Find the Best and Worst Shoes for Arthritis

Our feet, with their 52 bones, 66 joints and more than 200 muscles, tendons and ligaments, are high-precision instruments that connect us to the earth, support our skeleton and provide balance and mobility.

Yet we often neglect and even abuse them – forcing them into footwear that doesn’t fit, that sacrifices function and comfort for style, or that is simply the wrong shoe choice for our particular feet. Anyone who has worn a fabulous pair of shoes for a special occasion, only to tear them off at the first possible moment, knows how painful a bad shoe decision can be. That’s especially true when choosing shoes for arthritic feet.

Why It’s Important to Choose the Best Shoes for Arthritis

Making healthy choices for your feet, much like eating a nutritious diet or getting regular exercise, can add up to big improvements in quality of life, says Marian Hannan, associate professor of medicine at Harvard Medical School and co-director of musculoskeletal research at the Harvard-affiliated Institute for Aging in Boston. “People should start thinking of their shoes as a factor they can modify to help minimize pain and maximize their ability to get out and do things.”

The wrong shoe worn by someone with arthritis in their hips, knees, ankles or feet can exacerbate existing problems and, down the road, cause damage and complications to many joints beyond the feet, she adds.

“The right shoe can reduce or eliminate foot pain, which has a huge impact on the body’s function and mobility,” says Hannan.

Kirsten Borrink agrees. After years of struggling with foot pain from rheumatoid arthritis, or RA, diagnosed in her 20s, the former teacher started a website and blog, Barking Dog Shoes, which showcases frank reviews of a variety of shoe styles that Kirsten has personally tried. It includes video demonstrations of the author in action.

To help keep you on your feet comfortably, we teamed up with medical experts who weigh in on the pleasing and painful points of 10 different types of shoes, and with Kirsten, who recommends her top picks in each category. Here’s to healthier feet!

Reviews for the Best and Worst Shoes for Arthritis

High Heels

Experts are united in their low opinion of high heels, defined as heels higher than 2 inches. “High heels are bad for everyone’s feet, and for people with any kind of arthritis, they’re even worse. They’re hard on the arch and ball of the foot and can wear down joints,” says Bryan West, a podiatric surgeon who practices in Livonia, Mich.

Studies show wearing stilettos and other heels contributes to both foot pain and arthritis. Researchers at Iowa State University in Ames measured forces on the knee in women wearing flats and wearing 2-inch and 3.5-inch heels. Women who made a habit of wearing high heels had an increased risk of knee joint degeneration and knee osteoarthritis, or OA. Risk – as well as the frequency of low back pain – rose with the height of the heel, according to their study, presented at the 2010 annual meeting of the American Society of Biomechanics.

In a study, published in Arthritis & Rheumatism, Hannan found that women with a history of wearing high heels also experienced more foot pain later in life than those who opted for healthier shoes.

Kirsten’s Pick: Earthies, a new line of high heels by earth footwear that features a cupped heel, anatomical arch and cradle toe area to distribute weight evenly.

Low Heels

These can produce the same problems as higher heels, just to a lesser degree. Add a pointy toe and you can have even more discomfort.

“Feet take on the shape of the shoe,” explains orthopaedic surgeon Carol Frey, MD, clinical assistant professor of orthopaedic surgery at University of California, Los Angeles. “Pointy toes cause deformities such as hammertoes – a common complication of RA that’s also seen in ankylosing spondylitis, psoriatic arthritis and lupus – and pinched nerves.

Remember, if a shoe hurts, it’s damaging your foot.” If you want to wear low heels, experts recommend those with rubber soles, wedge heels and roomy toe boxes. These styles are more slip-proof, and the greater surface area of the sole helps absorb shock, adds stability and reduces stress on pressure points.

Kirsten’s Pick: Aravon’s offers low-heeled shoes in wide sizes with roomy tow boxes and many have rocker soles, which in small studies have been shown to reduce joint pain.

Flip-Flops

Experts say these shoes, which are not particularly stable and can increase falling risk, are best for people who do not have problems with their feet or with balance. But flip-flops may offer some benefit to people with knee OA, according to a 2010 study published in Arthritis Care & Research.

Researchers at Chicago’s Rush University studying the joint load, or stress, caused by different shoes worn by people with knee OA found that wearing flip-flops (as well as going barefoot and wearing flat, flexible walking shoes) creates significantly less knee stress than clogs and sneakers known as stability shoes, which have cushioning in the heel and forefoot and a firm, dense midsole that supports the middle area of the foot.

“In OA, higher joint loads are linked to more pain and arthritic damage and progression,” says lead study author Najia Shakoor, MD, a rheumatologist and associate professor of medicine at Rush University. “Other studies have shown being barefoot is good for knee load, and we found flip-flops reduce knee load by about the same percentage.”

Kirsten’s Pick: The podiatrist-designed footbed of Orthaheel’s flip-flops provides excellent arch support and pronation control, and has been shown to relieve plantar fasciitis pain.

Sandals

Many sandals offer little more than a sole and a few thin pieces of leather to keep your foot in place. If you have arthritis in your lower extremities, look for sandals with more support.

“The strappier the better,” says New York City podiatric surgeon Jacqueline Sutera, an associate of the American College of Foot and Ankle Surgeons. “Straps let you adjust the shoe for a secure, custom fit. One of those straps must go across the back of your ankle. Without a back strap, toes overgrip the edge of the shoe, and this encourages foot strain and hammertoes.” Avoid sandals with straps that cut across sensitive areas of your foot, she adds.

Kirsten’s Pick: Wolky’s Cloggy sandal has adjustable instep, forefoot and heel straps and a memory-foam footbed. Wolky’s Jewel sandal has a removable footbed to accommodate orthotics, which makes them a great fit for medium to wide feet.

