If the Shoe Fits: Are Your Shoes Helping or Hurting Your Balance?

When you have trouble with your balance, you might think the only solution is to work on your balance exercises. But have you ever considered that your shoes could be affecting the way you walk and how steady you feel?

Your ability to stay balanced depends on your brain receiving and combining information from three major systems: your vestibular system (inner ear), vision, and somatosensory system (information from your muscles, joints, and skin). Your feet are an important part of that last system, providing your brain with information about where your body is and what surface you're standing on.

Because your feet provide so much information about the surface you're standing and walking on, it makes sense that what you put on your feet can influence how you move.

So, What Shoes Are Best for Balance?

There is a lot of debate about what type of shoe is best for someone with balance concerns. Should it have a thick sole? A thin sole? More cushioning? A higher collar?

The truth is, there isn't one perfect shoe for everyone.

However, there are a few characteristics to look for when choosing footwear if you have balance concerns.

1. Make Sure the Shoe Fits Properly

This is arguably the most important factor.

Your foot should feel secure inside your shoe without being squeezed or uncomfortable. Your feet shouldn't be sliding forward, backward, or side-to-side while you walk.

A loose-fitting shoe can cause you to change the way you walk to keep the shoe on your foot. For example, you may unconsciously grip your toes or alter your step to prevent the shoe from slipping off.

This is one reason slippers, loose-fitting shoes, shoes with very flexible uppers, or shoes with flimsy heel counters may not be the best choice for someone who is already unsteady.

A properly secured shoe allows your foot to move with the shoe rather than forcing you to adapt your walking pattern to keep the shoe in place.

2. Look for a Secure Closure

When possible, choose a shoe that can be securely fastened to your foot.

Laces are one option because they allow you to adjust how snugly the shoe fits around your foot. Research has found that shoes with secure fixation can improve aspects of walking, including step length, walking speed, and foot clearance.

These changes can be especially important for someone who is already at an increased risk of tripping or falling.

If you have difficulty tying your shoes, there are other options, including elastic laces and other secure closure systems, that can make footwear easier to manage without sacrificing fit.

3. Pay Attention to Heel Height

High heels aren't ideal when you're concerned about balance.

Increasing heel height changes the position of your body and alters your walking mechanics. Higher heels can shift your center of gravity and reduce stability during walking.

For someone who already has difficulty maintaining their balance, a lower heel is generally a better choice. Some research suggests that heel heights above approximately 2.5 cm (about 1 inch) can have unfavorable effects on balance and gait.

This doesn't mean you need to give up your favorite shoes forever. But if you frequently feel unsteady, choosing a lower-heeled shoe may give you a more stable foundation.

4. Consider the Height of the Shoe Around Your Ankle

You may also notice that some shoes come higher up around the ankle than others.

A higher shoe collar can provide additional mechanical stability around the foot and ankle. Some research suggests that this type of footwear may also improve proprioceptive feedback, the information your body receives about the position of your joints.

For someone with balance concerns, a shoe that provides some additional support around the ankle may be worth considering.

However, higher doesn't automatically mean better. The shoe should still be comfortable and allow you to walk naturally.

5. Check the Bottom of Your Shoes

Traction matters.

Your shoes should have a sole that provides appropriate slip resistance for the surfaces you regularly walk on. This becomes particularly important if you frequently encounter smooth, wet, or slippery surfaces.

And don't forget to look at the condition of your current shoes.

Worn-out soles don't provide the same traction as they did when the shoes were new. If the tread on the bottom of your shoes is significantly worn down, it may be time to replace them.

So, What Should You Actually Look For?

If you're shopping for shoes and have concerns about your balance, start with these basics:

• A proper fit — your foot shouldn't slide around inside the shoe.

• A secure closure — laces or another fastening system can help keep your foot securely in place.

• A low heel — avoid excessive heel height if you're concerned about stability.

• A stable shoe — a shoe that provides appropriate support around the foot and ankle may be helpful.

• Good traction — make sure the sole provides appropriate slip resistance and isn't excessively worn.

• Comfort — once you've found a shoe that meets these criteria, choose the one that feels best to you.

  
  

The Bottom Line

There isn't one brand, style, or type of shoe that will magically improve everyone's balance.

Instead, think about your shoes as the foundation you're standing on. Your footwear should fit properly, keep your foot secure, provide appropriate traction, and allow you to walk comfortably and naturally.

And if you're still having trouble with your balance despite wearing appropriate footwear, your shoes may not be the problem.

Balance problems can come from many different factors, including changes in the vestibular system, vision, sensation, strength, and coordination. A physical therapist can help determine which systems may be contributing to your balance difficulties and develop an individualized plan to help you feel more confident on your feet.

Kim IJ, Hegazy F. Enhancing Footwear Safety for Fall Prevention in Older Adults: A Comprehensive Review of Design Features. Ann Geriatr Med Res. 2024;28(2):121-133. doi:10.4235/agmr.23.0167