As Jessica Simpson sang about her boots which were made for walking, pretty heels are also made for walking. High heels aren’t meant to be limited to being worn only while seated or only for short periods of time; they are meant to make you feel comfortable and confident when walking for lengthy periods. High heels are evidently a part of many women’s lifestyle choice, ideally meant to be worn without worry or hesitation. As podiatrists, we aim to maintain or treat the foot to be pain-free, even if high heels are a part of the equation. Our treatment plans are tailored to help patients with their problems revolving around a variety of shoe types.
Many women face problems wearing heels; the two main factors are pain and instability. With regards to pain, very often, it is most prominent in:
Arch pain may occur when the pitch of the calcaneus (heel bone) is artificially lifted, as this angle may cause pulling and tension at the arch for certain foot types. Depending on the situation, a high heel would always engage the foot arch but shouldn’t strain it. Ideally, the arch should maintain its natural position; failure to do so can cause pain. If this is not addressed and the arch is constantly strained, microtears will occur within the soft tissue connections which maintain the shape of the midfoot.
The bones in the front of the foot consist of the metatarsals. They are slim and narrow in comparison to the heel bone. These bones were not designed by nature to withstand one’s entire body weight. The uneven distribution of pressure when wearing high heels encourages forces to shift to the forefoot. An orthotic can help to transfer the forces from such a localised area, allowing for more even distribution.
Deformities in the toes are common; bunions and hammertoes can be exacerbated in women who are constantly in high heels. Pain can increase significantly as these deformities progress in stages, especially in narrow shoes due to joint impingement pain or skin friction against the shoe. Women who have a more flexible foot type can develop these toe deformities from abnormal joint movement and positioning, exacerbated by shoe choices. Stabilising the foot is essential to avoiding this problem.
In summary, foot mechanics are complex on its own. With heels (and other footwear types) as an extra variable, these mechanics can change drastically and often require additional aids to help with pain relief or degenerative pathologies. Specialist treatment for this is possible; podiatrists are experts in the foot and in footwear. Seek treatment for a more comfortable and stable stature when wearing beautiful heels.
Author: Podiatrist Emily MAH
Editor: Principal Podiatrist Michael LAI