Stilettos may look good, but they’re killing your feet
Now is the season when women take their freshly pedicured toes al fresco, often courtesy of strappy high-heel sandals or opentoed pumps that look fabulous but sometimes feel like the masochistic torture tools many podiatrists insist they are.
Michael Liebow, a podiatrist in Bethesda, Md., pulls out a wince-inducing photograph of a foot Xrayed 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.
The X-ray is a prop that Liebow says he shows to patients who “walk into the office in 6-inch heels and say, ‘My feet are killing me! Why?’ ”
He says he tells them: “That is not how your foot has evolved to walk.”
To sum up his brief and frequently futile plea for foot health: Humans are meant to walk heel-totoe, 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, Liebow explains, “you’re altering the position of the foot and how the foot is to function. Therefore, lots of bad things happen.”
Shall we count the ways?
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 highheel 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. His patients will take the shots, but give up the shoes?
Women, Liebow says, “will wear their highheeled shoes until their feet are bloody stumps.”
Take Danielle Pletka, vice president for foreign and defense policy studies at the American Enterprise Institute. She wears four- or five-inch heels to work most days; on a recent Tuesday, she towered in 5-inch stilettoheeled black Sergio Rossi open-toed booties.
“There are lots of things that impact the way you look that aren’t necessarily optimal for every muscle in your body,” says Pletka, who admits she has some high pairs “that are uncomfortable, no question.” But, she adds, “you want to look nice. I always get nice comments on my shoes. And I like it.”
Erika Schwartz, a podiatrist who practices in Washington, says that when she asks her patients to stick with heels less than 2 inches high, “some say, ‘Oh, you’re so cute! No, I’m not going to wear under 2 inches, but it’s very cute of you to say that!’ ”