We all know heeled shoes look great and can boost your image, but most high heels can be a burden. Even the most well made, opulent pair of heels can leave your feet aching after a couple of hours of walking. Some might say this discomfort is the price of beauty, and we must make sacrifices for the sake of fashion, but how high can you go before it’s a liability for your feet? Well, the short answer would be a heel-bound accident: tripping, getting stuck in a grate or twisting an ankle, which can put you in the emergency room. Thinking long term is more likely a way to judge the damage high heels can render on your fabulous feet.
• Wearing high heels all day every day can actually cause some serious problems with your feet.
• You can help prevent injuries and pain from high heels by regularly stretching the plantar fascia and calves.
Structurally, the plantar fascia–the fibrous tissue along the bottom of your foot that connects your heel bone to your toes–is also connected to the calf muscle, which in turn connects to the hamstring. The hamstrings attach to the pelvis and low back, which is why wearing high heels can make your backache along with your feet. Also, walking on the balls of your feet will shift your center of gravity forward, forcing you to arch your back when you stand and further contributing to back pain.
“The reason heels are bad is that when you are in any kind of shoe that has elevation or a heel, your weight gets shifted forward to the ball of the foot,” says Jackie Sutera, D.P.M., a podiatric surgeon at City Podiatry in New York. “The higher the heel, the more weight, and pressure get shifted forward. Your knees and hips then have to push forward and your back has to hyper-extend backward to counterbalance,” she explains. This can translate to the leg, hip, and back pain. “It misaligns the whole skeleton and that’s in a nutshell why it’s really bad for you.”
On top of all that, heels cause more noticeable damage to the feet and ankles. Here’s what you need to know before stepping into that gorgeous new pair of stilettos:
High heels can cause all sorts of cosmetic problems for your feet.
The pressure your toes experience being pressed forward can lead to hammertoes (when the toe becomes bent downward permanently), bunions (a swollen, bony bump that forms on the side of the big toe), and ingrown toenails. “If you already have them it gets worse. If you don’t have them, they can develop, especially if you have a genetic component,” Sutera says.
They can also leave you with real injuries.
Similarly to how overusing muscles can lead to injury, repeatedly wearing high heels can cause all sorts of painful problems. Straining your ankles and other tendons surrounding the foot can lead to tendonitis. “Because your foot is elevated and the weight goes forward, a lot of tension gets taken off the Achilles tendon and it shortens over time,” Sutera explains. “That’s why a lot of women who are a little older don’t feel good in flats because the tendons are so tight from overuse of high heels their whole lives” that it’s uncomfortable when they’re stretched to their original length.
Extra weight and pressure on the front of the foot can even cause a stress fracture. Heels can also cause pinched nerves. “The most common is called Morton’s neuroma,” Sutera says. It occurs on the ball of the foot, usually between the third and fourth toe. “You can get heel spurs [a calcium buildup on the bone], arthritis, and heel pain, as well,” she adds. If your feet are ever seriously hurting you and it won’t ease up, see a podiatrist to figure out what’s wrong.
Repeatedly wearing heels can actually wear away your foot’s natural cushioning.
“What ends up happening with overuse is the fat pad on the bottom of the foot starts to become a lot thinner over time,” Sutera says. “When you don’t have a natural cushion anymore, you can get generalized pain on the bottom of the foot.” This pain is called metatarsalgia. The rate at which these fat pads atrophy depends on the person, but over-wearing high heels and even walking around in crappy flip-flops can contribute to the process over time.
If you’re going to wear heels, there are some things you can do to minimize and mitigate the effects.
Sutera recommends some things you can do to make wearing heels a better experience for your poor feet:
- Massage and stretch your legs at the end of the day. “The Achilles tendons and calf muscles get really tight, so doing calf stretches and massages can undo that,” Sutera says. Downward dog or a runner’s calf stretch against the wall will suffice. If you have a pinched nerve or other pain in your toes, massage in between the thin bones. “That usually helps to open up space, promote circulation, and calm everything down,” says Sutera. Simply spreading and stretching your toes apart will help, too.
- Ditch shoes that are worn out or no longer fit. “I don’t care how much money you spent, they will hurt you if they’re not in good shape and don’t fit you well,” Sutera says.
- Choose wedges and platforms over a thinner heel. “There’s a greater surface area to distribute body weight across, and it gives you much more stability as well.”
- Alternate heel heights throughout the week. You should also switch shoes throughout the day so you’re not in heels all day long. That way, your feet aren’t always forced into the same angle day in and day out.
- Aim for a 1-2 inch heel. There are a number of foot conditions that can actually be helped by wearing slight heels. When somebody uses a completely flat shoe, the foot collapses down, the arch collapses down, you stretch the muscles, the tendons, the ligaments, and that can develop stressful symptoms.
- Pick shoes with stronger soles. Next time you’re considering a new shoe purchase, pay attention to sole firmness under the ball of the foot. The more rigid the sole is, the better.
- Wear commuter shoes. It’s difficult to grasp this idea when you’ve worked to perfect your outfit before leaving the house, but your feet will thank you later. “If women in their 20s started doing this now, they would have fewer problems when they get older,” says Sutera. Wear shoes with a thick sole, arch support, and shock absorption, and wait to change into those sky-high heels until you arrive at your destination.
- Pump in moderation. Heels aren’t good for your feet. But no one expects you to just stop wearing them. If you make better shoe choices most of the time and wear high heels minimally,
Dr. Surve, co-director of the Texas Center for Performing Arts Health and an associate professor at the University of North Texas Health Science Center Texas College of Osteopathic Medicine, helps dancers and other frequent heel wearers counteract the head-to-toe toll high heels take on the body. He treats high heel pain daily, taking a whole-person approach to help performers avoid long-term harm.
“From an osteopathic perspective, we’re looking for the body to be centered from head to toe. High heels put the foot at an angle and pull muscles and joints out of alignment, so the effects aren’t limited to the feet,” Dr. Surve explained. “It’s not unusual for people who spend lots of time in high heels to have low back, neck and shoulder pain because the shoes disrupt the natural form of the body.”
It’s also important to understand that the slope of the shoe is more important than heel height when it comes to comfort, Dr. Surve notes. Look for a platform sole to decrease the angle between the heel and the ball of the foot, so your weight can be more distributed across the entire foot. A thicker heel also spreads your weight more evenly and decreases the risk of spraining your ankle.
The best thing to do is to not wear heels, but if you do get a shoe that’s built with advanced footbed cushioning and arch support. We have that advanced footbed cushioning and arch support in all our styles but “NO HIGH HEELS FOR LADIES!”
Here’s a video that tells you about my past dealing with high heel shoes for ladies: