60% of Adults Wear Wrong Shoe Size, McDowell Urges Measuring Feet Every Time

Q: Your foot size constantly changes. Are you making the number one mistake that leads to chronic knee and hip pain?

Yes. The most common mistake is wearing the wrong shoe size, and experts say it can set off the chain of problems that ends in chronic knee and hip pain. Physical therapist Milica McDowell says about 60% of adults wear the wrong size. Adult feet do not keep “growing,” but they do change shape over time. Aging, weight changes, pregnancy, and flattening of ligaments and soft tissue can make feet longer, wider, or both. That is why a size that fit years ago may no longer fit now. Poorly fitting shoes change how you walk. Shoes that are too tight can compress nerves, restrict circulation, and stop the toes from spreading naturally. Shoes that are too loose can cause instability and force the foot and lower leg muscles to work harder to stabilize each step. Over time, that can contribute to plantar fasciitis, bunions, hammertoes, heel pain, and altered gait mechanics. Because the foot is the body’s base, those changes can travel up the kinetic chain and increase stress on the knees, hips, and lower back. McDowell’s advice is simple: measure both feet every time you buy shoes, and fit to the larger foot. A good walking shoe should feel comfortable immediately, hold the foot snugly without squeezing, and leave about a half-inch or thumb’s width in front of the longest toe. Experts also favor a wider toe box and a lower heel-to-toe drop. If you switch to lower-drop or minimalist shoes, do it gradually. Persistent foot pain, numbness, or swelling warrants medical evaluation.

2 articles · Updated · TODAY · Jun 23

Milica McDowell says the biggest foot-health mistake is skipping a fresh measurement when buying shoes, even for adults who have worn the same size for decades.
About 60% of adults wear the wrong shoe size because feet can lengthen or widen with age as ligaments and tissues flatten; weight changes and pregnancy can also alter fit.
Ill-fitting shoes can cause blisters, calluses, numbness and nerve damage in the short term, and over time contribute to plantar fasciitis, heel spurs, bunions and hammertoe.
McDowell advises measuring both feet before each shoe purchase, sizing to the larger foot, and leaving about a half-inch between the longest toe and the shoe front.
For walking shoes, she also recommends a wider toe box, lower heel-to-toe drop and less cushioning, with persistent pain warranting a doctor visit.