Most falls are preventable, and the fixes are smaller than you think. Your shoes are one of the most important pieces of fall prevention equipment you own. The right pair can improve your balance, grip, and confidence. The wrong pair can turn a simple walk to the mailbox into a hazard.
1
What Makes a Shoe Safe
Low, wide heel (under 1 inch)
Heels shift your weight forward and reduce your contact with the ground. Even a small heel changes how your foot hits the surface. Flat shoes or shoes with heels under 1 inch keep your weight centered over your feet.
Closed back (no slip-ons, mules, or slides)
Your shoe needs to move with your foot, not slide around on it. Slip-on shoes can catch or slide off at the worst moment. Laces, velcro, or buckles keep the shoe secure to your foot.
Non-slip sole with tread
The bottom of your shoe should have visible texture or tread pattern. Smooth soles are slippery on most surfaces. Look for rubber soles with patterns that can grip different surfaces.
Proper fit with room for your toes
Your longest toe should have a thumb's width of space from the front of the shoe. Shoes that are too tight cause balance problems. Shoes that are too loose cause your foot to slide inside the shoe, which also affects balance.
2
Shoes to Avoid
Slippers outside the bedroom
House slippers are designed for carpet and short distances. They typically have smooth soles, loose fits, and no support. Keep slippers in the bedroom and bathroom only.
Flip-flops and slides
These require you to grip with your toes to keep them on, which changes your gait and can cause trips. The thin sole provides no support, and they offer no protection if you stumble.
High heels (over 1 inch)
Any heel over 1 inch shifts your weight forward and reduces stability. This includes chunky heels, wedges, and platforms. Save these for seated events only.
Worn-out athletic shoes
Athletic shoes lose their tread and support over time. If the sole is smooth or the shoe compresses easily when you press on the heel, it's time to replace them. Most athletic shoes need replacing every 300-500 miles of walking.
Shoes that are too big or too small
Shoes that don't fit properly cause your foot to work harder to stay balanced. Too big means sliding inside the shoe. Too small means cramped toes and altered gait.
3
Best Shoe Types for Fall Prevention
Walking shoes or athletic shoes
These are designed for movement and typically have good tread, support, and secure closures. Look for shoes specifically labeled as walking shoes rather than fashion sneakers.
Oxford-style shoes with laces
Low-profile dress shoes with laces provide a secure fit and professional appearance. The closed design and lace closure keep the shoe firmly attached to your foot.
Mary Jane style shoes with straps
The strap across the foot provides security while maintaining a dressier look than athletic shoes. Choose styles with low heels and good sole tread.
Boots with low heels and good tread
Ankle boots can provide extra stability and are excellent for outdoor use. Look for boots with non-slip soles and secure closures.
4
Shopping for Safe Shoes
Shop in the afternoon
Your feet swell slightly throughout the day. Shoes that fit in the morning may feel tight by evening. Shopping later in the day ensures a better fit for all-day wear.
Bring your own socks or orthotics
If you wear special socks or shoe inserts, bring them when trying on shoes. The fit will be different with your regular gear.
Walk around the store
Don't just stand in the shoes. Walk the length of the store if possible. Pay attention to any sliding, pinching, or instability.
Check the return policy
Even careful shopping can result in shoes that don't work at home. Make sure you can return shoes if they cause problems after a few days of wear.
5
When to Replace Your Shoes
Sole wear
If the tread is worn smooth or worn unevenly, the shoe has lost its grip. This is the most important replacement signal for fall prevention.
Upper wear
If the shoe no longer holds its shape or the closure system (laces, velcro, buckles) no longer keeps the shoe secure, it's time to replace.
Comfort changes
If shoes that used to be comfortable now cause pain, pressure points, or instability, your feet may have changed or the shoe may be worn out.
Every 6-12 months for daily shoes
Even with light use, shoe materials break down over time. If you wear the same pair of shoes most days, plan to replace them at least once a year.
6
Special Considerations
Orthotics and inserts
If you use custom orthotics, make sure new shoes have removable insoles and enough room to accommodate your inserts. The shoe should fit properly with your orthotics in place.
Swelling or foot changes
Feet can change size and shape with age, medication, or health conditions. Have your feet measured when shopping for shoes, even if you think you know your size.
Different shoes for different activities
You may need different shoes for indoor use, outdoor walking, and dressier occasions. Having 2-3 pairs of appropriate shoes is better than trying to make one pair work for everything.
Weather conditions
Wet surfaces are more slippery. If you'll be walking on wet pavement, look for shoes specifically designed for wet conditions or consider temporary traction devices that slip over your regular shoes.
Where to Start
Begin by evaluating the shoes you currently wear most often. Do they meet the four safety criteria: low heel, closed back, good tread, and proper fit? If not, shopping for one pair of safe, comfortable shoes is a worthwhile investment.
If you've had a fall or near-fall, pay attention to what shoes you were wearing. This information can help you identify which pairs in your closet are safest and which ones need to be replaced.
The right shoes won't prevent every fall, but they're one of the most straightforward improvements you can make. Combined with other fall prevention strategies like home modifications and strength exercises, proper footwear is a practical step toward staying steady on your feet.
Free Resources
- AARP Fall Prevention Guide (includes footwear safety information)
- CDC Fall Prevention Resources (evidence-based prevention strategies)
- National Institute on Aging Fall Prevention (comprehensive safety guides)
- Eldercare Locator to find your local Area Agency on Aging (may offer fall prevention programs)