When it comes to the health and well-being of your musculoskeletal system, few things are more important than what you put on your feet. Indeed, your choice of footwear affects everything from your joint health to your postural alignment to your walking and running gait, and more. Making sure your footwear is maximally foot-healthy is an essential part of avoiding foot, leg, and back pain, preserving mobility, and taking care of your body. This article is intended to highlight and describe foot-healthy footwear features to look for and includes a checklist you can download and refer to when you are next shopping for shoes.
When assessing footwear for suitability, there are a number of distinct features—some of primary importance, some of secondary importance—that you’ll want to consider. These features all contribute, in one way or another, to the healthy and proper functioning of your feet. In general, we believe that the less a shoe does to your foot, the better for your foot, and so our recommendations for how to shop for shoes reflects this belief and favors footwear that allows your foot to function like a healthy bare foot inside your shoe.
To kick things off, let’s first focus on the major factors to consider when assessing and selecting shoes before addressing some of the minor—though still very important—aspects of footwear to contemplate. When shopping for shoes, make sure that the specific model you select possesses a:
Often, shoes that are touted as having a “wide toe box” are only wide at the ball of the foot and then taper toward the ends of the toes. What you want to look for, instead, is a toe box that is wide at the ball of your foot and then continues to get wider out toward the ends of your toes, such that the widest part of the toe box is at the very ends of your toes. A “foot-shaped” toe box (i.e., a toe box that's shaped like a natural human forefoot), helps prevent passive toe deformities as well as all of the foot and toe conditions listed in the paragraph above. It’s also significantly more comfortable and a definite “must have” in any foot-healthy shoe.
The gold standard that we at Natural Footgear use to assess the appropriateness of a given shoe’s toe box is whether or not the shoe is compatible with Correct Toes toe spacers. Correct Toes gently realigns your toes in their intended anatomical position; that is, in line with their corresponding metatarsal bones. If a shoe can comfortably accommodate your foot with Correct Toes on, this is one positive sign that the shoe is foot-healthy and capable of supporting your foot in a natural and effective way.
In the same vein, the Shoe Liner Test is another essential tool you can employ when assessing whether or not a shoe’s toe box is going to be wide enough to comfortably accommodate your forefoot. This video demonstrates how to perform this important test of shoe suitability:
In addition to a wide, foot-shaped toe box, many people—especially those with hammertoes—will benefit from a tall toe box. The toe box should, ideally, be tall enough to prevent the “knuckles” of any hammered toe from contacting the top of the toe box.
When it comes to toe boxes, there's one more important consideration: It's important to judge toe box fit not by how it accommodates a foot that already has passive toe deformities, but by how it accommodates a foot that’s in its healthiest possible configuration; that is with toes straight and well splayed. So, even if you haven’t yet achieved optimal toe splay, the shoe you select needs to have a toe box that’s roomy enough to allow you to eventually get there. Toe spacers happen to be a very good way to approximate where your toes need to be, but if you don’t have or use Correct Toes, you still need to be able to judge a toe box based on your toe orientation after your toes have adjusted to their future healthiest alignment (by manually spreading and straightening your toes, or, if that’s not possible, simply by visualizing what perfect toe alignment would look like for you).
What to look for: When shopping for shoes, it pays to give a shoe’s toe box the high scrutiny it deserves. Look for footwear that is widest at the ends of the toes and with a toe box that is shaped like a natural human forefoot.
2. Completely Flat Sole
A completely flat sole—what is sometimes referred to as a “zero drop” platform—is another crucial consideration when shopping for shoes. A flat-soled shoe allows your foot to rest and act upon a level plane, which is what nature intended for optimal foot function. A shoe that is completely flat from heel to toe will also help stabilize your foot and ankle, reducing your chances of ankle sprains and other problems in this lower leg region. It can be tough to find truly flat-soled shoes, though, as most conventional footwear contains two injurious design elements—heel elevation and toe spring—that contribute to a variety of foot and toe ills.
