Best Shoes for Knee Pain: How Footwear Impacts Joint Health

Every step you take creates a chain reaction through your body. When your foot strikes the ground, the impact travels upward through your ankles, knees, hips, and spine. Shoes with proper cushioning, arch support, and stability features can help:

• Absorb shock that would otherwise travel to your knees
• Promote proper alignment of your feet, ankles, and legs
• Distribute pressure evenly across your foot
• Reduce excessive pronation or supination (inward or outward rolling of the foot)
• Provide stability that reduces lateral knee stress

• Worn-out cushioning: Shoes lose 30-50% of their shock-absorbing ability after 300-500 miles of use
• Improper arch support: Can lead to overpronation or supination, creating misalignment that stresses the knees
• Excessive heel-to-toe drop: High drops (>10mm) can increase pressure on the patellofemoral joint by up to 15%
• Inadequate stability: Allows excessive foot movement that can translate to knee strain
• Poor fit: Too tight or too loose shoes alter your natural gait, creating compensatory movements

Heel-to-toe drop refers to the height difference between the heel and forefoot of a shoe. Research suggests that a lower drop (0-8mm) may reduce knee stress for many people by promoting a more natural gait pattern and midfoot strike.

• High drop (8-12mm): Traditional design, may increase knee stress for some
• Medium drop (4-8mm): Good balance for most people with knee pain
• Low drop (0-4mm): May reduce knee stress but requires adaptation period

Note: If you’re used to high-drop shoes, transition gradually to lower drops to avoid calf strain or Achilles tendon issues.

Understand Your Foot Type

Different foot arches require different types of support:

• High arches: Look for neutral shoes with extra cushioning
• Normal arches: Neutral shoes with moderate cushioning work well
• Flat feet/low arches: Stability shoes with motion control features

You can determine your arch type with a simple “wet test” – wet your foot and step on a piece of paper. The imprint will show if you have high, normal, or flat arches.

A simple test to check if a shoe provides adequate support:

1. Hold the shoe at both ends
2. Try to bend it in half
3. The shoe should bend primarily at the ball of the foot (where your toes bend naturally)
4. If it bends in the middle or is too rigid to bend at all, it may not be ideal for knee pain

• Replace shoes regularly: Most shoes lose 30-50% of their cushioning after 300-500 miles (about 6 months of regular use)
• Consider custom orthotics: For severe knee pain, custom insoles can provide targeted support
• Rotate between multiple pairs: This extends shoe life and provides different support patterns
• Gradually transition to new shoes: Alternate between old and new pairs for 1-2 weeks
• Wear appropriate shoes for each activity: Don’t use walking shoes for running or vice versa