It might be time to re-think your favorite shoe type.

By Jenn Sinrich
December 06, 2019

Whether you're someone who loves or hates to wear heels, you know the often-painful symptoms that come with wearing a shoe that stands several inches high. "High heels shift your weight unnaturally forward to the ball of your foot and change your entire biomechanics as you walk," explains Jacqueline Sutera, D.P.M., a podiatrist in New York City. "They also force your knees and hips to shift forward, while your back hyperextends backwards." In the short term, heels may cause temporary symptoms like swelling, blisters, painful corns and calluses, and arch fatigue, all of which can become cumbersome for your feet, explains Miguel Cunha, D.P.M, a Manhattan-based podiatrist and founder of Gotham Footcare. The long-term effects are more serious—and can be quite debilitating.

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One of the most common heel-caused ailments are damaged toenails, explains Cunha: The shoes compress toes together, causing the big nail to grow into the skin, otherwise known as an ingrown nail. "This results in irritation of the surrounding soft tissue, often causing pain, redness, swelling, warmth, and sometimes infection," he explains. Bunions are another unfortunate symptom: The unsightly bony bumps, which form where the large toe meets the joint, can be quite painful and are typically aggravated by heels. The reason? "The shape of the shoe does not accommodate the normal structure of the forefoot," explains Cunha. An even uglier abnormality? Hammertoes, which happen when the toe contracts (the tendons on the bottom of the foot overpower those on top) during a muscular imbalance—and doesn't straighten back out.

Inflammation is another sorry symptom of too much heel wear, explains Cunha. Metatarsalgia, inflammation and pain in the ball of the foot, occurs when "body weight is pushed forward to the balls of your feet" (heels with narrow toe boxes are often the culprits with this condition). Worse is the inflammation of your Achilles tendon, the largest in the body. "When wearing high heels, you put constant pressure on the Achilles tendon by shortening and tightening it," says Dr. Cunha. "Repeated and extended wear of high heels shorten the tendon permanently, which leads to inflammation and pain when you wear flat shoes and forces the tight tendon to stretch."

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Cunha also says that arthritis sufferers should steer clear of sky-high shoes, since their height can exacerbate the inflammatory joint condition. "The accumulation of weight onto your toe joints over time may lead to the erosion of cartilage and the formation of bony spurs that restrict the motion of your toes, ultimately leading to painful and debilitating arthritis."

While tossing your favorite pair might sound the safest idea, there are ways to wear high heels without compromising foot health. Sticking with a pair just one to one-and-a-half inches in height will place less tension on the Achilles tendon—and therefore reduce those nasty inflammatory effects. Believe it or not, says Cunha, a completely-flat shoe isn't the answer either: "I recommend avoiding shoes that are completely flat, however, as they will contribute to pronation and collapse of the arch, which may contribute to plantar and posterior heel pain, shin splints, knee pain, and back pain," he adds. "An arch angle of less than three-quarters of an inch in relation to the front is actually better for you than shoes that are completely flat because it takes the stress off the Achilles which can help with alignment."

Ensuring you're wearing the correct size ("A too-large-sized heel will still force the distribution of weight onto the ball of your foot," which could cause bunions, notes Cunha) and choosing heels with a wider toe box ("This reduces the probability of developing conditions like Morton's Neuroma or aggravating an existing bunion deformity") will also help, he says, as will selecting shoes with supportive ankle straps. If you are, however, going to splurge on a shoe with a four-inch heel, attempt to find a pair with a platform, which will provide more support, notes Cunha.

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