Basic Structure

Basic structure of a shoe: (graphic with labels)

Shoes may have up to 20 individual parts to make up the upper and sole unit. The most important of these to grasp are:

The Heel – which includes the raised portion at the back of the shoe. Shoe heel designs have considerable variability in height, width and shape.

Another part of the back of the shoe is the

Heel Counter – the material that cups the back of the heel of the foot.

The Midsole – lies between the outsole and the insole and provides support, stability and cushioning to the foot.

The Outsole – the part of the shoe which is in direct contact with the ground and needs to be waterproof, durable, flexible enough for normal function, and a reasonable coefficient of friction to prevent slipping.



There are more than 200 separate operations required to make a pair of shoes.

Shoes are built on a ‘Last’, which is a wooden or plastic shape which a shoe is formed around during manufacture. The last will determine the final shape of the upper, and how this will fit to the sole unit.

The sole of the shoe can be made from a variety of materials from leather, wood and rubber to various forms of foams and plastics. The construction and features of the sole of the shoe probably have the greatest impact on how the person wearing the shoe feels and functions.

The shape of the sole unit determines how the upper fits, and creates the overall shape of the shoe AND, the overall shape to fit the FOOT. With shoes being generally made of reasonably rigid, firm materials there is little to no room for them to ‘stretch to fit’!

The final shape of the entire shoe, the combined sole and upper shape, determine the ‘fit’ of the shoe to the foot. Shoe ‘fit’ is the most important aspect of footwear choice for ourselves, and our patients. Ideally, foot shape should match shoe shape, in width, depth and curvature.

(here we will have images of X-ray of foot inside a high heel etc)

With such a variation in human foot shape and with foot deformities common, matching a foot to a suitable shoe can be a huge challenge! Add to this challenge, fashion, tradition and aesthetics, and the challenge is multiplied ten-fold!