Heel elevation—in any amount—is an element that you want to avoid in footwear. It’s essentially the degree to which a shoe lifts your heel above the ball of your foot and is a common inclusion in most conventional shoes. Wearing shoes with heel elevation will cause you to develop contracted and shortened posterior leg muscles and tendons, impair your normal gait and propulsion, strip your foot of its natural arch support, and lead to excessive foot/ankle pronation. Your best bet for maintaining foot health and function is to select men’s or women’s footwear that possesses a simple, flat sole without any degree (i.e., not even 1 millimeter) of heel elevation.
Similarly, toe spring is another common design inclusion in conventional footwear that you would be wise to avoid. Toe spring, the upward ramping of the toe box that’s built into some shoes, causes a number of foot and toe problems, including tendon imbalances that lead to crooked toes and the displacement of your forefoot fat pad away from a position that cradles and protects the heads of your metatarsal bones.
Helpful Tip: You can remove toe spring from most shoes (to at least some degree) by folding the shoe in half, with the sole of the forefoot touching the sole of the heel, and placing the shoe under a heavy object, such as a bookshelf, for 24 to 48 hours.
When shopping for shoes, you’ll particularly want to avoid shoes with rigid toe spring, which holds your toes in an extended position for prolonged periods. Rigid toe spring differs from flexible toe spring, in that the latter is less harmful to your foot and toes than the former. Flexible toe spring is less worrisome because it can often be compressed out of the shoe by your body weight alone (and therefore does not hold your toes in an unfavorable and deviated position for extended amounts of time).
What to look for: Look for footwear that is truly zero drop (i.e., shoes that let your foot rest on a completely flat support platform from heel to toe). If the shoe appears to have toe spring, try it on, if you can, to see if the toe spring will easily compress out when you’re weight-bearing (i.e., standing, walking, running, etc.).
3. Flexible Sole
Crucial to developing a strong, resilient foot is adopting footwear that possesses a truly flexible sole. Indeed, whether or not a shoe has a flexible sole is one of the more important considerations when shopping for shoes. In our experience, we’ve found that shoes with thinner, more flexible soles offer better ground feel, encourage more mindful walking and running, and improve foot strength by allowing your entire forefoot, toes included, to do more of the weight-bearing work. A lot of conventional shoes possess rigid, inflexible soles that supposedly offer “support” and “protection” that the foot “needs,” but in reality, more rigid soles essentially immobilize your foot, making it weaker over time and less capable of functioning as nature intended.
What to look for: Look for footwear that you can easily bend, fold, or twist in multiple directions or easily roll up into a ball. These are all indications of a truly flexible (and foot-healthy) sole.
4. Minimal Cushioning
What you may be surprised to learn, given almost everything you’ve no doubt heard about footwear, is that the more cushioning or padding a shoe possesses, the harder and more damaging on your lower extremity joints it may be. This is due to the fact that shoes with lots of cushioning dull your ability to sense what is going on in your feet and body, and they result in a gait that involves more vertical motion (i.e., up and down bouncing) and abrupt heel striking. This usually translates into greater forces being applied through your lower extremity joints, not less. Shoes with minimal cushioning, on the other hand, encourage quieter, more gentle footfalls and a better overall ground feel, which allows you to adopt a walking or running gait (with a neutral foot strike) that better mitigates impact forces on your body.
That being said, some folks who are transitioning to healthier, more foot-shaped footwear after many decades of wearing conventional shoes may not tolerate footwear with relatively little cushioning—at least, not right away. These individuals may need a little more padding between their foot and the ground, at least for a period of time, until foot adaptations begin to occur and less cushioning can gradually be introduced. In general, though, we favor footwear with relatively little cushioning, and we favor footgear—such as Pedag metatarsal pads—that promotes and utilizes the natural cushioning (i.e., fat pads) built right into your foot.
We have published some guidelines in the Stack Height section immediately below that discuss specific parameters to consider regarding foot padding and are based upon your own shoe-wearing history and where you are at in the transition process.
What to look for: Look for footwear that incorporates relatively minimal cushioning and affords your foot excellent ground feel. If you’re just making the transition to healthy footwear after many years of wearing heavily-cushioned shoes, consider adopting an otherwise foot-healthy shoe with slightly more padding beneath your foot and then work toward using thinner-soled footwear over time.
