Flat shoes can cause discomfort and deformities in the toes, yet some studies indicate that certain flat styles may ease knee stress and strengthen the feet. The key lies in selecting the right pair for the individual foot shape and activity. Overall, the evidence leans toward a nuanced view rather than a blanket verdict.
Many flat shoes feature a shallow, narrow toe box. Tight footwear limits natural foot movement and can contribute to toe bone misalignment over time. Conversely, overly loose or overly wide shoes may permit excess foot movement, leading to irritation and the formation of calluses on sensitive areas. Inadequate sock choice can also introduce microtrauma to the toenails, potentially thinning and weakening the nail plate over time.
Health professionals frequently advise wearing low-heeled options rather than completely flat shoes. A modest heel can shift some load away from the forefoot and distribute it through the soft tissues that support the arch, including the plantar fascia. Research suggests that moving from a fully flat shoe to a slightly elevated heel reduces the traction demands on the plantar fascia during standing. Additional findings indicate that many people can adapt to different heel heights with minimal adjustment period.
Ballet flats are sometimes criticized for offering limited support because of their flexible soles and minimal heel structure. However, shoe experts do not reach a single consensus on how much support is truly necessary. Extra cushioning can improve comfort and lessen pressure on the skin of the sole, but current data do not show a clear reduction of pressure on the ankle and nearby joints from added padding alone.
Minimalist or “barefoot” style shoes have been shown to lower knee joint loading compared with traditional boots. Their flexible soles may also enhance activation of specific foot muscles used to push off during walking, running, or jumping. Yet the research is not unanimous, and conclusions about the overall safety or advantage of minimalist footwear remain unsettled.
In practice, the evidence does not offer a definitive verdict on ballet shoes. What is clearer is that ill-fitting flat footwear can contribute to problems in the foot, ankle, and knee. A practical guideline is to choose shoes that do not pinch the toes and provide a sufficiently wide sole for stability. Some support and a mild heel can be preferable to a completely flat, highly flexible sole. Consumers are advised to consider fit, support, and overall foot mechanics rather than relying on trend alone.
When selecting footwear for a child, professionals emphasize fit and growth considerations. Parents are encouraged to look for ample toe space, a secure heel, and good arch support to promote healthy foot development. A footwear choice that balances comfort with structural support helps reduce the likelihood of future foot concerns, while allowing active movement and play to continue unhindered.