In some cases, people with worn out shoes that offer little to no support have no symptoms and no problems. Others have to replace their shoes as soon as any wear causes an uneven support base. It's unclear why there is such a wide range of responses. Some people may just have a more sensitive sense of proprioception (sense of joint position) that signals change immediately.

In a recent study from Canada two groups of adults with knee osteoarthritis were compared wearing two different kinds of shoes. The first group had on a high-end walking shoe by New Balance. The second group had a special medical training device called Masai Barefoot Technology® (MBT®).

The MBT is designed to increase muscle activity in the foot and lower leg. The hope is that the shoe will reduce pain and improve walking ability. The results of the study showed that patients in both groups had improved pain and function. Only the groups with the MBT® showed a change in balance.

Finding a perfect shoe that works for everyone may not ever happen. But finding the right shoe for you is possible. Start with a good walking shoe and break it in gradually. You can do this by wearing it for short periods of time each day. Gradually increase your wearing and walking time.

Replace the shoes when you see signs of breakdown on the inside or outside. Don't wait until the shoe has holes in it or shows evidence of severe wear. It's a small price to pay for good benefits in the long-run.