5. Low Stack Height
Somewhat confusingly, shoe cushioning and shoe stack height are not quite the same thing. Shoe cushioning refers to the padded portion of a shoe’s sole, whereas stack height is defined as the total amount of shoe material between the foot and the ground. This number, usually reported in millimeters (mm), is the sum thickness of a shoe's insole, midsole, and outsole. The lower a shoe's stack height, the more likely it is that you'll be able to sense or feel the ground beneath your foot and experience a more natural gait. Shoes with lower stack heights also place your foot closer to the ground and, in so doing, help prevent ankle sprains, which are all too common in those who wear shoes with higher stack heights.
Helpful Tip: You can remove the included (usually optional) shoe insole or liner to turn a higher stack height shoe into a lower stack height shoe, usually without compromising foot comfort. This can be helpful in the progression from transitional-type shoes (i.e., wide toe box, zero drop shoes with thicker soles) to more minimalist shoes.
Of course, we understand that not everyone who adopts foot-healthy footwear does so from the same starting point, and the ability to tolerate thinner-soled footwear is dependent on a number of factors, including the amount of time a person has worn conventional footwear, the specific foot health considerations a person is managing, and whether or not additional helpful footgear is being worn simultaneously. So for that reason, we can’t offer a one-size-fits-all recommendation for what constitutes an ideal stack height for footwear. In general, though, we have found the following stack height guidelines to work well for most people, most of the time:
16 mm to 25 mm: This stack height works well for those who are new to wide toe box, zero drop footwear and who have a history of wearing conventional footwear for many decades.
9 mm to 15 mm: This stack height works well for those who have already successfully worn “transitional” footwear for a period of 6 to 12 months or for those who have worn conventional footwear for up to several decades.
3 mm to 8 mm: This stack height works well for those who are already accustomed to minimalist footwear or who have already engaged in a foot strengthening/rehabilitation program. For the latter group, especially those with moderate-to-severe, footwear-acquired foot and toe deformities, we recommend at least one year of foot rehabilitation work and visible improvement in joint alignment and function—particularly improvement in the first metatarsophalangeal joint—before adopting such minimalist footwear.
These stack height guidelines are not hard and fast rules; they simply represent what we have seen work well for our patients and customers in the past. Again, everyone comes to healthy footwear from a different place, and what works for one person may not work for someone else.
What to look for: In general, look for footwear with a low stack height to achieve optimal ground feel and help prevent ankle sprains. For those just transitioning to foot-healthy footwear after many years or decades of using conventional footwear, look for shoes with a stack height that offers your foot a nice blend of comfort, protection, and ground feel.
6. Lightweight Design
Many conventional shoes are needlessly heavy. In most cases, the material used to construct a shoe does not need to be so weighty. Specialty footwear exceptions do exist, but for the most part, additional shoe weight is a hindrance to the optimal functioning of your foot and lower body. This is particularly true for athletes. Carrying less weight on your feet means you can move faster and with greater deftness—two important outcomes that can translate into better athletic performances. But even for non-athletes, a lighter shoe offers the possibility of a lighter step (i.e., reduced joint impact) and a more natural gait. We tend to favor footwear that weighs 12 oz. or less per shoe (and the lighter the better).
What to look for: Look for footwear that offers your foot a lightweight yet durable protective covering so that you can move about in the most natural way possible.
Additional Important Features to Consider
Now that we’ve discussed the most important footwear features to assess when shopping for shoes, let’s take a closer look at other (still very important) shoe design considerations. The presence (or absence) of these things, depending on the specific factor being considered, can lead to improved foot health and function over time. When shopping for footwear, we recommend considering the following additional footwear aspects:
Let's explore each of these additional important features to consider when shopping for shoes.
