Q: I work in a formal environment and wear high heels to the office most days. When I dress up for special occasions, my heels are even higher. I’m starting to wonder: Are high heels bad for my feet?
A: Sorry to say it, but the short answer is yes. High heels are responsible for many causes of foot pain and problems for women that only become more pronounced over time. Also, the higher your heels, the more damage you’re doing.
How High Heels Cause Damage
According to a 2014 survey by the American Podiatric Medical Association (APMA), 49 percent of women wear high heels, even though 71 percent of them say the heels hurt their feet. Does that curb their appeal? Nope. The survey found that the average woman who does wear high heels owns nine pairs of them, and 38 percent said if they liked them, they’d wear the shoes anyway, even if they hurt.
I say: ouch! If you’re wearing 3- to-4-inch stilettos every day you may be setting yourself up for foot, ankle, knee, hip, and back pain in the future. But you don’t need to swear off high heels entirely. Most podiatrists and podiatry organizations say it’s okay to wear high heels up to two inches, and I agree with them.
How Bad are High Heels for Your Feet?
Let me explain the ways high heels can hurt you:
When your foot is restricted by a shoe that’s tilted at an unnatural angle, your weight shifts forward and puts pressure on your toes and on the ball of your foot. By putting all of your body weight on that one small area of your foot, you’re creating problems and pain. Here are some of the sore spots:
Bunions
High heels are not the cause of bunions, but they can aggravate that bony joint at the base of your big toe if you already have bunions. The point of the shoe’s toe and the pitched angle of your foot put extra pressure on the bunion to cause the pain.
Hammertoes
Hammertoes are often caused by too-tight shoes or high heels that put pressure on the toes and thus cause the toes to contract into an unnatural shape. Other problems from shoes that constrict the feet are corns and calluses (formed when the skin rubs against the shoe) or ingrown toenails.
Achilles tendon
Women who wear high heels every day are at risk of a shrinking Achilles tendon, which runs from the back of the heel to the calf. Even though there might be no pain while wearing the high heels, going barefoot or wearing flats may cause the tendon and muscles in the calf to stretch, which does cause pain. A shortened Achilles tendon can sometimes lead to plantar fasciitis (heel pain).
Fractures and sprains
The higher the heel, the more likely a fracture or sprain will occur because of instability. It’s not only the shoe that’s unstable, but the higher heel causes a woman’s body weight to pitch forward even more. To compensate, she may lean backwards, which makes it easy to lose her balance and twist an ankle.
Knee, hip, and back pain
Leaning backwards to compensate for the forward pitch of your body in high heels can cause a wide range of problems. By overarching your back and changing the position of your spine, you cause an unnatural posture that can eventually put stress on your knees, hips, and lower back.
There’s No Need to Abandon High Heels Entirely
In spite of this potential for pain, I know women like to wear high heels for many different reasons, and I’m not saying you need to abandon them entirely. Just be smart about wearing them.
Here are some of my suggestions for how to avoid foot pain and injury:
- Stick to lower heels for most occasions. As I already mentioned, two-inch heels won’t cause your body weight to shift forward as much as higher heels, and you won’t be as much at risk for foot pain and deformities, ankle sprains, and other problems.
- Find heels with a wider toe box, or wear open-toe heels. When you wear tight shoes with a pointed toe, it goes without saying that you put more pressure on the ball of your foot and your toes are more cramped. A wider toe box can help ease the pain from bunions, hammertoes, and ingrown toenails.
- Limit your time in very high heels. The longer you wear very high heels, the more stress you put on your feet and toes. This can lead to fractures and twisted ankles, as well as shortened leg muscles and heel pain. A thicker heel can add more stability.
- Use padded insoles. As you age, you lose some of the fat deposits on the balls of your feet. So there is less of a buffer between the weight of your body and the ground. Silicone pads in your shoes can act as a good shock absorber for the feet and may also reduce wear and tear on your knees.
- Stretch your legs. At the end of a day in heels, take some time to stretch your calf muscles and roll your ankles around. Not only will you be helping to keep your tendons and muscles long and flexible, it feels really good!
My final words of advice: even though there are many reasons that high heels are bad for your feet, it’s okay to wear them on occasion. But for the most part, be sure to buy and wear shoes that fit your feet and will support your body weight without pain. That goes for running shoes, boots, flats, and flip-flops — as well as high heels.
Dr. Shier