Best Shoes for Knee Pain
There is no single best shoe for knee pain, and the research is thinner than shoe ads suggest. Here is what the trials and guidelines actually say, and the shoe features worth looking for, without brand names.
Published by Innovare Tx · Facts last checked September 23, 2026 · Educational information, not medical advice.
How we chose this list
- Features, not brands. Every feature listed is backed by a trial, a guideline or AAOS patient guidance, and the source is named.
- Where evidence is missing or negative, we say so.
- Footwear is a comfort and support measure. It does not change the joint itself, and it works best alongside exercise and, if needed, weight loss.
- If you have diabetes, numbness in your feet or a foot deformity, get footwear advice from your clinician.
1. A stable, supportive walking shoe
The best trial on this question, published in the Annals of Internal Medicine in 2021, randomly assigned 164 people with medial knee osteoarthritis to wear either flat flexible shoes or stable supportive shoes for at least 6 hours a day for 6 months. Flat flexible shoes were not better on any outcome. Stable supportive shoes improved knee pain on walking more, and fewer people in that group reported side effects (15% versus 32%).
The authors note limits: there was no "usual shoes" comparison group and the participants were a select group. So this tells you supportive shoes are a sensible default, not that they are a treatment. A small 2022 lab study in 28 people with medial knee osteoarthritis also measured lower loading rates on the inner knee in supportive shoes than in flat flexible ones.
- Supportive shoes beat flat flexible shoes for walking knee pain in a 6-month randomized trial
- Fewer side effects with supportive shoes
- Evidence comes mainly from people with medial (inner) knee osteoarthritis
Checked on: Paterson KL, et al. The Effect of Flat Flexible Versus Stable Supportive Shoes on Knee Osteoarthritis Symptoms: A Randomized Trial. Ann Intern Med. 2021 · Starkey S, et al. Tibiofemoral contact force differences between flat flexible and stable supportive walking shoes in people with varus-malaligned medial knee osteoarthritis. PLoS One. 2022
2. A firm heel counter
The heel counter is the stiff cup at the back of the shoe. AAOS advises that walking shoes have stiff material around the heel that keeps it from turning in or out or wobbling.
Squeeze the back of the shoe: it should hold its shape. A soft, collapsible heel gives little control.
- Holds the heel steady (AAOS)
- Quick test: the back of the shoe should not fold easily
Checked on: AAOS OrthoInfo: Exercise Walking · AAOS OrthoInfo: Shoes: Finding the Right Fit
3. Arch support and a slight heel rise
AAOS suggests walking shoes that support the arch and elevate the heel slightly.
"Slightly" is the key word. A modest rise is different from a dress heel (see below).
- Supports the arch (AAOS)
- Small heel rise, not a high heel
Checked on: AAOS OrthoInfo: Exercise Walking
4. A roomy toe box with about a half inch at the front
AAOS recommends about 1/2 inch of space between your longest toe and the tip of the shoe, and enough room to move your toes.
Your toes should not press against the front or sides of the shoe when you stand and walk in the store.
- About 1/2 inch past the longest toe (AAOS)
- Room to wiggle your toes
Checked on: AAOS OrthoInfo: Shoes: Finding the Right Fit
5. The right width, not just a bigger size
AAOS notes that the same shoe model often comes in several widths, and that getting the width right matters more than simply going up a size.
A shoe that is too long to make up for being too narrow can let the foot slide, which works against the stability you are after.
- Ask for wide or narrow widths (AAOS)
- Too long lets the foot slide
Checked on: AAOS OrthoInfo: Shoes: Finding the Right Fit
6. Low heels: under 2 inches
A 1998 study in The Lancet found that walking in high heels increased force across the kneecap joint and put about 23% more compressive force on the inner (medial) part of the knee than walking barefoot. That was a small study in healthy women, but it points in a clear direction.
AAOS advises keeping heels under 2 inches. Save higher heels for short occasions if your knees are sore.
- High heels raised inner-knee forces by about 23% in a lab study
- AAOS: keep heels under 2 inches
Checked on: Kerrigan DC, et al. Knee osteoarthritis and high-heeled shoes. Lancet. 1998 · AAOS OrthoInfo: Shoes: Finding the Right Fit
7. Skip wedged insoles unless your clinician suggests them
Lateral and medial wedged insoles are designed to shift load across the knee. The ACR's 2026 update conditionally recommends against them for knee and hip osteoarthritis; the 2019 guideline explained that the available studies do not show clear benefit.