Built-In Arch Support & Motion Control
Some shoes incorporate built-in “arch support,” which often takes the form of arch props or bumps that attempt to fill the space beneath your main foot arch to control pronation or address a variety of foot ailments. Some shoes also incorporate sole materials and/or designs (e.g., grooves or channels) that try to dictate or “control” foot movement. Not only are these design elements uncomfortable, but in most cases, they also represent a band-aid solution (at best) to a problem (i.e., a destabilized main foot arch) that’s actually caused by the combined effects of three design flaws mentioned above: Heel elevation, tapering toe boxes, and toe spring. Indeed, pronation control and foot symptom management via built-in arch support or other motion control “features” is detrimental to your foot health and is something you should avoid.
What to look for: Look for footwear that does not incorporate any built-in arch support or motion control features.
A foot-healthy shoe possesses a breathable upper, which is a function of both the upper design and the materials used to construct it. A breathable upper helps keep your foot cool and dry, which is an important consideration in preventing foot problems associated with moisture accumulation (e.g., blisters, athlete’s foot, toenail fungus, etc.). A breathable upper also helps prevent undesirable shoe odor.
What to look for: Look for footwear that is well ventilated and that incorporates natural fibers, mesh paneling, and looser weaves.
Just as rigid soles are a problem in many types of footwear, so too are rigid uppers. A rigid upper may force your foot and toes into an unnatural and problematic configuration and impede natural foot movement, and you should avoid it if at all possible. A softer and more flexible upper is more accommodating and expansile, and this can make a huge difference in terms of both foot comfort and foot health. A flexible upper is important for every set of feet, but perhaps particularly so for individuals with wider feet who might not otherwise be able to experience a comfortable fit.
What to look for: Look for footwear with an expansile upper that can be easily stretched in multiple directions.
A shoe last is a 3-dimensional wooden or plastic mold around which a shoe is constructed. Last shapes vary from one shoe company or brand to the next (and sometimes even between different models within the same brand). Not all lasts are created equal. In our experience, we have found that shoes with straighter lasts are usually better for natural foot health. Some lasts are quite curved, which can present problems for certain sets of feet due to the way the curved last affects the 4th and 5th toes.
What to look for: Look for footwear that has a straight or relatively straight last (i.e., when looking at the bottom/sole of the shoe, the front half of the shoe should be more or less in line with the back half of the shoe, not curved to one side).
Some shoes possess a concave footbed or insole, which means that, when wearing the shoe, your foot sits in a semicircular “bowl.” While this may be fine for your heel, it is not fine for the other weight-bearing portion of your foot: Your forefoot and toes. A concave footbed, especially a more rigid one, effectively inverts your transverse foot arch—the arch that runs across your foot, from one side to the other. Inverting the transverse foot arch strips this arch of its inherent stability and makes sensitive tissues and structures in the ball of your foot—nerves, blood vessels, and bones—more vulnerable to problems. Concave footbeds, which are shaped like the bottom of a boat, essentially, have been used by some conventional footwear manufacturers as a way to fit feet into shoes that would otherwise be far too narrow.
What to look for: Look for footwear with a completely flat and level footbed, both from heel to toe and from one side of your foot to the other.
Most shoes (conventional or foot-healthy) come with an optional (i.e., removable) liner or insole. Most people believe that shoe insoles are mandatory for foot comfort and shoe performance, though they do not necessarily improve the feel of a shoe and often dampen your ability to sense the ground. When it comes to insoles, there are a few key considerations:
Are they fixed or removable?
Are they of a uniform thinness?
Are they constructed from quality materials?
What to look for: Look for footwear that includes removable insoles or insoles that are uniformly thin. If the insole is fixed (i.e., glued or sewn to the bottom of the shoe), it should be of uniform thinness and made of comfortable and durable materials.
Note: One type of insole that we really like and use ourselves is Naboso insoles, which are thin and flexible and incorporate a textured pattern for proprioceptive effects.
Ideally, a shoe's tread should work in conjunction with your foot (in its optimal, natural configuration) to improve foot stability and help prevent slips and falls. Too many shoe manufacturers rely on an aggressive tread pattern alone as a salient feature for traction; in reality, the tread pattern matters less than the relative “grippy” nature of the sole material. Indeed, thick lugs are less important than how the outsole material interacts with ground features and how the foot is positioned within the shoe (which is, ideally, on a level plane and close to the ground, with toes splayed, for optimal stability).
