I am 54, a size 10 and wear Dansko shoes. I ordered a medium-regular length. These pants are a must-especially if you wear compress socks-they don't stick to the sock and ride up! I was unsure about the Extreme stretch because it is extreme! But when I started gaining weight-it really helped. These are now all I buy. They are so comfy I deviated from my favorite scrub tops to try this brand (these tops were not approved by work due to coloring-until now-YAY!!) I would size down one full size.