How to Select Foot-Healthy Shoes

Selecting foot-healthy shoes—shoes that truly support long-term foot health—is one of the most important considerations in caring for your feet, as most foot and toe problems are caused by conventional footwear. Indeed, shoes that are generally regarded as appropriate (and even healthy) by many foot care professionals and society at large actually cause a variety of foot and toe deformities and lead to numerous musculoskeletal health problems, from bunions to hammertoes to ingrown toenails to knee osteoarthritis.

But how do you know which shoes will help you achieve optimal foot health and which ones will cause problems? In this article, we have compiled some helpful tips to help you differentiate between shoes that will improve your foot health and shoes that will hinder it. Our top tips for selecting foot-healthy shoes are:

1. Avoid shoes with design flaws
2. Take stock of toe box width & shape
3. Use Correct Toes as a guide
4. Perform the Shoe Liner Test
5. Plan ahead for foot lengthening
6. Understand natural foot anatomy

Let's delve into each of these tips a bit more to gain a greater understanding of how they relate to natural foot health and shoe selection.

Tip #1: Avoid Shoes with Design Flaws

Four main design features found in conventional footwear—including shoes and boots, and many sandals—are responsible for the bulk of negative foot health effects that occur over time: Heel elevation, toe spring, tapering toe boxes, and rigid, inflexible soles. Shoes or boots that possess these injurious design elements represent the majority of footwear sold today, though an increasing number of footwear companies are producing more healthy-foot-shaped, minimalist designs that incorporate less (or no) heel elevation, wider toe boxes, and more flexible soles. Please see our men's and women's shoe pages for examples of such footwear.

For a more comprehensive list of common footwear design inclusions that can cause foot pain and problems, check out our article entitled Problematic Shoe Design Features. This article goes into greater detail about the many design aspects incorporated into conventional footwear that you should consider avoiding when selecting shoes. Sorting out the good from the bad is not terribly difficult once you know the potential pitfalls to look for in shoes. Still, if you have any questions about the foot-healthiness of any particular shoe brand or model, we welcome your questions and will do our best to provide helpful and relevant feedback.

Tip #2: Take Stock of Toe Box Width & Shape

Toe box width is perhaps the single most important design element to consider when selecting footwear (though you could make a strong case for any of the design elements mentioned above in terms of importance for and impact on foot and toe health). A shoe’s toe box should accommodate natural toe splay and natural foot posture; that is, it should be wide enough to allow your toes to spread out the way nature intended, such that each individual toe is in line with its corresponding metatarsal bone.

In addition to toe box width, toe box shape is also an important consideration. The ideal toe box shape should resemble a reversed spade, such that the shoe is narrowest at the heel, sufficiently wide at the ball of the foot, and then becomes even wider out toward the ends of the toes. No part of a shoe's toe box should contact or encroach upon any of your toes, including, especially, your first and fifth toes, which are most vulnerable to the deforming effects of tapering toe boxes.

In terms of what's optimal for width in other parts of the shoe, a shoe can be on the snugger side around the heel and throughout the instep and still be perfectly foot-healthy. Most people need the width the most at the ends of the toes to preserve foot shape and function, and a good shoe accounts for this. For more information about shoe width and what to look for, please see our article entitled How to Determine Proper Shoe Width. Another article from our blog, called Shoe Sizing Techniques: Traditional vs. Natural, provides additional insights into the topic of shoe sizing.

Tip #3: Use Correct Toes as a Guide

One way to know for sure if a given shoe is wide enough in the toe box to accommodate natural toe splay is to try using the shoe in combination with Correct Toes toe spacers. We recommend Correct Toes as a tool to help reposition your toes in their normal (and natural) anatomical arrangement or orientation. You can wear Correct Toes throughout the day or as a night splint to help realign your toes and address or prevent foot problems. This toe spacing device works best (i.e., performs the most corrective work on the toes) when it's worn during weight-bearing activity, and it fits in certain shoe models, including all the options featured on our men's and women's shoe pages.

You can learn more about the many merits of Correct Toes in this article, entitled Top 10 Benefits of Correct Toes. This article, called Correct Toes vs. Other Toe Spacers, compares Correct Toes to other toe spacing devices available on the market. Note: It's important to avoid using Correct Toes inside shoes that possess any degree of toe box taper. Doing so will be uncomfortable and unproductive in terms of rehabilitating your toes and restoring optimal foot health.