Athletic Shoes

Most athletic shoes fall into two categories: stability sneakers and neutral sneakers. Stability sneakers have a dense, cushioned midsole and heel that help control motion and overpronation, a tendency for the foot to roll inward more than it needs to for optimal weight distribution and shock absorption.

Although Dr. Shakoor’s study found stability shoes increase knee stress more than flatter shoes do, they still can be a good choice for some. “Stability shoes take weight off the ball of the foot, which is important for people with hip, knee, foot or ankle OA, RA, toe arthritis, or pain in the footpad,” says Dr. Frey.

Foot structure matters, too. “Stability shoes provide good cushioning and motion control for people who overpronate,” Dr. West says.

If you’re not sure whether you have normal pronation, Dr. West advises checking with staff at a store specializing in athletic shoes. “Bring in an old pair of running shoes. They can determine your pronation by looking for the distinctive wear patterns caused by abnormal pronation.” He notes that some stores offer high-tech digital foot scans that can pinpoint biomechanical issues.

A neutral shoe is one that doesn’t correct for over- or underpronation, says Dr. Frey. “They offer good shock absorption and cushioning that people with arthritis can benefit from,” Dr. Sutera says. “Their neutral design typically allows them to easily accommodate an insert or custom-molded orthotic, often prescribed for patients with arthritis.”

Dr. Frey says neutral sneakers are best “for walkers and runners with normal pronation and no biomechanical problems. If you over- or underpronate or have issues caused by injury or age, you’re better off with a shoe with attributes that address your problems.”

Kirsten’s Pick: Running and athletic shoe styles change every year. Asics, New Balance, Avia and many other brands offer stability and neutral shoes in a variety of widths with a variety of features. Try on several at an athletic shoe store to find the ones that feel best and suit your needs.

Clogs

Dr. Shakoor’s study showed clogs increase knee stress. And Dr. West, who doesn’t often recommend clogs, particularly lightweight plastic varieties, says, “They’re not a good everyday shoe for people with arthritis in the arch, big toe or ankle, or who have stiff, swollen foot joints.”

Well-made clogs with a rubberized sole, a closed back and heels lower than 2 inches can be a reasonable choice for people without knee or foot arthritis, says Dr. Sutera. “They must have a closed back. Foot strain and toe deformities can result if your toes have to grip to stay in any shoe.”

Kirsten’s Pick: the Dansko  offers several closed-back clogs with tons of support.

Boots

Boots can be a healthy, stabilizing option for people with ankle arthritis or other ankle issues, says Dr. West, though he is quick to add that this does not include high-heeled styles. “People with arthritis should choose boots with low, more stable, rubber-soled wedged heels or flatter boots with good arch support. Hiking boots are generally sturdy and give good ankle support,” he says.

Sturdiness is important, but hiking boots also need some flexibility. “If they’re so stiff you can’t flex your foot, they’ll prevent a normal walking motion,” Dr. Sutera says.

Kirsten’s Pick: Clarks’ offers comfortable and stylish ankle boots.

Foot Gloves

These strange-looking shoes – which look something like rubber-soled slippers with a space for each toe – are relatively new to the footwear scene. They feel similar to being barefoot, but provide protection from items on the ground that can injure feet.

Dr. Sutera says foot gloves, often marketed as alternatives to running shoes, are not a good choice for people with arthritis. “They don’t offer any shock-absorbing protection for your skeleton as your foot hits hard surfaces.”

Kirsten’s Pick: Vibram FiveFingers foot gloves might not offer support, but they protect feet and provide traction. Consider them for the beach.

Flats

Not all flats are created equal. “You need three things in a flat: cushioning, arch support and shock absorption,” Dr. West says. “A good test for a flat is to see if you can bend it in half or wring it like a dishtowel. Flexibility is also important, but if you can easily contort the shoe, pass.”

Dr. Shakoor found flat, flexible walking shoes are one of the best choices for people with knee OA. “If you need a little more cushioning, add an over-the-counter insole.”

Kirsten’s Pick: Naot’s Matai provides solid support and pronation control and includes a removable, cork-and-latex, anatomical footbed that accommodates orthotics.

Meet the Tester: The Shoe Whisperer, Kristen Borrink

After enduring years of excruciating foot pain from RA, Kirsten Borrink’s hunt for comfortable, fashionable footwear ended in September 1998 with a Dansko brand shoe that fit her like a glove.

“When I saw that the style name was Kirsten, I nearly cried. For the first time in 14 years, I was walking in shoes without pain – and I looked stylish!” says the former middle and high school Spanish teacher. Diagnosed with RA in her 20s, the disease had severely affected the small joints of her feet and toes, limiting the pretty, blue-eyed blonde’s fashion options.

The little black clog changed all that, and inspired her to seek other manufacturers that catered to feet like hers. The list grew, as did Kirsten’s shoe wardrobe, prompting her husband to suggest she blog about her mounting expertise.

Kirsten’s blog, Barking Dog Shoes, went live to the world in August 2007 and now includes an extensive listing of shoes, boots, sandals and more with reviews of them all. Kirsten has turned the family’s suburban Chicago den into a veritable shoe store as manufacturers send their wares for review.

“When companies send me their shoes to try on and assess, they know they will get an honest opinion, as do my blog’s viewers,” says Kirsten, whose personal shoe wardrobe of vetted types and styles has grown from two pairs to more than 40, ranging from casual athletic shoes and flats to dressy heels and boots.

“My criteria are simple. Aside from being stylish, a shoe must have a roomy toe box, solid arch support and good cushioning, specifically for the ball of the foot,” she says. —Judy Alexandra DiEdwardo

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