Can Bad Shoes Cause Knee Pain?

Written by: Matias Malkamaki

Medically reviewed by: Dr. Nicholas A. Cheney, DO, FAOAO

Joint pain is a common problem for people, especially as they grow older. While many factors play into the development of knee, ankle, and foot pain, one easily modifiable type is the shoes we wear.

If you simply consider the fact that one is almost always wearing shoes while weight bearing, it can be easy to see how a shoe that changes your natural walking and standing mechanics could wear down parts of your anatomy. Thus, choosing the right kind of shoe for everyday wear is important. However, this can be difficult to do.

The footwear industry has been growing on a rapid upward trajectory in recent years. The global market has been valued at $365.5 billion in 2020 and is estimated to reach upwards of $500 billion by 2027. This booming market makes trying to figure out what kind of shoes to wear increasingly difficult. Not only are there aesthetic decisions to make, but also ergonomic.

Sadly, many styles of shoes can be damaging over time. Wearing the wrong shoes can cause or exacerbate pain, take the foot out of a balanced position, and put unnatural amounts of stress on parts of the foot not made to handle the entire weight of our bodies for extended periods.

Now, you might wonder how the shoes you wear can be better or worse for your knees or other joints. The reasoning is that when the natural balancing of the foot is compromised, there is an upstream effect on the ankles and knees. For example, when someone loses their natural foot arch, their ankle joint starts to bend towards the space between their feet. This poor ankle position can then cause one’s tibia to rotate internally, leading to medial tibiofemoral cartilage damage and/or what is known as knock-knees.

Other common patterns of improper foot positioning due to shoes can result in improper knee position and pain. This shows why one should not just pick shoes that look good but also ones that support a healthy foot, ankle, and knee with balance and proper arch support and positioning.

If you are experiencing knee pain and wonder if your shoes might be the cause of your pain, then schedule an appointment to talk to one of our highly skilled healthcare professionals at OrthoNeuro. They will educate you about what kind of shoes will give you more support and make you more comfortable. Schedule an appointment with us today!

What Kind of Shoes Typically Cause Knee Pain?

Some shoes that can damage your biomechanics are high heels, sandals, boots, and flats. Here are some reasons why these shoes can cause or exacerbate knee and lower limb pain.

High Heels

Starting with high heels, the two inches or more of extra heel height transfers the weight that is usually evenly distributed across one’s foot to the front of it. Those who wear heels risk spraining their ankle because of the heel’s very narrow base.


The next type of shoe to discuss is sandals. These shoes, in general, aren’t made with much cushioning, have less stability/support due to their open nature, and sometimes don’t have a back. The lack of backing can lead to gripping the shoe with your toes when you walk (eventually leading to hammertoes or general foot strain). If looking for sandals, try to find ones that have lots of straps for support, have at least some cushioning, and some arch support is always helpful.


Finally, for flats. Flats can be a good option if they do not sacrifice cushioning, a natural toe box, and arch support. Unfortunately, many shoes taper down at the end, which can end up forcing the toes into a cramped position that hinders them from spreading out the force of one’s body appropriately (pointed toes). One of the selling points of these types of shoes is their flexibility. The ability to twist a shoe or fold it in half does not benefit the mechanics of one’s foot.


Boots have some pros and some cons. The tall and snug nature of boots means they help stabilize the ankle joint and be protective against sprain injuries. However, they often have a high heel which can stress the front of the foot. Problems can also result if they are too stiff. Having a rigid shoe sole can disrupt a normal walking pattern and put more stress on the knees.

What Kind of Shoes Prevent Knee Pain?
Now that you have some awareness of how poor shoe design breaks down proper foot mechanics, what are some of the things to look for in a good shoe? The key seems to be finding a stable and supportive shoe over a flat, flexible one.

A few studies have been done demonstrating that regular activity in a stable and supportive shoe decreases pain in more people than does the same activity in flat and flexible shoes. This finding is especially true for people with medial knee osteoarthritis and varus malalignment. The reason for this is that medial tibiofemoral contact force is reduced by wearing such shoes.

So, to sum it up, wear shoes that provide stability and support through cushioning, a naturally wide toe box to prevent crowding, arch support, and a wide contact surface for that all-important stability. Many people wear athletic shoes to find the support they need for their feet.


While there is clearly a benefit to wearing supportive shoes, just having the right shoes will not always prevent pain from developing, nor will they likely reduce all associated knee pain on their own. If you are already experiencing pain that is taking away from your quality of life, you should get evaluated by one of our excellent physicians to better understand what the root cause of your pain is and how it should be handled.

Here at OrthoNeuro, we have a large and strong team of foot, ankle, knee, and hip specialists ready to serve you and assist in returning you to a better quality of life. Do not hesitate to check us out at

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