What to look for: Look for footwear that possesses a reasonably grippy outsole and a tread pattern that doesn't try to overdo it.
Men’s vs. Women’s Models
The truth is, many shoe companies try to appeal to female customers by narrowing the toe box of their shoes (relative to the men's version in the same model). The belief is that a narrower shoe is a more elegant shoe, and therefore more marketable and desirable to women buyers. In our experience, we've found that women usually do better when purchasing smaller sizes in the men's version of a given model, due to the relatively wider toe box that usually accompanies men's footwear (unless the model possesses a “unisex” design, in which case buying based on gender is irrelevant). This is particularly important, because women have a relatively wider forefoot than men (though a relatively narrower heel). There are some things women can do to ensure a good fit around the heel in men's shoes, if need be, including using a tongue pad to take out any slack that might lead to heel shifting within the shoe.
What to look for: Look for footwear that can easily accommodate your forefoot. If the women’s version of a particular model is not sufficiently wide in the toe box, try the men’s version in this same model to assess the fit.
Compatibility with Other Helpful Footgear
The ability to comfortably wear other helpful natural footgear within your shoes—footgear such as Correct Toes (as described earlier in this article), Injinji toe socks, Pedag metatarsal pads, Naboso insoles, and Tuli’s heel cups— is an important consideration in determining the foot-healthiness of a given shoe. There should be ample room within a truly foot-healthy shoe to accommodate any or all of this beneficial footgear.
Note: Some shoes may not be compatible with other helpful footgear with the insole in but may become so after removing the liner. Indeed, removing the insole can open up a lot more space inside the shoe, especially in the toe box area.
What to look for: Look for footwear that can easily accommodate a variety of other helpful footgear without your foot feeling cramped or constrained in any way.
Construction & Durability
Your shoes are an investment in your musculoskeletal health, and you want them to last for a long time. Indeed, a good pair of shoes needs to stand up to the many challenges you will put them through. And so, for that reason, a shoe’s construction and durability are key things to try to assess when shopping for shoes. It can be difficult to know for sure if a given shoe has quality construction, and you really can’t judge the quality of a shoe based solely on the country in which it’s manufactured. You can, however, get a sense of a shoe’s construction by doing some online research and reading reviews from other customers who have already purchased that particular model. If there are any serious construction issues or common defects that seem to occur with the model, these should become readily apparent when reading others’ reviews.
What to look for: Look for footwear that possesses quality construction and will stand the test of time and use.
Donning Process & Lacing System
A shoe’s donning process and its lacing system often go hand in hand, and they are important things to evaluate when shopping for footwear. We tend to favor footwear that is easy on/easy off, as this increases the likelihood that you will use it. It may seem like a minor point, but shoes that are harder to don tend to see less use. Also, in regards to the lacing system, we prefer shoes with lacing systems that offer you, the user, the ability to leave the lowest eyelets undone (this can be helpful in opening up some additional room around the ball of the foot when needed). Further, when it comes to lacing systems, we prefer footwear that allows you to swap out the existing laces for “no-tie” laces (for improved comfort and overall ease of use).
What to look for: Look for footwear that’s easy to put on and take off, and look for footwear that incorporates a lacing system that is both comfortable and effective and that allows for some customizability.
Foot comfort is one of the more subjective things to assess when shopping for shoes, but it’s an important consideration. A foot-healthy shoe doesn’t necessarily have to be comfortable to be effective, but you will be more likely to consistently wear a foot-healthy shoe if it feels comfortable on your foot. Certain factors help determine whether or not a shoe is comfortable, including the type of material the soles and upper are constructed from, how the shoe fits around your instep and heel, how the shoe’s tongue sits against the front of your ankle and foot, the quality and usefulness of the included insole, the roominess of the shoe’s toe box, etc.
