Finding comfortable shoes can be difficult when Charcot-Marie-Tooth disease (CMT) affects foot shape, ankle strength, sensation or walking. The right footwear depends on the individual, but useful features may include a secure heel, adequate toe depth, removable insoles, adjustable fastenings and enough room for prescribed orthoses or an ankle-foot orthosis (AFO).
Charcot-Marie-Tooth disease is an inherited condition affecting the peripheral nerves. Despite the similar name, CMT is not the same condition as Charcot foot (Charcot arthropathy), which is a separate and serious condition commonly associated with neuropathy and diabetes.
How CMT Can Affect Footwear Needs
CMT varies considerably from person to person. Some people experience high arches (pes cavus), claw or hammer toes, foot drop, ankle weakness or reduced sensation. These changes can make ordinary footwear feel tight over the toes or instep, allow the heel to move, or leave too little room for an orthosis.
Footwear cannot treat CMT, and there is no single shoe that suits everyone. A neurologist, orthotist, podiatrist or physiotherapist can help assess your individual needs, particularly if your foot shape or walking pattern is changing.
What to Look for in Shoes for CMT
1. Enough Depth Around the Toes and Instep
High arches, claw toes and hammer toes may require more internal height as well as width. A roomy toe box should give the toes space without allowing the whole foot to slide around inside the shoe.
If toe pressure is a particular concern, focus on internal depth as well as width and check that no upper seam or overlay sits directly over a sensitive toe.
2. A Secure Heel and Stable Base
A firm heel counter and a stable sole can help hold the foot more securely than a very soft, unstructured shoe. The shoe should feel stable without pressing painfully against the ankle or heel.
Because CMT can affect each person differently, avoid assuming that the stiffest or most cushioned shoe will automatically be best. Comfort, fit and compatibility with any prescribed device matter more than a single feature.
3. Removable Insoles
Removable insoles create space for prescribed foot orthoses and make it easier to adjust the internal depth of the shoe. If you use custom insoles, take them with you when trying footwear and check that the heel remains secure once the original insole has been removed.
4. Adjustable and Easy-to-Use Fastenings
Laces provide detailed adjustment, while touch fastenings or zips may be easier for people who also experience weakness or reduced dexterity in their hands. The best option is the one that holds the foot securely and can be adjusted comfortably throughout the day.
5. Appropriate Weight
An unnecessarily heavy shoe may contribute to fatigue, especially when lifting the front of the foot is difficult. However, lightweight footwear should still provide enough structure and stability for the wearer’s needs.
6. Space for an AFO or Other Brace
Some people with CMT use an AFO to support foot drop or ankle weakness. Footwear worn with an AFO commonly needs:
- A wide opening so the foot and brace can enter without excessive force
- A removable insole to create additional depth
- A secure lace or touch fastening
- An enclosed heel and toe
- A heel height and sole shape compatible with the device
Do not simply buy a larger shoe without checking the overall fit. Take the AFO to a fitting and follow the advice of the orthotist who supplied it. You can also view our foot drop supports.
Choosing Shoes for Common CMT-Related Foot Changes
High Arches
High arches can concentrate pressure under the heel and forefoot and may also make footwear feel tight across the instep. Look for appropriate instep depth, a secure heel and enough room for any prescribed insole.
Claw or Hammer Toes
Toe deformities usually require depth as well as width. Check the inside of the shoe for seams or firm overlays that sit directly over a sensitive area, and make sure the toes are not touching the end or top of the shoe.
Foot Drop and Ankle Weakness
Foot drop can alter the way the foot clears the ground while walking. Some people are prescribed an AFO or another orthosis. The footwear and device should work together, so it is sensible to have both assessed at the same time rather than selecting footwear in isolation.
Reduced Sensation
If sensation is reduced, pressure or rubbing may not be immediately obvious. Check the inside of the shoe before wearing it, introduce new footwear gradually, and inspect the skin after use. Seek professional advice if redness persists or if the skin becomes damaged.