SHOP CORRECT TOES

Another important thing to consider for foot health, and something related to getting the most out of your foot-healthy shoes, is sock tightness and the impact socks can have on toe position inside your shoe. Conventional socks, which possess a single sleeve that contains all the toes, may contribute to toe deformity and foot problems by pulling your big toe into a hallux valgus position, or a position in which your big toe is shifted toward your foot’s midline (also known as a “bunion configuration”). Consider stretching the seams of your socks, especially the seam that runs across the ends of your toes, to reduce their tightness. Or, best of all, buy socks that are less constricting, such as toe socks.

In our experience, we have found that a combination of Correct Toes, Injinji toe socks, Pedag metatarsal pads, and Naboso insoles produces synergistic foot health benefits. A truly foot-healthy men's or women's shoe should easily accommodate all of this helpful footgear, and the ability to do so is another indication of the effectiveness and appropriateness of a given shoe. Compared to conventional foot care approaches (i.e., surgery, injections, and orthotics), adopting and using these key pieces of natural footgear is a simple, economical, and effective approach to resolving many foot and toe problems.

Tip #4: Perform The Shoe Liner Test

Getting a proper shoe-fitting from a trusted foot health professional (ideally, from someone with knowledge of normal foot anatomy and natural foot care approaches) is another important consideration when selecting foot-healthy shoes. Most people fail to get an individualized shoe-fitting and select shoes that are too narrow, especially in the toe box. If getting a proper shoe-fitting is not possible, you can assess almost any pair of shoes by performing the Shoe Liner Test to determine if they are sufficiently wide and appropriately shaped for your foot.

This test involves pulling the liner or insole out of your shoe and standing on it, with all your weight centered over your foot. If any part of your foot, including your toes, hangs over the margins of the liner, then the shoe is too narrow for your foot. When performed wearing Correct Toes toe spacers, the Shoe Liner Test is the gold standard for determining whether or not a given pair of shoes will help or hinder your foot form and function.

Tip #5: Plan Ahead for Foot Lengthening

Many people who make the transition to foot-healthy (and foot-shaped) minimalist footwear experience the phenomenon of foot lengthening over time. With external forces (such as tapering toe boxes and toe spring) that normally act to constrict the foot finally at bay, your foot will become longer and wider, eventually achieving its true length and width. It's not unusual for women to see a corresponding increase in shoe size, typically on the order of a half-size to a full size. Men often see even greater gains in shoe size; sometimes up to two full sizes beyond what they were originally wearing! This change doesn't happen overnight, but it instead occurs over a period of months and years, assuming you continue to use foot-healthy footwear and other natural footgear on a regular basis.

With this foot lengthening and widening in mind, you might consider purchasing a slightly larger shoe size to accommodate the coming changes, though nothing too drastic. A half-size up from your usual size is generally a good place to start. The slightly larger shoe size also means more roominess in the toe box, which is usually welcome, especially if you intend to pair your foot-healthy shoes with Correct Toes. You certainly want to avoid purchasing too large a size, as a lot of extra material past the ends of the toes makes for a sloppy feel and an increased risk of tripping or performing an errant footfall. We usually recommend leaving about one centimeter of space beyond the toes to accommodate some foot lengthening and toe unfurling.

Tip #6: Understand Natural Foot Anatomy

Caring for your feet involves selecting footwear that is shaped like how a human foot is meant to be shaped; that is, with the widest part of the shoe at the ends of your toes, not at the ball of your foot. Evidence of true human foot shape can be seen in newborns or in populations around the world—especially in Africa, South Asia, and Southeast Asia—who have largely gone unshod most of their lives. Many Nepali mountain porters, for example, prefer to go barefoot or wear just a thin, unobtrusive sandal when carrying their heavy loads. Porters' feet are strong and possess excellent toe splay, and foot health in this population is outstanding.

Your feet are inherently strong and resilient and, in most cases, do not require arch support, pronation control, or any of the other features shoe manufacturers have been touting for years. Observations of unshod cultures reveal the true depth of this statement: Populations who go shoeless or who wear minimalist footwear experience only a fraction of the foot and lower extremity problems that plague shoe-wearing populations. If arch support and other common conventional shoe design features are required for foot health, we would expect to find most of the developing world crippled with foot problems, which clearly is not the case. Understanding and accepting the true nature of human foot shape is a vitally important part of adopting foot-healthy footwear.

Anatomical Footwear for Improved Foot Health

Selecting the proper footwear, including shoes, boots, and sandals, is an important and constructive way to build strong, healthy feet and prevent more invasive foot or ankle interventions, such as surgery, down the line. Most immediate and long-term foot problems are preventable and do not require the use of conventional approaches (including arch orthotics or motion control footwear) to correct. Indeed, judiciously selecting footwear that protects your feet but still allows them to feel the ground and develop the flexibility they need is crucial in realizing optimal foot health and reclaiming your natural foot health heritage.

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