Of course, and as mentioned above, “comfort” can be a tricky or deceptive thing to measure, especially for individuals who are new to functional footwear—and especially as it pertains to the bottom, or underfoot, part of the shoe. For example, a shoe that has a springy outsole, or a squishy insole, or that places various aspects of the foot (e.g., heel, toes, etc.) in a different configuration can feel like comfort at first, especially when standing or walking around the shoe store or at home. However, these kinds of characteristics are, with continued weight bearing, bad for the feet, and they can lead to foot and joint pain and deformities that are, ultimately, anything but comfortable. Conversely, a shoe with a flexible, minimalist outsole can feel “hard” or “uncomfortable” at first, but as gait and foot function improve, so will perceived comfort. The point: The initial impression of “comfort” can be deceptive, so use care when evaluating this particular factor.
What to look for: Look for footwear that holds your foot snugly in place throughout your instep and around your heel while allowing plenty of room in the toe box to let your toes roam free. A great shoe should feel comfortable right out of the box (especially for those accustomed to minimalist footwear), without requiring a long (or any) “break-in” period.
A Note About Shoe Appearance
Coming from healthcare backgrounds, we at Natural Footgear tend to assess footwear from a foot health perspective, first and foremost. But we’ll also be among the first to say that a shoe’s appearance does matter. In fact, it matters a lot. We all have a deep psychological connection to fashion and our appearance, and we tend to buy and use footwear that allows us to look our best. The whole point of this article, though, is to highlight the many foot-health-related objective and subjective factors that we believe you ought to consider during the shoe shopping process. The best possible scenario of all, of course, is that you find a shoe that ticks off all the foot health boxes and meets your standards for visual appeal.
Shoe Shopping Checklist
Here is a checklist—a summary of all the points listed above—that you can use as a quick reference guide when shopping for foot-healthy shoes. These are the key questions to ask yourself when handling and assessing any shoe you might potentially buy.
Does the shoe you’re considering:
Have a toe box that’s widest at the ends of the toes (not just a toe box that’s wide at the ball of the foot)? Possess a healthy-foot-shaped design?
Have the ability to accommodate Correct Toes toe spacers without discomfort?
Pass the Shoe Liner Test?
Have a completely flat sole from heel to toe?
Have toe spring? If yes, is the toe spring rigid or flexible?
Have a sole that can be easily bent, folded, or twisted in multiple directions
Have an expansile upper that can be easily stretched?
Have minimal cushioning?
Have a low overall stack height?
Possess a lightweight design?
Avoid the use of any arch support or motion-control features?
Incorporate a breathable upper?
Have a straight (as opposed to curved) last design?
Have a footbed that is completely flat (i.e., not concave) from side to side?
Include a removable liner or a liner that is uniformly thin? If the liner is not removable, is it at least uniformly thin and made of durable and comfortable materials?
Possess a reasonably grippy sole and a tread pattern that’s not overly aggressive?
Vary at all in fit and feel between the men’s and women’s versions? (some women may need to try the men’s version in order to achieve sufficient toe box width)
Finding healthy footwear at conventional shoe stores can be quite challenging (if not impossible). However, armed with your checklist of features to consider and factors to assess, you’ll be in a good position to sort through all the various models you come across. You’ll most likely have more success, though, by visiting certain specialty shoe stores that focus on flatter, more flexible, and wider toe box options. Certain running specialty stores may also offer a good selection of more foot-shaped and foot-healthy athletic shoes. Of course, all the men’s and women’s footwear models featured on the Natural Footgear site are ones that we ourselves have found to support foot health, respect the inherently brilliant design of the human foot, and help restore natural foot shape and function.
Dr. Marty Hughes is a chiropractic physician, or DC. He received his doctoral degree from Western States Chiropractic College (WSCC), now known as the University of Western States (UWS). Dr. Marty has always been interested in foot health, due to the connection between the feet and the spine. He has worked as a freelance writer for LiveStrong.com, for whom he contributed over 2,200 health-and-fitness articles. He is a co-founder of Natural Footgear and an ardent supporter of natural foot care approaches. Dr. Marty enjoys road cycling, trail running, hiking, canoeing, and cross-country skiing as well as exploring the mountains of Western North Carolina.
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