Knee arthritis is one of the most common reasons people start paying attention to their shoes. And for good reason.
The inner compartment of your knee takes an enormous amount of load with every step. That load is influenced by the shoes on your feet, the height of the heel, the stiffness of the sole, and how stable your foot is during each stride. The research on this is more detailed than most people expect, and some of it might surprise you.
Unlike hip arthritis, where the shoe research is still fairly new, knee osteoarthritis has been studied across multiple clinical trials and biomechanical studies. The findings do not always point in the same direction. Here is an honest look at what the science actually shows, and what it means for choosing your next pair of shoes.
Skip to Shoe RecommendationsWhat the Research Says About Shoes and Knee Arthritis
For years, experts recommended cushioned and supportive shoes for people with knee arthritis. But for a long time, that advice was based mostly on opinion, not evidence from actual clinical trials.
Now we have that evidence, and it tells a more complicated story. Different types of shoes affect the knee in different ways, and the best shoe for you may depend on your specific situation.
The case for stable supportive shoes
The largest and most rigorous trial on this topic was published in Annals of Internal Medicine in 2021. Researchers enrolled 164 people with moderate to severe knee osteoarthritis. One group wore stable, supportive shoes. The other wore flat, flexible shoes. Both groups wore their shoes at least six hours a day for six months.1
The result: stable supportive shoes reduced walking pain significantly more than flat flexible shoes. People in the stable shoe group reduced their knee pain during walking by about 63% more than the flat shoe group.2
A survey of over 200 people with knee arthritis found that most believed cushioned, supportive shoes helped their symptoms most, and those were the styles they wore most often. But the majority had never received any specific footwear advice from a healthcare provider.3
The case for flat flexible shoes
Here is where it gets interesting. While the 2021 clinical trial favored stable shoes for pain relief, biomechanical research tells a different story about what is happening inside the knee joint itself.
Multiple studies have found that flat, flexible shoes actually reduce the load on the knee joint compared to more structured shoes. A key biomechanical study found that clogs and stability shoes produced about 15% higher peak knee forces than flat walking shoes, flip-flops, and barefoot walking, which showed similar, lower knee loads.4
Researchers also found that flat flexible shoes increase the knee adduction moment (the inward force on the knee joint) by significantly less than stable supportive shoe styles.5 The knee adduction moment is an important measure because it reflects how much load the inner part of the knee is taking, which is where most knee arthritis occurs.
A Brazilian clinical trial in women with mild to moderate knee OA found that wearing minimalist flat shoes for six months resulted in meaningful improvements in pain, physical function, and a 21.8% reduction in knee joint loading during gait.6
So which is it?
The honest answer is that both types of shoes have research supporting them, just for different reasons. Flat flexible shoes tend to reduce the mechanical load on the knee joint. Stable supportive shoes showed greater pain relief in the largest clinical trial.
One important distinction: the 2021 trial enrolled people with moderate to severe knee OA. The Brazilian minimalist shoe trial enrolled women with milder disease. It is possible that what works best depends partly on how advanced the arthritis is.
What is clear from all the research is that shoe choice matters. And there are some things every person with knee arthritis should know.
The One Thing Every Study Agrees On: Avoid High Heels
Regardless of which shoe type you prefer, the research is unanimous on one thing. High heels are bad news for knee arthritis.
A study published in The Lancet found that walking in high heels produced about 23% more compressive force on the inner part of the knee compared to walking barefoot.7 A systematic review confirmed that higher heels consistently increase the knee adduction moment, meaning more stress on the part of the joint where arthritis most commonly develops.8
If you have knee arthritis, keeping your heel low or flat is one of the most straightforward things you can do to protect your knee with every step.
What to Look for in the Best Shoes for Knee Arthritis
Low or no heel
This is the one thing the research agrees on most clearly. A low or flat heel reduces the forces going through the knee joint. The higher the heel, the more stress on the inner knee.
Good cushioning
Cushioning in the midsole absorbs some of the impact from each step before it reaches the knee. People with knee arthritis consistently prefer cushioned shoes, and research supports that cushioning can reduce perceived pain during walking.
A firm, stable base
For people with moderate to severe knee arthritis, the current best clinical evidence supports a shoe with a firm, structured sole. It should feel solid underfoot without being so rigid that it fights your natural movement. A shoe that is very floppy offers little support. A shoe that is completely rigid can create its own problems.
