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Your Sneakers Might Be the Cause of Your Foot (and Hip and Knee) Problems

Your cushy shoes might be damaging your feet without you even realizing it. Here is a breakdown of what our feet need for optimal health.

The global footwear industry is a $300 billion industry projected to reach over $500 billion within 5 years. That’s a LOT of marketing dollars directing the conversation about how we think about the shoes that we put on our feet. Unfortunately, much of that messaging is geared towards driving more sales, not maintaining healthy feet. I would argue that over 80% of people are wearing shoes that are damaging to their feet. I know that sounds hyperbolic but, once you understand how the foot and ankle work, it should start to make more sense.

Let’s dive in.

You Get Good at What You Do

Let’s start with some basic first principles of how the body works. The body is a self healing system of systems and it simply adapts to the demands that you place on it. In the scientific world, this is the SAID principle at work (Specific Adaptation to Imposed Demands). In lay speak, this simply means that your tissues adapt to what you do. A not-so-good adaptation: Sit in a chair all day and your body adapts to being a good chair sitter. Your hip flexors shorten, your glutes turn off, and your shoulders will round forward.

On the flip side, a good adaptation: If you stress your body by lifting heavy weights, your body adapts with stronger muscles. You get the idea. The feet are no different. Put your feet in shoes that are narrow, stiff, and super cushiony for decades and your feet will adapt. 

  • Your toes will lose their natural wide splay and squish together. 
  • Your foot will become stiff and rigid.
  • Your foot will lose its strength and become weak.

A weak, stiff foot with squished toes is not healthy. And even worse, these negative adaptations in the foot can lead to problems up the chain like knee pain or low back issues. And forget about having good balance with a stiff, weak foot. As we get older, falls become a huge risk factor so it’s crucial we maintain good balance as we age. Good balance requires a strong, mobile foot with splayed toes that act as a strong base of support.

Step 1 – Remove the Unnatural Shoes

So, how do we go from a weak, stiff foot to strong, mobile foot? Start with the shoes.

My favorite food nerd Nick St. Louis, creator of the Foot Collective, has some simple advice… “Wear natural shoes, have healthy feet. Wear unnatural shoes, have unhealthy feet. Simple, really.”

Some Definitions: 
“Natural footwear: Footwear that allows natural foot function (allows feet to move like feet).
Unnatural footwear: Footwear that inhibits natural foot function (prevents feet from moving like feet).”

So, let’s move towards a more natural shoe. 

Natural vs Unnatural Shoes Occur on a Spectrum

All footwear exists on a continuum from natural to unnatural. The goal is to gradually shift away from unnatural towards natural.

4 signs of unnatural footwear. 

  • Lifted heel vs forefoot (high heel drop)
  • Rigid material
  • Lots of cushion
  • Narrow toe box

A few examples might help. Let’s start with one of the worst offenders: the high-heeled shoe. 

I know, I know – it might be great for feeling tall, elegant, and sexy, but it’s a horrible environment for your feet. 
Lifted heel ✔️
Stiff material ✔️
Narrow toe box ✔️

Looking at those pictures, it should be pretty clear how your foot will look if you’re always wearing high heels. 

Now, I tell my female clients that if they want to get their sexy back and wear high heels, go for it, but just don’t do it every night. 

The Danger Is in the Dose

You can wear those shoes occasionally and not incur too much damage, but if they are your primary shoes, you will start to develop problems over time.

Next up is those super-cushioned, comfy running sneakers…

Sure, they might feel good and comfy, but you’re essentially turning off all the communication between your feet and your brain. The sensory information from your feet is crucial for optimal foot health. The more of the ground you feel (the less the cushion), the more your foot will adapt and get stronger.

Wear super-cushioned shoes for long enough and those connections between foot and brain become disconnected. This can lead to all sorts of problems not only at the foot, but also in surrounding joints like the knee and hip.

The last issue with so many shoes out there is high heel drops, where the heel is slightly higher than the forefoot. You’re essentially walking around on a ramp all day and that will shorten your calf muscles and can limit ankle range of motion. And again, as we talked about above, this can have a negative impact on the knee, hip, and lower back.  If your calves are chronically tight or if you have some knee or low back pain, a good first step is to reduce that heel lift in your shoes.

Natural End of the Spectrum

The goal is to move towards natural footwear and, if your feet can handle it, spend some more time barefoot. This will allow your body to naturally restore itself. Of course, if you’ve never spent time barefoot, you’ll want to ease into it just like you would any other activity. And for those who want to turn your next workout into a foot training session, try your next workout without shoes. 

What to Do Next

I’ll leave you with some practical guidelines on how to move towards natural footwear. Again, referencing my favorite foot people over at the Foot Collective.


  • Flat (forefoot and heel at the same height)
  • Flexible (able to be bent, twisted, curled up)
  • Thin sole (the more “stuff” between you and the ground the less input your brain gets about the ground)
  • Wide (the widest part of a natural, healthy foot is the tip of the toes. Most shoes squish our feet laterally, especially at the toes and this has big consequences like bunions, collapsed arches, neuromas, etc.)”

I’ll be back with part 2 where we dive into 5 basic foot screens to test your foot health and the steps to correct any issues you might have. Till next time, be mindful of those unnatural shoes and let’s start restoring your foot health one day at a time.

Nick Holt is a personal trainer and movement specialist who helps men over 40 move, look, and feel better. Surfing transformed his body from a debilitating back injury and got him in the best shape of his life in his 40s. He uses the principles of surfing, functional mobility, and strength training to help guys over 40 get in the best shape of their lives. 

Based out of Tamarindo, Costa Rica, Nick trains clients in person and also works with people online through his various remote-coaching programs. He’s currently running a September promo on this flagship 3-month transformation program and offering spouse / partner discounts. If you want a custom strength training, mobility, and nutrition program with accountability, you can schedule a chat with him here.


See medical disclaimer below. ↓


  1. UUUGGGHHH…. As a 66 year old woman with pronounced genetic bunions, an encapsulated first metatarsal joint and a butchered attempt at a bunion repair when I don’t wear some kind of shoe with support I get major debilitating pain. I power walk 4-6 miles a day (for health and wellbeing) and I need a medium support shoe. I wish I had someone near me to help with my feet issues. Sadly, podiatrists opt for surgery (not again) or cortisone shots. this is the WORST part of aging for me

    • Hey Dianne — sorry to hear that, no fun. Are you doing any exercises for the feet or toes? I’ve had clients with bunions and metatarsal issues who have corrected their issues with toes spreaders and simple mobility exercises, especially big toe work — I’ll be sharing more in my next guest post, stay tuned! Or you can also reach out to me – my contact info is above – and happy to point you in the right direction..


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The ideas expressed here are solely the opinions of the author and are not researched or verified by AGEIST LLC, or anyone associated with AGEIST LLC. This material should not be construed as medical advice or recommendation, it is for informational use only. We encourage all readers to discuss with your qualified practitioners the relevance of the application of any of these ideas to your life. The recommendations contained herein are not intended to diagnose, treat, cure or prevent any disease. You should always consult your physician or other qualified health provider before starting any new treatment or stopping any treatment that has been prescribed for you by your physician or other qualified health provider. Please call your doctor or 911 immediately if you think you may have a medical or psychiatric emergency.


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