How Heels Are Killing Your Feet

How Heels Are Killing Your Feet
Tue 20-08-2013

Michael Liebow, a podiatrist, pulls out a wince-inducing photograph of a foot X-rayed in a high-heel shoe: It reveals the ball of the foot at a nearly 90 degree angle to the bones in the rest of the foot. It does not look good.

"That is not how your foot has evolved to walk."

"Humans are meant to walk heel-to-toe, with the leg at about a 90-degree angle to the foot and the ankle joint employing a 60-degree range of motion during normal daily activities. By wearing a high heel, you’re altering the position of the foot and how the foot is to function. Therefore, lots of bad things happen."

Among the more common problems podiatrists say they see in women are calluses and, more painfully, corns, hard nuggets of keratin buildup caused by pressure on the skin. With high heels, corns develop up under the balls of the foot where the weight of your body presses down, and they feel like small rocks underfoot when you walk. Liebow also sees capsulitis, a painful inflammation of the joints where the toes attach to the foot, and neuromas, or pinched nerves, where pointy high heels squeeze the toes. And when the heel is frequently in a high-heel shoe, it can cause the Achilles tendon (which connects the calf muscle to the heel bone) to tighten. When you kick off your shoes and the heel comes down to the floor at the end of the day, the extra stretching of the tendon can lead to a condition called Achilles tendinitis.

Wearing high heels can also cause inflammation of the connective tissue at the bottom of the foot, the plantar fascia. That can result in severe heel pain and the need for aggressive treatments such as oral anti-inflammatories, oral steroids, cortisone injections, walking boots and crutches.

All of these conditions can be incredibly painful, requiring corticosteroid shots and, ideally, flatter and wider shoes.

"The bigger the heel, if it’s chunky or a wedge, seems to be better because the shoe has a wider base of stability. A skinnier heel and you’re more likely to have ankle spraining." 

Liebow, too, has a  short list of things you can do to minimize the problems if you insist on wearing high heels. The list includes buying only shoes with good padding at the balls of the foot and a gradual slope (rather than the 90-degree angle shown in his X-ray), so “the force is more evenly distributed” over the foot.

As for how high you can safely go with heels, Liebow says, “there’s no height that’s good.” But “most women can handle a heel of an inch or two with minimal side effects.”

"Uggs are really bad for your feet: They don’t support your arches." Liebow agrees that some people have problems wearing such boots, which often have little or no support; the same goes for flip-flops.