Tips for Choosing High Heels

Look into any woman’s closet, and you can count on finding at least one pair of high heels. They symbolize many different things to women, evoking emotional descriptions such as “sexy”, “stylish”, or “cute” – along with the more practical, “they make me taller.” We would argue that “dangerous” may be a better adjective, based on what wearing high heeled shoes can do to the foot and ankle.

In our podiatry practice, we see hundreds of women each year whose heels have driven them straight to us. They come in with painful deformities such as bunions and hammertoe, or problems related to nerve compression or inflammation, including capsulitis, metatarsalgia and Morton’s neuroma.

Even if you avoid these conditions, the American Podiatric Medical Association (APMA) states that wearing high heels over three inches on a regular basis can contribute to the shortening of the Achilles tendon, thereby causing tightness and chronic pain in the calves. This is because higher heels increase the probability of muscular imbalance while walking in the shoes.

But we know that the science pales in comparison to your love of high heels, so we’ve put together some of the most important foot health considerations to keep in mind when you are choosing high heels.

If the Shoe Fits…

As simple as this sounds, it’s not always how we act when presented with a pair of shoes we absolutely love. Most women who can’t say no to a certain pair of heels will rationalize the purchase by saying things like “I’ll never wear them for more than a couple of hours, tops” or “I’ll break them in and then they’ll be perfect.” Once in a while they are right, but most often that imperfect fit is just something they get used to dealing with.

The APMA found that 42% of women stated that they would wear a shoe they liked, even if it caused discomfort. That’s not reassuring, when 73% of them admitted to already having a shoe-related foot problem.

You need to be certain that the high-heeled shoes you are buying fit correctly. If your foot slides forward, creating a gap at the heel, it does not fit, no matter what size is stamped on it. That sliding is a major cause of pain and pressure at the toes.

Also, you must avoid cramming your feet into narrow shoes. This is the most effective way to reduce the risk of bony changes – bunions, neuromas and hammertoes. Even if everything else is perfect, a narrow toe box should be avoided at all costs. You may feel like you’re settling by choosing another pair of heels, but you’re really just protecting your feet.

Look for Cushioning

Shoes that provide a cushion or padding beneath the ball of the foot are less painful to wear for long periods of time than those that do not. It does a little to reduce or offset some of the heel height, and softens the contact points on the parts of the foot that are under the most pressure. This is especially important as women age, because they are gradually losing fatty deposits in the sole of the foot that protected them from pain in their youth.

Choose a Reasonable Height

With this one precaution, you will avoid the most common foot pain complaint, which is soreness at the ball of the foot. Choose moderate high heels, preferably closer to 2” in height. You can still purchase stiletto style heels at that height, to provide the elongation you may be looking for. In general, you’ll also find that the further back the heel is, the more stable you’ll feel walking in them.

Room in the Toe Box

Do not torture your toes. A high stiletto with a pointy closed toe may catch your eye, but it’s not good for your foot. Avoid any shoe that squeezes your toes into a tiny point. When squeezed together, your toes work harder at maintaining stability and there is a high probability of toe contractures, in which scar tissue prevents a joint from moving normally. As if that’s not enough, a tight toe box can place pressure on your toenails, forcing them into the skin leading to ingrown nails. Be safe with a deeper, wider toe box that still allows your toes to move a little.

Wear the Appropriate Footwear

This is for all the ladies that strap on a pair of high heels in the morning, and dream of taking them off all day…but don’t. If you’re wearing high heels for a full work day, you can still give your feet a break by wearing something more supportive during your commute, and when you’re not meeting with people. If this is you, give serious consideration to the 2” heel recommendation and leave the higher heels for special events. Your feet will thank you for it.

At Houston Foot and Ankle Care, we treat all types of foot and ankle problems. Please call us at (713) 541-3199 if you are experiencing any type of foot pain, or change in level of mobility. Dr. Gabriel Maislos is a board certified Houston podiatrist experienced in treating and correcting bunions, hammertoe, tarsal tunnel syndrome and other conditions. We accept most major forms of medical insurance.

Call (713) 541-3199 if you experience:

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Houston Foot and Ankle

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