November 9, 2026, 9:05 am | Read time: 6 minutes
The favorite shoes that were comfortable for years suddenly pinch at the toes or feel too tight? Indeed, feet can change as we age. Many women notice this around the age of 40. Connective tissue and foot muscles lose stability, the arch can flatten, and the forefoot can widen. But why do feet change at all, why are women particularly often affected by a bunion, and what helps when familiar shoes no longer fit?
Do Feet Get Bigger and Wider with Age?
Feet can indeed become longer and wider over a lifetime. This is not due to bone growth but a change in foot structure. The body’s weight is distributed differently on the foot, which can flatten and widen under pressure. This can also change the required shoe size.1
Why Women’s Feet Change Over the Years
Connective Tissue and Ligaments Lose Elasticity
As we age, connective tissue changes, causing ligaments and tendons to lose strength and stabilize the arch less effectively. This makes it easier for the foot to give way under pressure, allowing it to become longer and wider.
The Foot Muscles Deteriorate
The small muscles that support the arch can also lose strength over the years. If the foot becomes less stable, its shape can change, and the forefoot can widen.
The Fat Pads Change
The natural fat pads under the heel and forefoot can shift or lose volume over a lifetime. They then support the foot less evenly, which may not necessarily change its size but can affect pressure distribution and stress on foot structures.
Pregnancies Can Permanently Widen Feet
“During pregnancy, hormonal changes, including those caused by relaxin, loosen connective tissue and ligaments. Combined with increased body weight, this can cause the arch to flatten. In some women, feet remain permanently longer or wider after pregnancy,” explains Dr. Heidi Gößlinghoff, a gynecologist, reproductive medicine specialist, and psychotherapist focusing on fertility and hormonal women’s health.
Hormonal Changes During Menopause
“Estrogen affects connective tissue and the musculoskeletal system,” says Dr. Gößlinghoff. “When estrogen levels drop during menopause, the interaction between muscles and connective tissue also changes. However, there is no scientific evidence that menopause directly leads to a larger shoe size.”
Joint Wear and Misalignments
As we age, joint structures in the foot can change due to wear or conditions like rheumatoid arthritis. Misalignments such as bunions can also cause the forefoot to widen.
Changes Due to Body Weight
Higher body weight increases the mechanical load on the feet. This can exacerbate existing weaknesses in connective tissue and foot muscles, promoting the flattening of the arch.
Why Women Are Particularly Prone to Bunions
In bunions, the most common misalignment of the female foot, the big toe shifts toward the smaller toes, while a visibly noticeable bump forms at the base joint of the big toe. This misalignment affects women much more often than men. Genetic predisposition and individual foot structure are considered significant risk factors, while tight shoes and high heels can further promote the misalignment. “The fact that women are more often affected is likely due to several factors. However, a direct causal link with hormonal changes during menopause or pregnancy has not yet been proven,” says Dr. Gößlinghoff.
Also interesting: Effective training after 40–what women should pay attention to
When Feet Suddenly Get Thicker: When Is an Illness Behind It?
Fluid Retention
If feet become significantly thicker in a short time, swelling may be the cause. Fluid accumulates in the tissue, causing feet and ankles to increase in size. Such swelling can occur temporarily after long periods of sitting or standing and in high temperatures. If it persists or worsens, venous diseases, certain medications, and conditions of the thyroid, heart, or kidneys should be considered and medically ruled out.
Liver Diseases
In advanced liver diseases, the production of the protein albumin, which helps retain fluid in blood vessels, can be impaired. If there is too little of it, fluid can more easily enter the tissue. In addition to swollen legs, fluid can also accumulate in the abdominal cavity.
When Swollen Feet Should Be Medically Examined
Have newly occurring or persistent swelling medically examined. Especially sudden swelling with pain, redness, or warmth, particularly if only one leg is affected, must be clarified promptly. If shortness of breath or chest pain occurs, immediate medical help is required.
What Helps When Feet Become Larger or Wider?
Foot Training and Insoles
If the arch gives way, targeted exercises can strengthen the foot muscles and improve stability. Insoles can also help distribute the load better and reduce pain. For persistent pain or a pronounced misalignment, an orthopedic examination is always recommended.
Cushioning the Sole of the Foot
If the natural cushioning under the sole of the foot has decreased, well-cushioned shoes or special insoles can help. Foot exercises can support muscle function, but lost fat pads cannot be specifically rebuilt through them.
Help for Bunions
For a bunion, the focus is initially on relieving the base joint of the big toe and alleviating discomfort. Wider shoes, pads, or toe spreaders can reduce pressure but cannot permanently reverse the bony misalignment. Very narrow shoe tips and high heels are unfavorable for such complaints and should be avoided. If pain persists despite conservative treatment and significantly impairs daily life, surgery may be considered.
Do Foot Misalignments Always Need Treatment?
Why You Should Train Your Foot Muscles
What to Look for When Buying Shoes
Look for a cushioned sole, enough room for the toes, and avoid unnecessary pressure points. At the same time, the shoe should fit well at the heel and provide enough support. It is also worth measuring both feet while standing, as they can be different sizes.
Is Walking Barefoot Good for the Feet?
Walking barefoot engages the foot muscles and enhances the perception of the ground. For healthy, resilient feet, it can be a useful addition but is not a cure for age-related foot changes. Transitioning to barefoot shoes, which are considered healthy, should also be done gradually. Those who have worn shoes with heavily cushioned soles for years need to give muscles and tendons time to adjust to the changed load.