Why Measuring Heel-To-Ball Matters In Shoe Fit

Almost everyone who comes into my office gets his or her foot measured. Why? Wearing the wrong size shoe can cause foot pain and the majority of patients I treat cannot remember the last time they had their foot professionally measured.

The gold standard for measuring feet is the Brannock Device®. The company has a great Web site, https://www.brannock.com/, which I think everyone should visit. This site includes handy conversion charts for children and European sizes. Developed in 1927, the Brannock Device measures arch length (heel-to-ball) and foot length (heel-to-toe). While everyone is familiar with heel-to-toe, almost no one is familiar with heel-to-ball, which is generally the more important measurement.

The above photos illustrate these two different foot measurements. The first person’s foot measures a 13 (heel-to-ball) and the second person’s foot measures a 7.5 (heel-to-toe). Some of us have a longer heel-to-ball measurement and some of us have a longer heel-to-toe measurement.

Whichever measurement is longer (heel-to-toe or heel-to-ball), that is your shoe size.Interestingly, most people have a longer heel-to-ball measurement but are wearing the shorter sized heel-to-toe shoe. While the toes are not crowded in this shoe, the arch is not properly supported.

So why does foot size matter to a podiatrist? For one thing, if your patient should be wearing a size 10 (heel-to-ball) and he or she is wearing a size 8 (heel-to-toe), then the patient could develop functional hallux limitus over time with an elevated first metatarsal. In the short term, plantar fasciitis is a likely possibility.

How about when you are ordering custom orthotics? Sometimes I have the lab scan and mirror my cast, but what if I have not measured the foot and the short side is reflected in the cast instead of the long one? I can guarantee those orthotics will not work right. These are but a handful of examples but the list goes on and on.

Primary care doctors weigh their patients. Podiatrists should have their staff measure the foot size of their patients. It is easy to do and can make quite a difference.

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