High Heels and You

Dr. Belinda Dotter

It's spring and time to wear gorgeous high heeled sandals. Here’s some information and tips to keep your foot in tip top shape when wearing them!
Studies have shown that high heeled shoes create excess pressure on the plantar surface, or sole of the foot, which can lead to metatarsalgia (ball of the foot pain), excess stress on foot joints, and painful calluses. The higher the heel is, the more probability that muscular imbalances are occurring while walking in the shoes — causing certain leg and foot muscles to work too hard. These imbalances can lead to problems such as knee pain, heel pain (plantar fasciitis), and hammer toes.

Common Mistakes:

1. Incorrect Size:  You may be surprised to learn that your shoe size has changed over the years. A change in foot size can often be attributed to hormonal changes and natural changes in soft tissue that occur with aging. The next time you shop for shoes, be sure to measure your feet for both length and width. Be aware that the right size shoe may not always be a good fit, so it helps to try on a few different styles until you find the most comfortable fit. Shoe sizes can vary to almost 1 size depending on the manufacturer!
    
2. Extreme Height: One of the most common problems with high heels is pain under the ball of the foot. A higher heel means more stress on the ball of the foot, ankle, and knee, which increases as the height goes up.  
   Try these to minimize pain and possible injury: 
   
   -  Prefer to wear a platform shoe, this adds height without the extreme slope and pressure on the ball of the foot. 
   -  Wear a chunky heel instead of stilettos.
   -  Find a heeled shoe where the heel is positioned more toward the back of the shoe, which is more stable than a heel positioned more toward the center of the shoe.
    
3. Not Enough Coverage:  Shoes with very little to no straps on the top of the shoe.  This will allow too much motion on an already unsteady, elevated heel. You can bet that long periods of walking in these shoes will leave you with tired, sore feet and put you at risk for an ankle sprain. Your best bet is to choose styles that fit the shape of your foot well, offering adequate material to hold your foot in the shoe — a good example is a high-heeled boot or a shoe with straps across the toe area, arch, and ankle.
    
4. Pointy Toed Shoes:  Seeing the way the toes are squeezed into these pointy-toed shoes are painful to observe. Besides the toes being pushed into a cramped space, there is an issue with the shoe's toe material not covering enough of the toes. This forces the toes to work harder at maintaining stability, possibly contributing to toe contractures, such as hammer toes. A better choice is a shoe that has more material across the toes and more of a rounded toe box. Another toe problem that can be aggravated by high-heeled shoes is a bunion deformity.