Built-in arch support
Research on the footwear preferences of people with knee arthritis found that built-in arch support and a cushioned insole were the features they valued most and sought out most often.9 Arch support helps keep the foot aligned, which flows up the chain to influence how your knee tracks with each step.
A secure heel fit
A shoe that holds your heel firmly in place helps keep your gait smooth and even. When the heel slips or the foot rocks around inside the shoe, it changes how load is distributed across the knee thousands of times per day.
What About Lateral Wedge Insoles?
Lateral wedge insoles are thin inserts that tilt your foot slightly outward. The idea is that they shift load away from the inner compartment of the knee, which is where most knee arthritis occurs.
The biomechanics support the concept. Research shows lateral wedge insoles can reduce the force on the inner knee by around 5 to 10% with every step.10 During stair climbing, one study found reductions in knee forces of up to 15% with a lateral wedge insole.11
However, randomized trials comparing lateral wedge insoles to flat insoles have not consistently shown a meaningful difference in pain relief. The mechanical effect is real, but pain response varies from person to person.
They are inexpensive, low-risk, and worth trying, especially inside an already supportive shoe. If they help, keep using them. If they do not make a difference after a few weeks, they are probably not the right fit for your situation.
Shoes I Recommend for Knee Arthritis and Knee Pain
The two brands below consistently check the boxes that matter most: cushioning, a stable and firm-but-not-rigid base, a low heel, and a secure fit. Both are comfortable enough that you will actually want to wear them all day.
Note: The links below are affiliate links. If you buy through them, I may earn a small commission at no extra cost to you. I only recommend products I genuinely believe in.
KURU Footwear
KURU builds shoes around foot health and pain relief. Their KURUSOLE technology wraps around your heel with each step, cushioning the impact and keeping your foot stable and well-supported. That kind of heel control is especially helpful for knee arthritis because it reduces the small wobbles that change how load travels up into the knee.
Three models stand out:
KURU ATOM is their everyday athletic sneaker. It has a wide, stable base, strong midfoot support, and the signature heel cushioning. The sole is firm without being rigid, which lines up well with what the research suggests. Great for walking, errands, and daily use.
KURU Quantum 2 is their most supportive option. It has a wider platform, reinforced arch support, and extra heel cushioning designed for longer time on your feet. If knee pain flares up a lot during or after walking, this is the one to look at.
KURU FLEX Via is their more flexible, flatter sole option. If the biomechanics research on flat flexible shoes resonates with you, or if your knee arthritis is on the milder side, this is worth considering. It still has KURU’s signature heel support, just with a more flexible, lower-profile sole underfoot.
Shop KURU FootwearOn Cloud
On Cloud shoes use their CloudTec sole, a row of cushioned pods on the bottom that compress when you step and spring back for the next stride. This gives you both cushioning and a responsive, stable feel underfoot. Three models work particularly well for knee pain:
On Cloud 6 has a firm, low-profile sole that keeps you close to the ground for a stable, controlled feel during walking. The sides of the sole are slightly higher than older versions, which helps prevent the foot from rolling inward. A good option for mild to moderate knee arthritis.
On Cloudnova 2 is the most structured of the three. It has a stiff plate built into the sole that reduces unwanted twisting and side-to-side movement during each step. It also has a wider platform and tends to run slightly wider overall, which many people with knee arthritis find more comfortable.
On Cloud X 4 is their more flexible, flatter option. It is designed around natural foot movement with a lower profile and more flexibility underfoot. If you respond better to a shoe that stays closer to the ground and allows more natural foot motion, this is the On Cloud model to consider.
Shop On CloudOther Brands Worth Knowing About
KURU and On Cloud are my go-to recommendations, but they are not the only options worth knowing about. Fit matters a lot with knee arthritis, and the right shoe for you also depends on the width of your foot and where you fall on the stable-to-flexible spectrum. I am not an affiliate or paid partner of any of the brands below. These are simply brands I think are worth knowing about.
If you have a narrower foot
Brooks is one of the most widely recommended brands for joint pain and has earned the American Podiatric Medical Association Seal of Acceptance. Their Ghost and Glycerin lines offer excellent cushioning with a snugger fit that works well for narrower feet. They come in narrow widths and have a smooth heel-to-toe transition that is easy on the knee.
