This is what happens to your body if your shoes don't fit right

National Geographic

2 days ago

Even comfortable shoes can throw your body out of alignment. Experts reveal how everyday footwear can trigger pain in your back, hips, knees, and more—and what to wear instead. Colored MRI-style X-ray shows a lace-up boot enclosing the foot and directing pressure along the arch and ankle. By shaping how the foot moves and bears weight, footwear like this can influence posture, gait, and pain throughout the body. Photograph By Nick Veasey,Science Photo Library
You might not think much about your shoes when running errands—dropping the kids off, picking up groceries, swinging by the pharmacy. But the footwear you choose for these everyday moments could be shaping your health more than you realize.
Ill-fitting footwear can worsen or cause foot ailments like bunions, corns, calluses, and toenail issues. 'Your feet are the foundation of your body,' says Miguel Cunha, a podiatrist and owner of Gotham Footcare. 'Having improper footwear, or shoes that are not supporting you, is going to have an impact on the rest of your body, whether it's from the standpoint of fatigue or creating imbalance in anatomical alignment.'
Understanding what's behind these changes is the first step to preventing pain that can spread beyond your feet. How your shoes cause pain
To move efficiently and without pain, your feet need footwear that supports their natural motion.
'Every time we walk, our feet need to be able to change shape,' says Otto Lam, a physical therapist at Good Reps Therapy. The heel should strike first, the foot should roll forward, and the toes should spread before pushing off—but the wrong shoe can disrupt this sequence.
'If someone with wider feet is in a narrow shoe, perhaps they won't be able to get their foot to fully conform to the ground, or, as we call it, pronate,' Lam says. That restriction can shorten steps and force the hips and lower back to work harder to move forward. Over time, these small compensations can lead to persistent pain, throw off your gait, strain your joints, and exacerbate balance issues. Colored MRI-style X-ray shows a stiletto shoe elevating the heel and forcing the foot into a downward angle. This altered position shifts body weight forward, changing gait mechanics and increasing strain on the knees, hips, and lower back. Photograph By Nick Veasey, Science Photo Library
Certain shoe styles create their own problems. Flip-flops, for instance, 'can cause us to grip or claw our toes to keep [the shoes] on,' Lam says. The gripping prevents the toes from relaxing or spreading out, which is necessary for standard walking mechanics. Not only can it create tension in the arches, but it may also cause pain in the calf muscles. Flatter or worn shoes with little arch support can also cause inner knee pain. High heels shift body weight forward, straining the forefoot and lower back. Slip-ons, minimalist shoes, and platforms can limit stability or natural motion, causing muscles to overwork.
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Even a single uncomfortable shoe can change how you walk. 'Let's say my right foot is uncomfortable and not my left in that shoe that I choose for whatever reason,' Lam says. 'I'm going to shorten my stride and put more weight on the other leg putting more stress on that side's knee, hip, and lower back.' Whether it's a bad fit, worn-out cushioning, or a mismatch between shoe design and foot shape, the wrong footwear can quietly set off a chain reaction of discomfort throughout the body. How to identify shoe-related pain
One of the first things Cunha asks his patients to do is place their shoes on the exam table—because the wear patterns tell a story. 'We all pronate when we walk, which is when our arch collapses. But if you overpronate then, you're obviously going to have more wear and tear on the inside of the shoe and on the heel.' This causes your foot to roll inward, followed by your leg, which can lead to various issues, including plantar fasciitis on the foot, Achilles tendonitis in the ankle, inner knee pain, hip pain, and lower back pain.
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To pinpoint the cause, Cunha often performs a gait analysis. Sometimes it's done in the office, but even a simple video of a patient walking toward and away from the camera can reveal abnormalities in stride or posture. These clues help determine whether pain stems from the body's mechanics or from footwear that doesn't match the wearer's needs.
'Even if you don't have foot problems, if you have back problems, I'd recommend custom orthotics,' Cunha says. While over-the-counter inserts can help in mild cases, custom orthotics are molded to your foot's unique shape and movement pattern, making them more effective for correcting imbalances that lead to chronic pain. How to find the proper footwear for you
Once you know what's causing the pain, focus on finding shoes that match your foot shape and movement. Flat feet may benefit from stability shoes with firm midsoles, while high arches often need extra cushioning to absorb shock. Wide feet require shoes with a roomier toe box, while narrow feet may need a snugger fit to avoid slipping.
Both Cunha and Lam recommend shopping for shoes in person. Not only can you test the fit for yourself, but you can also get your foot measured with a Brannock Device by someone who knows how to interpret the measurements. The device measures length, width, and arch length to determine the best shoe size.
'I always tell patients to buy their shoes at the end of the day when their feet are most swollen and they're in their worst shape due to the cumulative effect of effects of gravity,' Cunha says. Putting on a shoe that fits properly should provide some relief to your body. 'You can feel it in your back. You'll feel lighter. Even walking around the store, you'll feel your back pain ease up a little bit.'
For durability and anatomical support, Cunha recommends choosing shoes approved by the American Board of Podiatric Medicine. 'The shoe brands I recommend are Hoka, Brooks, Saucony, New Balance, and ASICS,' he says. 'They're fit over fashion.'
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It's also important to remember that even the best shoes have a lifespan. Walking or running shoes often last 300–500 miles, or about 6–12 months of regular wear. Everyday sneakers may last longer, but should be replaced when the tread wears down, the midsole feels flat, or new aches develop. Inspect them regularly for worn soles, compressed cushioning, or changes in support, and pay attention to any new aches in your feet or ankles that a shift in activity can't explain, Lam says.
Ultimately, the right shoe is the one that feels good on both feet and supports the way you naturally move. 'Our bodies are interconnected,' Cunha says. 'You have to treat the whole body and treat its individual components.'