longer and wider. That is why it is worth having your feet measured whenever you buy new shoes, rather than assuming you are still the same size.