Why Do My Shoes Wear Out More Quickly on the Outside Heel?

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I wear out shoes very quickly. In fact, I’ve worn down one pair of black dress shoes about 50% more on the heel on the outside, so I no longer wear them. Do you do this too? If your shoes wear faster on the outside heel, you might be wondering why this is happening and if it’s causing other problems that need to be fixed.

Foot Strike: Pronation vs. Supination

Walking styles vary from person to person. In the case of shoe wear patters, we want to look specifically at how the foot hits the ground. Some of us have a balanced, or neutral, foot strike. Some make contact with the ground with more pronounced inward pressure (pronation) on the foot. While others make contact with more pronounced outward pressure on the foot (supination).

If your shoes are wearing out faster on the outside, your foot supinates too much when you walk.

It’s important to understand that for a foot to evenly absorb the forces as it hits the ground, neutral contact between the foot and the ground naturally involves a slight rolling both inward and outward of the foot. This minimizes the ground forces as they move from the foot and up the leg.

But when the foot rolls too much one way or the other, this extra pressure can create problems, such as arthritis, not just in the foot, but all the way up the kinetic chain into the ankle, knees, hips, and even the spine (1). Likewise, problems can start at the top of the chain (the spine) and work their way down to the feet, causing supination.

Learn about Regenexx procedures for foot & ankle conditions.

How Irritated Back Nerves Can Lead to Supination

Supination can be caused by a number of different things. It can be congenital, based on, for example, the angle of your ankle or knee, a hip that sits too far forward or too far backward, or an abnormally shaped or aligned spine (i.e., scoliosis). Additionally, the way your foot is built, such as a super high arch, can cause the foot to supinate too much.

More often than not, however, what we see with supination and other foot problems is irritated nerves in the low back (2). Back pain may or may not accompany irritated low-back nerves, so just because you don’t have back pain with supination doesn’t mean a nerve issue should be ruled out. How in the world can the nerves all the way up in the back have anything to do with why your shoes wear faster on the outside edge of the foot?

The nerves in the low back supply the muscles in your leg and those muscles actually help to control how your foot hits the ground. So if there’s no irritation, those muscles balance the foot; if there is nerve irritation, even slight weakness on one side of the foot can change the strength of the muscles that keep the foot balanced, creating strange angles to the foot as it hits the ground.

How to Treat Foot Supination

If your shoes wear faster on the outside of the heel, and you know there is no congenital condition that would cause your feet to supinate, this may be a good indication that you have irritated nerves in the low back that should be treated before they cause more damage.

If it isn’t a nerve issue, many times you can strengthen these lower-limb muscles on devices like a BAPS board or use orthotics, and that can really help relieve pressure on the foot, knee, and other joints (3).

However, if you have or develop back issues, or if you just can’t treat and correct your supination conservatively, an X-ray–guided injection of platelet growth factors around the specific irritated nerves can be a good solution.

The upshot? Pay attention to those shoes wearing out more on the outside! This may mean that you have irritated nerves in the low back that are impacting how your foot hits the ground. If so, then there are things you can do to help!

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References

(1) Golightly YM, Hannan MT, Dufour AB, Hillstrom HJ, Jordan JM. Foot disorders associated with overpronated and oversupinated foot function: the Johnston County osteoarthritis project. Foot Ankle Int. 2014;35(11):1159-1165. doi:10.1177/1071100714543907

(2) Menz HB, Dufour AB, Riskowski JL, Hillstrom HJ, Hannan MT. Foot posture, foot function and low back pain: the Framingham Foot Study. Rheumatology (Oxford). 2013;52(12):2275-2282. doi:10.1093/rheumatology/ket298

(3) Parkes MJ, Maricar N, Lunt M, et al. Lateral wedge insoles as a conservative treatment for pain in patients with medial knee osteoarthritis: a meta-analysis. JAMA. 2013;310(7):722-730. doi:10.1001/jama.2013.243229
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Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications. View Profile

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