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Five Shoe-Lacing Strategies To Help Address Patient Comfort With Shoes

Denise Bonnin DPM

07/29/2019

As podiatrists, we counsel our patients regularly regarding proper shoe gear. Stability, cushioning, arch support, heel drop, and toe box are just a few aspects we consider in those recommendations. Although the type of shoe a patient chooses can greatly affect his or her comfort, another important factor is how the laces are tied. Most shoes come pre-laced in “zigzag” form but there is an art and benefit to tying them according to your patient’s needs. This small detail can make a big difference that patients will appreciate right away.

First, it is important that we’re using the same terminology with our patients when discussing the lacing on shoes. Here are a couple of terms that I explain with my patients in regard to shoe lacing.

Eyelets: These are the holes that the laces go through.
Over: When the laces are inserted in the eyelets from the outside going toward the inside of the shoe.
Under: When the laces are inserted in the eyelets from the inside going toward the outside of the shoe.

Below are alternative lacing solutions that I share with my patients for five common shoe and foot problems.

Problem #1: The patient’s shoes feel too tight.

Solution: Assuming that a different shoe size is not the best solution, consider parallel lacing to loosen up the fit.

Begin by lacing each end of the lace over one of the eyelets closest to the toes.
Hold on to one end of the lace, leaving the other aside for now.
With the lace end being held, stay on the same side of the shoe and skip down one eyelet, reentering the shoe under the third eyelet.
Take that same end, cross it to the other side of the shoe and enter it over the third eyelet on that side.
Continue with the same lace on the same side and skip another eyelet, entering under the fifth eyelet. Leave the lace there for now.
Now, grab the other end of the lace and enter it under the second eyelet on its same side.
Cross that lace to the other side of the shoe, and enter it over the opposite second eyelet.
With that lace, stay on the same side, skip an eyelet and enter under the fourth eyelet.
Cross to the other side of the shoe and enter the lace over the fourth eyelet on that side.
If you have more eyelets, continue this pattern, skipping an eyelet on each side before re-entering the shoe and crossing over.

Here one can see the technique as outlined in Problem #1.

Problem #2: High arches.

Solution: Make a little room for the dorsal midfoot.

Begin by lacing each end of the lace over one of the eyelets closest to the toes.
Cross both lace ends diagonally to the opposite second eyelets and enter over those eyelets.
Keep each lace on the same side of the shoe and enter under the third eyelet.
Then continue zigzag lacing as normal.

Here one can see the technique as outlined in Problem #2.

Problem #3: Painful toenails.

Solution: Lace to pull the shoe away from the painful toe.

Begin by lacing each end of the lace over one of the eyelets closest to the toes.
From here, measure out the laces so that one lace is about five inches longer than the other. Keep the shorter end of the lace on the side closest tothe toe that’s most painful.
Take the longer lace and zigzag it through all of the eyelets.
Then take the shorter lace and cross it all the way across the shoe, reaching diagonally from the eyelet closest to the toes to the eyelet closest to the ankle on the opposite side.
Enter the lace under that eyelet and finish tying. If you end up with both laces on the same side, just take the zigzag lace out of the final eyelet.

Here one can see the technique as outlined in Problem #3.

Problem #4: The patient’s heels slip.

Solution: Use tighter lacing closer to the ankle.

Begin by lacing each end of the lace over one of the eyelets closest to the toes.
Create a basic zigzag pattern until you reach the eyelets closest to the ankle. Then take each lace end and hook it directly back down and under into the eyelet right beneath it.
Laces should end up in the second to last hole from the top.

Here one can see the technique as outlined in Problem #4.

Problem #5: The patient has a wide forefoot.

Solution: Skip some zigzags to give the ball of the foot some space.

Begin by lacing each end of the lace over one of the eyelets closest to the toes.
Keep the lace ends on the same side and enter each end under the next eyelet down.
Then enter each lace end over the next eyelet down.
Zigzag the laces as normal to finish tying.

Here one can see the technique as outlined in Problem #5.

Illustrations or photos (as shown above) can also be very helpful to patients. Patient education is a cornerstone of treatment in my practice. Employing basic solutions such as these will enhance confidence in your knowledge and provide a useful adjunct to your usual treatment algorithms.

Dr. Bonnin is in private practice with Family Foot and Ankle Specialists in Piscataway and Hillsborough, NJ. This blog was adapted with permission from the author and originally appeared at www.stopfootpainfast.com.