Feet Are A Feminist Issue

In Sex and the City, Carrie and her friends pound the Manhattan pavement in stilettos. For me, the mystery isn't if they live happily ever after but whether or not they have bunions and hammertoes.

Many real-life Manhattan women walk around the city in rubber flip-flops, platform peekaboos, and floppy ballet shoes with elasticized backs. With the gladiator sandal trend there are now lots of ankles encased in complicated straps and buckles. Don't be fooled. Pancake-flat shoes without arch support can make a woman feel like she's been fighting all day long in a Roman amphitheater.

Shoes can transform an outfit from the mundane to the magical, as Sarah Jessica Parker's character loves to remind us. High-heeled shoes give the illusion of elongating the legs, which is slimming. And shoes are relatively easy to shop for; one doesn't have to enter a dressing room and disrobe. For many women, myself included, that fact alone makes shoe shopping particularly alluring. So if my toes squish just a little to fit, or if they flop and flip without any protection to keep them in place, who cares? Isn't that the price of being a woman?

It's hardly news that looking feminine can be painful--from plucking, waxing, injecting, chemical-peeling, and the slicing off of fat and bone. Whether we accept, reject, or howl against this premise that femininity is a masochistic process, we can all agree that a woman should not damage her body permanently in the pursuit of looking attractive.

Ladies, please forgive me: I don't enjoy being the messenger of depressing news. But you should be aware that your most fashionable shoes, no matter how chic and status-laden, harm your feet. They have cramped toe boxes, inadequate arch support, and force you to hobble rather than stride. I've never met anyone not horrified by Chinese foot-binding, in which girls' toes were deliberately broken. Yet we jam our own toes into shoes with barely enough room for a kitten's paw, leading to potential serious injury. Some women have even revived foot-binding in a sense: they undergo cosmetic foot surgery, shortening their toes to fit into their shoes.

Recently my feet and knees started to hurt even when I wore flats or sneakers. I visited a podiatrist, who informed me I have bunions. Bunions? The word made me think of onions and bad breath. Bunions, I now know, occur when the big toe shifts angle, pointing toward the little ones instead of straight forward. The large joint of the big toe becomes inflamed. It turns out that my pronated feet (they roll inward), which I always thought had no consequence other than my walking a little ungracefully, are a health hazard.

According to my podiatrist, my shoes did not cause my bunions--I can thank heredity for that--but they exacerbated the problem. And I am far from alone. The overwhelming majority of bunion sufferers are women--some podiatrists say the ratio of women to men is 9 to 1--because men are more likely to make practical, sensible shoe choices. Poorly fitting shoes also may lead to hammertoes (when toes curl down), corns (thickened skin), neuroma (when two bones rub together and pinch a nerve), and plantar fasciitis (heel pain). In a 2003 survey of women by the American Podiatric Medical Association, 73 percent reported experiencing physical problems from wearing shoes.

From now on, my podiatrist pronounced, I am to wear customized orthotic inserts with arch support in all my shoes, sandals, and boots. He did not recommend surgery, although many bunion sufferers do go under the knife. In a haze over the enormous expense of custom orthotics--which insurance companies do not reimburse--I was delayed in my realization that I was in for a big lifestyle change. Trendy shoes, especially sandals, do not accommodate orthotics. I've never been a fashion plate but I certainly never expected that before hitting midlife I would be cruising the grandma aisle at the shoe store.

I've had a few months now to scope out the selection of footwear called "comfort shoes." In truth, the choices aren't quite that limited. Many companies now create shoes with support that aren't ugly and some that are even a little cute. Many shoes also have insoles that can be removed, creating space for orthotics. I do wear high heels without orthotics once or twice a week, but only for a few hours at a time and I never do serious walking in them.

Pluck and wax if you must. But choose your shoes wisely; don't let ill-fitting shoes cut off the circulation of blood to your brain.