If you’re suffering with chronic pain, finding out the probable cause may be as easy as taking a close look at the heel wear pattern of your oldest pair of shoes. The heel wear pattern on the bottom of your shoes (how your shoes wear out) is an indication of how your foot moves when you walk. So if the outside heels of your shoes are worn out, it means one thing and if the inside heels of your shoes are worn out, it means something else.

Shoes, Orthotics, Insoles


Ideally, when you walk, your foot should move from heel to toe in a linear (straight) fashion.  If it does this, when you look at the bottom of your shoes, the heels and soles are worn evenly. But if your foot moves from heel to toe in a twisting fashion, when you look at the bottom of your shoes, the heels and soles wear unevenly.  Frequently, you’ll see the heel wear excessively on the inside or outside.

So what causes your foot to twist when you walk? There are many possibilities:

One possibility is if you have had an ankle injury that weakened the ligaments and/or muscles around your ankle joint. This results in your foot twisting and your heel hitting the ground at an angle.

Hitting the ground at an angle will cause the heels of your shoes to wear out.  Your heels will wear more on the inside if your lateral (outside) ankle ligaments and/or anterior tibial muscle (in the leg and foot) were injured and not fully recovered.  Your heels will wear more on the outside if your medial (inside) ankle ligaments and/or peroneal muscles (in the leg and foot) were injured and not fully recovered.

Another cause of foot twist and uneven heel wear patterns are certain diseases, such as Polio and Multiple Sclerosis. These diseases weaken the muscles in your legs and feet, allowing your feet to twist when you walk. The more severe the Polio or Multiple Sclerosis, the more severe your feet will twist. The specific leg and foot muscles that are involved will determine whether the heels of your shoes will wear out more on the inside or the outside.


What It Often Means When The Inside Or Outside Heel Of Your Shoes Wears Out

The most common cause of foot twist and uneven heel wear is inherited structural problems in your feet – the abnormal foot structures PreClinical Clubfoot Deformity and Rothbarts Foot – which force your feet to twist when you walk.

The most severe foot twist is associated with the PreClinical Clubfoot Deformity. If you have a moderate to severe PreClinical Clubfoot Deformity, this foot structure can force your heel to hit the ground on the inside edge of your foot. This will result in a heel wear pattern where the inside of your heel wears out more quickly than the outside.

If you have a mild PreClinical Clubfoot Deformity or a Rothbarts Foot, this can force your heel to hit the ground on the outside edge of your foot and will result in a heel wear pattern where the outside of your heel wears out more quickly than the inside.


What It Often Means When The Soles Of Your Shoes Wear Unevenly

The wear pattern in the sole of your shoe is an indication of how linear your gait pattern is:


  • If you walk in a perfect heel to toe fashion, the soles of your shoes will wear evenly.
  • If your foot twists while you walk, the soles will wear unevenly.


Frequently the inside sole underneath your first and second toes will wear more quickly than the rest of the sole. If your foot structure is a severe PreClinical Clubfoot Deformity, you’ll see wear spots developing in the soles to the point that there is almost no leather (or other material) left.

So unless you have a certain disease which predisposes your foot to twist, or an ankle injury that has weakened the ligaments and muscles around your ankle joint, chances are good that the inside or outside heels of your shoes are wearing out and your soles are wearing unevenly due to having a PreClinical Clubfoot Deformity or Rothbarts Foot. Since these two abnormal foot structures are so common and do such an efficient job of destroying your shoe heels, one could say that they’re a cobbler’s dream.