ASICS is another strong option for narrower feet. Their Gel cushioning technology targets impact absorption directly at the heel and forefoot, which helps reduce the jolt that travels into the knee. ASICS stability models are particularly well-regarded for people who also tend to overpronate.
Saucony tends to run on the narrower side and offers solid arch support and cushioning across most of their line. A good option if Brooks or ASICS do not quite feel right.
If you have a wider foot
New Balance is one of the best brands for wide feet, offering more width options than almost any other major brand, including 2E and 4E widths. Their Fresh Foam and 860 lines are particularly popular for knee pain, with solid cushioning, a slight rocker sole in some models, and strong arch support. A top choice if other shoes feel pinched or uncomfortable.
Hoka is known for their thick, maximally cushioned soles and a rocker-bottom design that rolls your foot forward smoothly with each step. Their shoes run slightly wide and have a large toe box. The rocker sole reduces pressure on the forefoot and knee, which some people find very helpful. Just be aware that the extra height of the sole can feel less stable at first.
Altra is a zero-drop brand, meaning the heel and toe sit at the same height, with a wide, foot-shaped toe box that gives your toes room to spread naturally. A good choice for people with wide feet who also want a flatter, more natural feel underfoot.
If you want a flatter or barefoot-style option
If the flat flexible shoe research resonates with you, or if you have milder knee arthritis and want to try a more minimalist approach, these brands are worth exploring.
Vivobarefoot is one of the most established barefoot shoe brands. Their shoes are zero drop, very flexible, and designed to let your foot move as naturally as possible. They fit a more average to slightly narrow foot. If you are new to barefoot shoes, expect a transition period as your feet and legs adjust.
Xero Shoes is a popular entry point into minimalist footwear. They tend to run a little wider than Vivobarefoot, are generally more affordable, and come in a range of styles from casual to athletic. Good for people who want to explore the flat flexible approach without a large investment.
Merrell offers a middle ground between traditional and minimalist shoes. Their Trail Glove line leans more barefoot, while other Merrell styles offer more cushioning and structure. A solid option if you want some of the benefits of a flatter shoe without going fully minimalist.
Shoes to Avoid with Knee Arthritis
None of this means you can never wear a casual shoe or sandal. It means these styles are not the best choice for long walks or days when your knee is already bothering you.
Shoes Are One Part of the Picture
Getting the right shoes is a smart move. But shoes alone will not stop knee arthritis from progressing or give you your life back.
The muscles around your knee, especially your quads and glutes, act like shock absorbers for the joint. When those muscles are strong, your knee has real protection with every single step. Building that strength is the most important thing you can do for knee arthritis.
Better shoes help support that work. They make it easier to stay active with less pain, which makes it easier to build the strength your knee needs over time.
Build Stronger Knees, Step by Step
Adventurers for Life is my membership built around exactly what works for knee arthritis and joint pain. Progressive workouts, movement coaching, and a community of people who get it. Try it free for 14 days with no obligation.
Start Your Free 14-Day TrialFrequently Asked Questions: Best Shoes for Knee Arthritis
What kind of shoes are best for knee arthritis?
The largest clinical trial found stable, supportive shoes with good cushioning reduced walking pain more than flat flexible shoes in people with moderate to severe knee osteoarthritis. Look for a firm but not rigid sole, built-in arch support, a low heel, and a secure heel fit. For milder arthritis, flat flexible shoes also have research support, especially for reducing the mechanical load on the knee joint.
Do flat shoes help knee arthritis?
It depends. Biomechanical research consistently shows that flat flexible shoes produce lower forces on the inner knee compared to more structured shoes. A clinical trial in women with mild to moderate knee OA found meaningful pain relief and improved function with flat minimalist shoes. However, the largest trial to date, which included people with more severe arthritis, found stable supportive shoes produced greater pain relief. Your disease severity may influence which works better for you.
Are high heels bad for knee arthritis?
Yes. Research has consistently shown that high heels increase the compressive force on the inner knee by roughly 23% compared to barefoot walking, and increase the forces associated with arthritis progression. If you have knee arthritis, keeping your heel low or flat is one of the most important shoe choices you can make.