Three TDO Footwear Options to Compare
These models are not universal CMT prescriptions. They are practical starting points with different strengths, and suitability depends on foot shape, ankle control, sensation and any prescribed orthosis.
Kendal 902 — Maximum Opening and AFO Space
Kendal 902 is the strongest starting point when a wide opening, maximum depth or room for an AFO is the main concern. Its upper opens fully towards the toes, while two adjustable straps, a 6E extra-wide and extra-deep fit and a removable insole make entry and adjustment easier.
Compare Kendal 902 for women and Kendal 902 for men.
Ashby 615.20 — Structured Leather and Extra Depth
Ashby 615.20 is a structured leather option to compare when high arches, claw or hammer toes, or prescribed foot orthoses require additional width and depth. It has a 6E fit, an adjustable fastening and a removable insole. Compatibility with an AFO still needs to be checked with the actual device and the wearer’s orthotist.
Compare Ashby 615.20 for women and Ashby 615.20 for men.
Ashby 616.20.19 — Breathable Mesh and Orthotic Space
Ashby 616.20.19 combines a breathable mesh upper with a 6E extra-wide and extra-deep fit, an adjustable strap and a removable insole. It may be useful to compare when breathability, toe space and room for a foot orthosis are priorities. It is not presented here as the first choice for a bulky AFO because the upper does not open as fully as Kendal 902.
Compare Ashby 616.20.19 for women and Ashby 616.20.19 for men.
All three designs use a rocker-shaped sole. This should not be treated as automatically suitable for every person with CMT. If balance, foot drop or an AFO is involved, check that the sole shape works with the individual’s gait and prescribed device.
Ready-Made or Custom Footwear?
Some people with CMT can use ready-made footwear with suitable depth, fastenings and removable insoles. Others may need footwear modifications or custom-made shoes, particularly when there is marked deformity, significant asymmetry or difficulty fitting an AFO.
If standard footwear repeatedly causes pressure or does not hold the foot securely, ask an orthotist or podiatrist whether a different shoe, a modification or custom footwear would be more appropriate.
A Practical CMT Footwear Checklist
Before deciding, check that:
- The toes have enough width and depth
- The heel is secure and does not lift excessively
- No seam or overlay presses on a sensitive area
- Any prescribed orthosis fits without crowding the foot
- The fastening holds the foot securely
- The sole feels stable for your walking needs
- Both feet are checked, as their requirements may differ
- The shoe is tested with the socks and devices normally worn
Frequently Asked Questions
Is Charcot-Marie-Tooth disease the same as Charcot foot?
No. Charcot-Marie-Tooth disease is an inherited condition affecting the peripheral nerves. Charcot foot, also called Charcot arthropathy, is a different condition involving damage to the bones and joints of the foot, often in people with neuropathy.
What are the best shoes for CMT and high arches?
There is no universal best model. Useful features may include suitable instep depth, a secure heel, a stable base and removable insoles for prescribed orthoses. The correct combination depends on foot shape, sensation, muscle strength and walking pattern.
Can I wear an AFO with ordinary shoes?
Some ready-made shoes can accommodate an AFO if they have enough depth, a wide opening, removable insoles and secure fastenings. The footwear must also be compatible with the device’s heel and sole requirements. Take the AFO to the fitting and follow your orthotist’s advice.
Should CMT shoes be extra wide?
Not automatically. Some people need additional width, while others mainly need more depth over a high instep or toes. A shoe that is too wide can allow unwanted movement, so fit should be assessed in three dimensions: length, width and depth.
Can footwear treat foot drop caused by CMT?
Footwear does not treat CMT or foot drop. Suitable shoes may accommodate and work with a prescribed AFO or other device. Assessment by an appropriate healthcare professional is important.
Find Supportive Footwear at TDO Therapy
TDO Therapy offers orthopaedic footwear with a range of widths, depths, fastenings and removable insoles. Because CMT affects people differently, we recommend checking the individual product specifications and arranging a fitting when you are unsure about compatibility with an orthosis or AFO.
Our Farnham shop provides specialist shoe fittings, and our online fitting guidance can help you compare measurements and features before ordering.