This is about wedged insoles specifically. If you have a foot problem, a clinician may still recommend a different insert for that reason.
- ACR 2026: conditionally recommended against for knee and hip OA
- Different from inserts prescribed for a foot condition
Checked on: Kolasinski SL, et al. 2019 ACR/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Care Res. 2020 · American College of Rheumatology: 2026 Update of the Recommendations for the Management of Osteoarthritis of the Knee, Hip, and Hand (summary)
8. Be cautious with special "knee" shoes and flat minimalist shoes
Shoes marketed as specially modified to change knee loading have not proved themselves. The 2019 ACR guideline conditionally recommended against modified shoes, saying that while footwear probably matters a great deal, studies have not defined the best type. (The 2026 update summary does not list modified shoes.)
Flat, flexible, minimalist shoes were tested against supportive shoes in the 2021 trial above. They were not better on any outcome, and more people wearing them reported side effects.
- Modified shoes: conditionally recommended against (ACR 2019)
- Flat flexible shoes: no advantage, more side effects in a 2021 trial
Checked on: Kolasinski SL, et al. 2019 ACR/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Care Res. 2020 · Paterson KL, et al. The Effect of Flat Flexible Versus Stable Supportive Shoes on Knee Osteoarthritis Symptoms: A Randomized Trial. Ann Intern Med. 2021
9. Shop at the end of the day, and fit the bigger foot
Feet swell during the day, by up to 8% according to AAOS, so it advises buying shoes toward the end of the day. One foot is often slightly larger than the other; fit the larger one. Wear the socks you will walk in.
A good shoe should feel right in the store. AAOS says not to buy a shoe that needs to be stretched or needs pads to keep your foot from slipping.
- Try shoes on late in the day (AAOS)
- Fit the larger foot
- No "breaking in" required
Checked on: AAOS OrthoInfo: Shoes: Finding the Right Fit
Shoes are one piece of the plan
The treatments with the strongest guideline support for knee osteoarthritis are exercise and, for people who are overweight, weight loss. Good shoes make it easier to walk and exercise comfortably, which is where much of their value lies.
If your knee pain began suddenly, followed an injury, or comes with swelling, locking or giving way, shoes are not the answer. Get the knee examined first.
- Stop and get checked if a new pair of shoes brings on new knee, hip or foot pain
- If you have diabetes or numb feet, check your feet daily and ask about footwear at your visits
- A physical therapist can look at how you walk and suggest what to change
Frequently asked questions
Sources
- Paterson KL, et al. The Effect of Flat Flexible Versus Stable Supportive Shoes on Knee Osteoarthritis Symptoms: A Randomized Trial. Ann Intern Med. 2021
- Starkey S, et al. Tibiofemoral contact force differences between flat flexible and stable supportive walking shoes in people with varus-malaligned medial knee osteoarthritis. PLoS One. 2022
- Kerrigan DC, et al. Knee osteoarthritis and high-heeled shoes. Lancet. 1998
- Kolasinski SL, et al. 2019 ACR/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Care Res. 2020
- American College of Rheumatology: 2026 Update of the Recommendations for the Management of Osteoarthritis of the Knee, Hip, and Hand (summary)
- AAOS OrthoInfo: Exercise Walking
- AAOS OrthoInfo: Shoes: Finding the Right Fit
Related guides
Best Knee Braces for Arthritis
Knee brace types for arthritis explained: unloader, hinged, kneecap, sleeves and taping, what the guidelines say about each, and how to wear one safely.
ReadBest Walking Trails in Addison and North Dallas
Ten walking trails and parks in Addison, North Dallas, Plano and Irving, with length, surface and amenities from official pages, plus tips for sore knees.
ReadBest Exercises for Knee Osteoarthritis
Ten exercises for knee osteoarthritis, how to do each one, a common starting dose, and when to stop. Based on ACR, AAOS and Arthritis Foundation guidance.
ReadBest Evidence-Based Treatments for Knee Osteoarthritis
What the American College of Rheumatology recommends for knee osteoarthritis, from exercise and weight loss to injections, and what it recommends against.
ReadTalk it through with a clinician
A list is a starting point. Book an evaluation at our Addison clinic, or call and we will verify your insurance before you come in.