How do I know if a shoe has enough support for knee arthritis?
Look for a shoe with a wide, firm base that does not compress or collapse easily underfoot. The midsole should feel solid when you press on it, but not completely rigid. A shoe that feels very floppy in your hands is unlikely to provide the support your knee needs during a full day of walking.
Should I try lateral wedge insoles for knee arthritis?
They are worth trying. Research shows they can reduce the load on the inner knee by roughly 5 to 10% per step, and even more during stair climbing. Clinical trials comparing them to flat insoles have had mixed pain results, but they are inexpensive and low-risk. Use them inside an already supportive shoe and give them a few weeks before deciding.
How long before I notice a difference from better shoes?
The main clinical trial measured outcomes after six months of wearing shoes at least six hours a day. Many people notice some difference within a few weeks. Wearing your shoes consistently throughout the day matters more than any other single factor. Give it at least six to eight weeks before deciding if they are helping.
Do I need custom orthotics for knee arthritis?
Not necessarily. A well-designed supportive shoe with built-in arch support may be all you need. Some people benefit from over-the-counter or custom orthotics, particularly if they have flat feet or significant inward rolling of the foot. Talk to a physical therapist if you are unsure whether orthotics would add value for your situation.
Can shoes help knee pain that is not from arthritis?
Yes. Whether knee pain comes from tendon issues, bursitis, patellofemoral pain, or general overuse, a supportive cushioned shoe with a low heel reduces the forces going through the joint with each step. The principles that help arthritic knees tend to help most types of knee pain.
- Paterson KL, Bennell KL, Campbell PK, et al. The effect of flat flexible versus stable supportive shoes on knee osteoarthritis symptoms: a randomized trial. Ann Intern Med. 2021;174(4):462–471. doi:10.7326/M20-6321
- Paterson KL, Bennell KL, Metcalf BR, et al. Stable Supportive Footwear for Self-managing Hip Osteoarthritis Pain: A Randomized Clinical Trial. Ann Intern Med. 2026;179:469–477. doi:10.7326/ANNALS-25-03660 [Commentary on knee vs hip findings]
- Paterson KL, Wrigley TV, Bennell KL, Hinman RS. A survey of footwear advice, beliefs and wear habits in people with knee osteoarthritis. J Foot Ankle Res. 2014;7:43. doi:10.1186/s13047-014-0043-8
- Shakoor N, Sengupta M, Foucher KC, et al. Effects of common footwear on joint loading in osteoarthritis of the knee. Arthritis Care Res. 2010;62(7):917–923. PMID:20710595
- Paterson KL, Bennell KL, Wrigley TV, et al. Effects of footwear on the knee adduction moment in medial knee osteoarthritis: classification criteria for flat flexible vs stable supportive shoes. Osteoarthr Cartil. 2017;25(2):234–241. PMID:27729290
- Trombini-Souza F, Matias AB, Yokota M, et al. Long-term use of minimal footwear on pain, self-reported function, analgesic intake, and joint loading in elderly women with knee osteoarthritis: a randomized controlled trial. Clin Biomech. 2015;30:1194–1201. doi:10.1016/j.clinbiomech.2015.08.004
- Kerrigan DC, Todd MK, Riley PO. Knee osteoarthritis and high-heeled shoes. Lancet. 1998;351(9113):1399–1401. PMID:9593411
- Nguyen LY, Harris KD, Morelli KM, Tsai LC. Increased knee flexion and varus moments during gait with high-heeled shoes: a systematic review and meta-analysis. Gait Posture. 2021;85:117–125. PMID:33548909
- Smith MD, McKendry R, Shah S, et al. An exploration of footwear preferences, attitudes and beliefs in people with knee osteoarthritis: a qualitative study. Musculoskelet Sci Pract. 2024;72:102948. doi:10.1016/j.msksp.2024.102948
- Lewinson RT et al. Laterally wedged insoles in knee osteoarthritis: do biomechanical effects decline after one month of wear? Arthritis Res Ther. 2009. PMID:19939281
- Sacco ICN, Trombini-Souza F, Butugan MK, et al. Joint loading decreased by inexpensive and minimalist footwear in elderly women with knee osteoarthritis during stair descent. Arthritis Care Res. 2012;64(3):368–374. PMID:22076748
