Are My Shoes Going to Give Me Bunions?

The Role of Footwear in Bunion Formation

The truth is that it isn’t always possible to know with 100 percent certainty the exact causes of one bunion or another. What does seem to be the case is that the list of risk factors for bunions includes a mix of both “nature” and “nurture” components.

On the “nature” side of the spectrum, it’s very well established that bunions do tend to run in families. In other words, there seems to be a genetic component that influences how likely a person is to develop bunions or not.

For example, even when controlling for footwear choices, bunions tend to be more frequent in people with certain foot structures—such as those with flexible flat arches. If your mother or grandmother had bunions, you are probably at a higher than average risk.

That being said, shoes do seem to make a difference on the “nurture” side of the equation.

To be clear, whether wearing shoes like stilettos or pointy-toed pumps actually cause bunions is still a matter of debate within the podiatric community. Some podiatrists think you need to have a vulnerable foot structure first, while others disagree.

That being said, if you are susceptible to developing bunions, making poor choices with your footwear certainly seems to act as both a trigger and accelerator. Shoving your feet into those pumps day after day, week after week will only increase the destabilizing forces and stress on your joints and cause your bunion to get worse and worse, faster and faster.

Preventing Bunions with Better Shoe Choices

So now that you know that, yes, shoes are indeed an established risk factor for bunions, you need to know how to make smart choices to mitigate that risk.

Here are our suggestions.

Daily Wear

For your everyday shoes, you’re going to want a comfortable pair of walking shoes. What should you look for?

• A proper fit. How many of us are guilty of buying a pair of shoes that don’t quite fit, just because of how cute they are? The temptation is real, we know. But don’t give in! Always measure your feet before buying (length and width), try on pairs, and walk around in them. They should be comfortable right away. Don’t justify a tight pair of shoes thinking that they’ll “break-in.”
• Space for toes to wiggle. Shoes with pointy, compact toe boxes that scrunch your digits together are a major risk factor for bunions. You want your toes to be able to lay flat in their natural position, plus be able to wiggle up and down and left and right comfortably.
• Good arch support and cushioning. Choose shoes that offer a solid base of support, including a soft and cushioned footbed with built-in arch support and a very slightly elevated heel. That should be good for most people unless you happen to need it…
• Orthotics. If you have an abnormal foot shape or gait pattern, you might be putting excessive pressure on your big toe joint regardless of the style of shoes you wear. However, the right pair of orthotics from our office may be able to offset these factors, reducing your risk of developing bunions (or keeping the ones you already have from getting worse.)

As much as possible, avoid wearing shoes that shift weight toward the front of your feet (such as high heels), shoes that keep the toes pinched together, as well as flats (which offer no support for your arch).

What About Those Special Occasions?

We know that, for many of our female patients, “Don’t wear high heels” isn’t always the most useful advice. Maybe they’re required for your workplace, or you just enjoy wearing them from time to time.

While high heels are never really recommended, there are some steps you can take to at least minimize the risk that they’ll do long-term damage to your feet.

• Wear them sparingly. Try to reserve those high heels for special occasions only. Avoid standing or walking in them for hours at a time, or many days in a row. If you do wear them out, bring along an extra pair of comfy shoes you can switch into before and after the event, or if your feet start to ache.
• Limit heel height. The shorter your heels, the better—at least when it comes to keeping weight and pressure away from bones and joints that can develop bunions once destabilized. We recommend a maximum cap of 2 inches.
• Give yourself a wide base of support. At a given heel height, a chunky wedge is going to be able to support a lot more of your weight comfortably than a spiky stiletto. The broader and wider, the better.
• Get on the platform. In general, platforms (or at least heels with respectably thick, sturdy soles) are going to do a better job absorbing impact forces and keeping pressure away from the balls of your feet than heels with very thin soles.

All the other rules we mentioned in the everyday wear section apply, too. Find shoes that fit correctly. Try to find heels with a more generous toe box (easier said than done, we know). And yes, orthotics for high heels do exist! Just make sure there’s enough depth in your high heel to accommodate them without squishing your toes.