Choosing everyday shoes: Do heels or flats cause more knee pain?

Everyday footwear choices can significantly affect knee health, according to an orthopaedic expert. Dr Ameet Pispati, director of orthopaedics and robotic knee surgery at Jaslok Hospital and Research Centre in Mumbai, explained that feet absorb and transmit forces through ankles, knees, hips, and spine with every step.

High Heels And Flat Shoes

High heels push the body's weight forward, alter the natural position of the ankle, and increase the load around the knee joint. They can also change posture and add stress to the lower back, though occasional wear is tolerable. However, flat shoes are not automatically a better choice. Thin, completely flat shoes and flip-flops provide little cushioning, stability, or support, and prolonged walking or standing in them can make feet work harder and aggravate existing foot, knee, or back problems.

When To See A Doctor

Dr Pispati advised looking for shoes that prioritise comfort rather than focusing solely on heels versus flats. Pain that continues despite changing footwear, is associated with swelling, locking, or giving way, or interferes with walking and daily activities requires a proper medical assessment. Underlying problems may include arthritis, a foot abnormality, a tendon problem, or another joint condition.

Context

Footwear choices directly influence how walking forces are distributed across the lower body. Medical professionals often evaluate shoes as part of diagnosing chronic knee or back discomfort. Different foot conditions mean that no single shoe type is ideal for everyone.