Are Your Shoes Causing Your Foot Pain?| Prescott AZ
Do experience foot pain when you walk,
exercise, hike, or simply stand?
Your shoes may be part of the problem.
At McKinney Physical Therapy, we see ALOT of people with foot pain. The very first thing we look at is their footwear. Shoes are often a significant part of the problem, and the most simple one to fix!
If you're experiencing foot pain, you may immediately think about plantar fasciitis, arthritis, tendon problems, bunions, or an old injury. But there is another question that is often overlooked:
A Simple Shoe-Fit CheckTake a look at your shoes and ask:• Is my longest toe hitting the end?
• Can I move my toes comfortably?
• Is the widest part of my foot being squeezed?
• Do I have redness, calluses, blisters, or numbness after wearing them?
• Does my heel stay securely in the shoe?
• Does the shoe feel stable during the activity I use it for?If you answered "no" to several of these questions, your shoes may be contributing to your foot pain. Your feet aren't shaped like the inside of a traditional pointed shoe. They are designed to spread, adapt to the ground, absorb and transfer forces, help maintain balance, and propel you forward. Your shoes should protect your feet without unnecessarily restricting those functions. You may not need to "fix" your feet. You may simply need to give them more room. |
Do Your Shoes Actually Fit Your Feet?
A surprisingly large number of people wear shoes that don't adequately accommodate the actual size and shape of their feet. A systematic review of 18 studies found that 63–72% of participants were wearing improperly fitted footwear based on foot length and width measurements. The review also found that improperly fitted shoes were associated with foot pain and problems such as corns, calluses, and toe deformities.
Width may be an especially important problem. Several studies included in the review found that 30–88% of people were wearing shoes narrower than their feet, and one study of American women found that 88% were wearing footwear narrower than their feet.
So if you have foot pain, don't just ask, "What is wrong with my foot?" Also ask: "Is my shoe allowing my foot to function normally?"
Your Feet Are Not Supposed to Look like Your Shoes
Take your shoes off and look at your feet. Your forefoot is naturally wider than your heel. Your toes are designed to spread and move. Your big toe should have room to remain relatively straight rather than being pushed toward your other toes.
Now look at many traditional shoes. The toe box often narrows toward the front, creating a shape that is very different from the natural shape of a human foot.
When you repeatedly place your foot into a shoe that is too narrow, the shoe, not your foot, determines where your toes are allowed to go. Over time, this can contribute to pressure on the toes and forefoot and may be associated with problems such as:
Bunions
Hammertoes and other toe deformities
Corns and calluses
Ball-of-the-foot pain
Toe pain or pressure
Irritation of sensitive tissues
General foot discomfort
The American Academy of Orthopaedic Surgeons specifically recommends shoes with a wide or open toe box that does not squeeze the toes for people dealing with painful bunions.
Your Shoe Size Is Only a Starting Point
Size difference between manufacturers. A size 9 from one manufacturer may fit very differently from a size 9 from another. More importantly, shoe length and shoe width are different measurements. You can be wearing the correct length but still have a shoe that is far too narrow.
Your feet can change over time, however, many people have worn the same shoe size for decades without ever reassessing whether that size still fits. Age, activity level, previous injuries, changes in body weight, arthritis, swelling, and other factors can change the shape and dimensions of your feet.
Your feet may be different sizes. You may also have one foot that is slightly larger or wider than the other.
Don't choose your shoes based solely on the size you've always worn.
Choose them based on how they fit your actual feet.
What Is a Well-Fitting Shoe Like?
There isn't one perfect shoe for everybody. A good shoe should match your foot shape, your activity, and your individual needs. However, there are several characteristics that are generally desirable.
1. A Foot-Shaped Toe Box
This may be the most important feature. Your shoe should have enough room in the front for your toes to spread naturally. The toe box should be:
Wide enough for your forefoot- Pointed toe shoes and ballet flats are generally not.
Long enough for your longest toe. There should be plenty of space between the end of your toes and the shoe when you are STANDING
Tall enough that your toes aren't rubbing against the top. You should be able to wiggle them easily.
