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Are High Heels <em>Really</em> Bad For Your Feet?

High heels and pointy-toed shoes have the stigma of being bad for feet, but this does not seem to stop women from wearing them. Are women unaware of the possible resultant foot deformities that are associated with these particular shoes?
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WARNING: High Heel Shoes May Cause Foot Pain, Bunions, and Hammer Toes.

People are more in tune with their bodies than ever before -- we consider the safety of the food we eat, purity of the water we drink and the quality of the air we breathe. We are concerned about environmental toxins, workplace stresses and so many additional external forces affecting our health.

There is a sense big businesses may not have your total health interests at heart, and this is seen in the tobacco industry and the fast food business. The Surgeon General places warnings on cigarettes. Fast food restaurants now post nutritional information for their customers to review.

But what about shoes? Can your footwear cause real long-term health consequences?

High heels and pointy-toed shoes have the stigma of being bad for feet, but this does not seem to stop women from wearing them. Are women unaware of the possible resultant foot deformities that are associated with these particular shoes? It would be hard imagine that women didn't know that certain shoes may be harmful for foot health. Some shoes may cause immediate foot pain as well as discomfort that may last for days. In a recent blog, I wrote about how to recover from a high heel hangover.

Perhaps women have a fashion "now" mentality and plan to deal with any resultant foot problems should they occur -- years down the road. Many know that certain shoes are "bad" but are under informed, as they don't know what actual foot problems can develop, or what's involved in correcting the problem.

Three common foot problems often associated with high heels and pointy-toe shoes are:

  • The Bunion: This is a bony prominence on the inside of the foot at the big toe joint and looks like a knob. A bunion forms when the big toe is pushed towards the second toe. A bunion is not the overgrowth of bone, rather the subluxation of the big toe joint over time. When surgery is indicated, it typically involves the breaking and resetting the dislocated bone with a screw(s). The surgeries involves six to eight weeks of recovery.
  • A Hammer Toe: This is a condition where a toe becomes buckled or crooked. Thick calluses may form on pressure spots. A common surgery, when indicated, involves removing the knuckle of the deformed toe. A wire holding the toe steady protrudes from the tip of the toe for several weeks.
  • Tight Calf Muscle (Equinus): Long term use of high heels are thought to cause shortening of the Achilles Tendon, resulting in more pressure being placed on the ball of the foot. Many foot surgeons consider this an underlying cause of several foot problems such as bunions, hammer toes, flat feet and others. Stretching may help counteract the problem. When surgeons believe this problem is pathologic, they may recommend lengthening of the Achilles tendon or cutting a muscle in the calf.
  • Are the shoes the cause of these foot problems?

    While foot health professionals see the problematic effects of high heel and pointy shoe use in their clinical practice, no study has directly linked shoes to bunions and hammer toes.

    Long-term large studies that can specifically link these conditions are not at the forefront of medical research -- and that is likely because nobody is dying of hammer toes. Smaller biomechanical studies have been performed that look into the altered foot mechanics of certain shoes.

    High heels and pointy-toed are not going away anytime soon as they are at the forefront of fashion. It is likely that shoe companies are not going to voluntarily display a warning that their shoes may cause the foot problems. However, some high fashion shoe companies have started to incorporate foot health features into their shoe design and construction, and this is a step in the right direction. As people gravitate towards healthier shoes then industry will respond by producing more healthier fashionable shoe options.

    Clearly I am not the Surgeon General, but I am a Foot Surgeon, and, in General, wearing high heels may result in the development of foot deformities. So be mindful about your exposure to high heels and pointy-toed shoes.

    What do you think?

    ~ Dr. Neal M. Blitz

    To learn more about Dr. Blitz, please visit