Your Shoe Size Grows After 50: How Ill-Fitting Footwear Harms Health

Dr. Rock Positano, co-director of the Non-Surgical Foot and Ankle Service at the Hospital for Special Surgery in NYC, explains that shoe size rarely remains the same from the twenties to the fifties. Research, including a study of 356 women, shows most participants were wearing shoes that had become too tight as their feet grew, leading to pain and deformities that affect daily activities. Factors such as extra weight, pregnancy-related relaxin hormone, and menopause-related hormonal shifts can increase foot size by one or two sizes.

Narrow toe boxes and high heels exacerbate the problem by forcing toes into unnatural positions. Positano recommends trying on new shoes in the late afternoon, standing with full weight, fitting the larger foot, and ensuring a thumb-wide gap between the longest toe and the shoe front. He stresses that “breaking in” a shoe is a myth and that comfort across the arch, heel and forefoot is essential to prevent tendonitis, blisters, and pain that can extend to the knees, hips and lower back.