Shaped more like your foot rather than a narrow triangle
Your toes shouldn't feel squeezed together. The goal isn't necessarily to buy a shoe labeled "wide." The goal is to find a shoe that actually accommodates your foot's shape.
2. Enough Length
Your longest toe should not be touching the end of the shoe. Research reviewed in the Journal of Foot and Ankle Research has cited approximately 10–20 mm of space between the end of the foot and the end of the shoe as an appropriate range for shoe fit.
That doesn't mean you should automatically buy a shoe two sizes larger. It means that your shoe needs adequate space in front of your longest toe while your foot is standing and bearing weight.
And remember: your longest toe isn't necessarily your big toe. For some people, the second toe is longer.
3. Enough Width
This is where many people get into trouble. The widest part of your foot should fit comfortably within the widest part of the shoe. You shouldn't feel your shoe squeezing the sides of your forefoot. You also shouldn't see your foot spilling over the edge of the shoe's sole. A shoe that is technically the correct length but too narrow can still be a very poor-fitting shoe. In fact, the research suggests that inadequate shoe width is extremely common.
4. Adequate Toe Depth
Your toes need room not only from side to side but also from top to bottom. If your toes are rubbing against the roof of your shoe, you may need a shoe with a deeper toe box.
This can be particularly important if you have:
Hammertoes
Bunions
Swelling
Arthritis
Prominent joints
Thickened toenails
5. A Secure Heel
A roomy toe box doesn't mean your entire shoe should be loose. Ideally, your heel should feel secure while the front of your shoe provides enough room for your toes. This combination, secure heel + roomy forefoot, is often a great place to start.
"But a Bigger Shoe Feels Weird!"
Yes, but only for a little while! This is something we hear frequently. You try on a shoe with a larger toe box or go up half a size, and suddenly your feet feel like they're swimming in the shoes. But hear us out!
If you've spent years putting your feet into narrow shoes, giving your toes more room can feel strange at first.
Your toes may feel like they're moving more.
Your foot may feel less compressed.
The shoe may initially look "too big" compared with what you're used to seeing.
That doesn't necessarily mean the shoe is too big.
It may simply mean your previous shoes were too small. Give your feet some time to adapt. You WILL get used to it! Start by wearing the new shoes for shorter periods around the house or during easy walks. One to two hours is a great start. Gradually increase your wearing time as long as they remain comfortable.
However, don't confuse "different" with "painful." A properly fitting shoe should not cause significant rubbing, pinching, numbness, or pain. And bigger isn't automatically better. A shoe that is excessively long can allow your foot to slide around and create its own problems.
Want to Test it Out?
Try These Simple At-Home Shoe-Fit Tests
You don't need sophisticated equipment to get a better idea of whether your shoes fit properly. These tests aren't a diagnosis, but they can reveal some obvious problems.
Test #1: The Insole Test
We use this one every day! Here's what to do:
Remove the removable insole from your shoe.
Place it on a piece of paper or cardboard.
Stand barefoot on the insole with your full weight on your foot.
Have someone trace around your foot while you're standing.
Compare the outline of your foot with the outline of the insole.
What are you looking for?
If your foot extends significantly beyond the edges of the insole, especially around the forefoot, your shoe may not be wide enough.
If your longest toe reaches the end of the insole, your shoe may not provide adequate length. This is particularly useful because your foot spreads and changes shape when you stand.
Important: The insole isn't necessarily an exact representation of the internal dimensions of the shoe, so this test is a screening tool rather than a definitive measurement.
Test #2: The Toe Test
Put your shoes on and stand normally. Make sure your foot is fully seated in the shoe and your heel is positioned appropriately. Now check the space in front of your longest toe.
You should have about 1-2 cm of space between your longest toe and the end of the shoe.
If your toe is touching the end, or you have to curl your toes to keep them from hitting the shoe, your shoes may be too short.
Walk around. Do your toes repeatedly hit the front of the shoe? If so, don't ignore it.
Test #3: The Width Test
Put your shoes on and stand normally. Look down at your feet.
