Diseases & Conditions
Tight Shoes and Foot Problems
Given the allure of online shopping, these days you may be more likely to purchase, keep, and wear shoes that look fashionable, but are not appropriate for your foot shape and/or size.
Women, especially, are more likely to purchase a shoe that is too small, putting them at risk for corns, bunions, and other deformities that may require surgery to correct.
Toe Deformities
Bunion
A bunion is a prominence (knob) of bone or tissue around the joint at the base of the big toe. As the bunion grows, the big toe may turn in toward the second toe and cause swelling and pain with shoe wear.
Although genetic factors may play a role in whether you develop bunions, in most cases, bunions are widely attributed to wearing shoes that are too tight.
Initial treatment involves one or more of the following:
- Wearing shoes with a wider toe box
- For shoes that are putting too much pressure on certain areas of your foot, use a ball and ring shoe stretcher to stretch out those areas and relieve the pressure points.
- Wearing a spacer between your big and second toe
- Taping your toe
- Applying ice to your toe
If these simple treatment measures are not effective, your doctor may discuss surgery to remove the bunion.
Corn
A corn is a type of callus that develops when tight shoes put constant pressure on the skin.
- Initial treatment involves applying a foam pad over the corn to help relieve the pressure.
- In addition, wearing shoes that fit properly and have a roomy toe area will help.
- For existing shoes that are too tight, use a ball and ring shoe stretcher to make the shoes roomier and relieve pressure points.
Hammer Toe
Hammer toes occur when the toe starts to curl instead of lying flat, and the middle toe joint bends upward. If you have your foot in a tight shoe, the top of the middle toe joint will rub up against the shoe surface and cause pain. In addition, the muscles that attach to the toes will continue to weaken if the foot stays in this abnormal position.
Initial treatment options include the following:
- Strapping techniques
- Wearing shoes with a wider toe box
- Using a ball and ring shoe stretcher to make tight shoes roomier and relieve pressure points
- Wearing toe splints
- Applying ice to the affected area
If these techniques are not effective, surgery to correct the deformity may be an option.
Crossover Toe
A crossover toe forms when the toes are crimped in a toe box that is too small, and the constant pressure causes the second or third toe to move over the toe next to it.
Initial treatment consists of the following:
- Wearing shoes with a wider toe box
- Using a ball and ring shoe stretcher to make tight shoes roomier and relieve pressure points
- Using spacers or taping to keep the toes apart
- Applying ice to the affected area
If this conservative treatment fails, surgery may be an option.
Ingrown Toenail
An ingrown toenail usually occurs in the big toe when the nail is cut short near the tip of the toe. This injury may be aggravated when you put your foot in a shoe that is too tight in the toe box, causing your first toe to be pressed against the second toe, and resulting in abnormal pressure on the nail. The constant pressure results in inflammation and nail pain.
Initial treatment involves the following:
- Wearing a shoe with a wider toe box
- Soaking the toe three to four times a day in warm water
To prevent ingrown toenails, trim your toenails straight across and avoid trimming the corners of the nails too short.
Diabetic Foot
People with diabetes often suffer from nerve damage (peripheral neuropathy) in the foot and are not able to feel skin irritations, or even punctures. If a shoe is too tight on their foot, it may result in blisters or sores that can quickly progress to serious infections.
If you are diabetic, check your feet daily for pressure areas, redness, blisters, sores, scratches, and nail problems. Learn more: Care of the Diabetic Foot
Shoe Selection for Foot Problems
- Always try shoes on before buying them. Even if you want to purchase shoes online, try them on in a store first, if possible. Once you know that the shoe is comfortable and the correct size, you can then make the purchase online. Ask the salesperson to measure the length and width of both of your feet to ensure a proper fit.
- When trying on a new shoe, make sure that your toes do not feel pinched or cramped, and that none of your toes are pushed over another toe. Have the salesperson check the position of your toes to confirm that there is enough room.
- Do not buy shoes that do not fit. There is no such thing as a "break-in period." With time, a foot may push or stretch a shoe to fit. But this can cause foot pain and damage.
- Evaluate the shoe for its overall construction. The shoe should bend in the toe box, not the shank (arch). A good stable shank will provide you with more support. You should not be able to easily squeeze the heel counter in on a new pair of shoes. Is the heel counter shallow or does it sit higher on the heel providing more stability for your foot?
- Determine if the toe box is appropriate for your foot. It is not just the shape of the toe box, but also the depth. A deeper toe box will have more room to accommodate a bunion, hammer toes, and a wide forefoot. A square toe box is the most desirable shape. If you are unable to get a square toe box, a round one is a better choice than a pointed shape.
- Shoes that lace, buckle, Velcro or have some type of strapping mechanism will provide more support to your arch.
- A shoe that has a removable insole is ideal so you can add an orthotic or more cushioned insole if needed.
- Shoes that do not have the tongue attached to the upper of the shoe will provide a better fit. It is difficult to add an extra insole or orthotic to a shoe with the attached tongue.
- If you must wear a shoe that is irritating your foot, using a ball and ring shoe stretcher to stretch the parts of the shoe that are creating pressure can help relieve pain.
For more helpful guidelines about choosing proper footwear: Shoes: Finding the Right Fit
Last Reviewed
January 2025
Contributed and/or Updated by
Peer-Reviewed by
AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS Find an Orthopaedist program on this website.