The United States older adult population is expected to double within the next 15 years. A growing percentage present with multiple co-morbidities that require competing footwear accommodations. Yet, attributed to footwear mass manufacturing methods, older adults often must rely on the use foot orthotics to conservatively manage lower limb ailments. However, orthotics addresses only problems at the foot, and may further limit space within a shoe. Thus, footwear manufacturers are encouraged to develop personalized solutions that can address problems at the foot, knee, and a hip. Ergonomic standards that account for individualized anthropometrics, ground reaction forces, and balance should be developed. Accordingly, a paradigm shift in footwear manufacturing methods appears necessary, and is promoted.