Do the sides of your forefoot bulge over the edges of the sole?
Do you feel pressure squeezing the ball of your foot?
Do your little toes feel pushed inward?
Do you have red marks along the sides of your foot when you remove your shoes?
These can all be clues that your shoe isn't providing enough width.
Test #4: The Toe-Wiggle Test
This one is simple. Stand in your shoes and try to move your toes.
Can you wiggle them?
Can you spread them apart at least somewhat?
Do your toes immediately feel compressed against one another or the sides of the shoe?
Your toes don't need to perform gymnastics inside your shoes, but they should not feel trapped.
Test #5: Look at Your Feet After You Take Your Shoes Off
Take your shoes and socks off after you've been wearing them for several hours. Look for:
Red marks & Blisters
Calluses or Corns – don’t ignore the tips of your toes!
Areas of irritation
Toenails that repeatedly hit the front of the shoe
Indentations along the sides of the foot
Numbness or tingling
These signs don't automatically mean your shoes are the cause of your pain—but they're worth paying attention to.
What Should You Look For in a Shoe?
Look for shoes that offer:
• A roomy, foot-shaped toe box
• Adequate width and toe depth- Your toes should have enough room to move rather than being squeezed into the shape of the shoe.
• Enough length for your longest toe- A commonly cited guideline is approximately 10–20 mm of space between your longest toe and the end of the shoe when standing.
• A secure heel
• An upper that doesn't squeeze your forefoot
• Cushioning appropriate for your activity
• The stability and flexibility you need
• A removable insole if you use orthotics
PRO TIPS:
1. Don't Automatically Buy a Longer Shoe
Too short and too narrow are not the same thing. If you have the option, try shoes that are both a size larger and shoes that are wider. People wearing shoes that are too narrow is an extremely common problem! (Although, admittedly, the wide options, especially for women, are limited.)
2. Timing is Everything
Try shoe shopping later in the day when your feet are likely at their most swollen. This will give you a more accurate fitting.
A Note About Barefoot or Minimalist ShoesYou may have heard that barefoot or minimalist shoes are the answer to foot pain. They're not necessarily the answer for everyone. Some people adapt well to minimalist footwear. Others may find that suddenly switching to a very flexible, low-cushion, or zero-drop shoe substantially increases the demands on their feet and calves. If you're already experiencing foot pain, don't make several major changes at once. First, Give your toes enough room. Then consider whether you also need changes in cushioning, stability, flexibility, or heel-to-toe drop. |
When Should You See a Physical Therapist?
If foot pain is interfering with your ability to walk, exercise, hike, work, or participate in the activities you enjoy, don't simply assume you have to live with it. A physical therapist can evaluate more than just the painful spot.
At McKinney Physical Therapy in Prescott, AZ, we can look at your foot and ankle mobility, strength, balance, movement patterns, activity demands, and footwear to determine what may be contributing to your symptoms.
Our goal is to help you understand your pain. not simply treat the place that hurts, and develop a personalized plan to get you back to the activities you enjoy.
If you're located in Prescott, AZ and are experiencing foot pain, schedule an evaluation with McKinney Physical Therapy and let's find out what's really going on.
A Note From McKinney Physical Therapy
This article is intended for general educational purposes and is not a substitute for an individualized examination. Persistent, severe, or unexplained foot pain should be evaluated by an appropriate healthcare professional.
References and Further Reading
Buldt AK, Menz HB. Incorrectly fitted footwear, foot pain and foot disorders: a systematic search and narrative review of the literature. Journal of Foot and Ankle Research. 2018;11:43. doi:10.1186/s13047-018-0284-z.
American Academy of Orthopaedic Surgeons. Tight Shoes and Foot Problems. OrthoInfo. Last reviewed January 2025.
Jones PJ, Rowlands AV, Davies MJ, Bus SA. Diabetes Foot Ulcer Prevention: A Review of Footwear Width Assessment for At-Risk Feet. Journal of Foot and Ankle Research. 2025;18(3). doi:10.1002/jfa2.70071.
