Killer Heels: What Your Favorite Shoes Are Doing to Your Feet

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What's the Damage?

Wearing killer shoes once in a while is okay, but over the long haul they can wreck your feet -- from twisted toes to inflamed nerves. Follow our advice on how to fix, or prevent, a problem.

Problem: Bunion or bunionette
What It Is: A painful deformity in which the big toe is pushed out of alignment at the joint that connects it to the foot. The toe angles in toward the smaller toes, and the misaligned joint forms a knobby bump at the inner edge of the foot. As for a bunionette, it may sound adorably pet-like -- "as if you could put a leash on it," says Mark Berkowitz, MD, an orthopedic surgeon specializing in feet and ankles at the Cleveland Clinic. But it refers to the same thing with your pinky toe.
Shoe Culprit: Genetics are a big factor, but shoes with a narrow or pointy toe contribute by forcing toes into the position you're trying to avoid.
The Fix: If you're in the early stages of bunions or bunionettes, lower-heeled, wider-toed shoes can at least keep the condition from getting worse. Special bunion-cushioning pads, available over the counter, can ease the pain of the bump rubbing against your shoes. For really bad bunions, surgery may be the best option, but it can involve breaking and realigning the joint, inserting metal pins, and other unpleasantness.
Prevention: If your mother, sister, or other family members have bunions or bunionettes, you're at greater risk. Avoid super-high stilettos that scrunch your toes and stick to properly supportive shoes as much as possible.

Problem: Hammertoe
What It Is: A deformity in which one or more of the four smaller toes scrunch up accordion-style at the first or second joint, with the tips angled downward like claws.
Shoe Culprit: Pointy-toe pumps, especially if they're also too small. Short, tight, high-heeled shoes crowd the toes, forcing them into a squeezed together triangle shape that becomes permanent in time.
The Fix: Once you've got hammertoes you're stuck with them. Shoes with a high, roomy toe box can ease pain and pressure. Surgery is a last-resort option that can include cutting and realigning tendons and removing bone.
Prevention: Steer clear of pointy toes and high heels and focus on shoes that fit well, aren't too small, and don't squish your toes.

Problem: Morton's neuroma
What It Is: It's caused by an irritated nerve in the front of the foot, often between the third and fourth metatarsal bones. The nerve thickens to protect itself, resulting in a benign tumor that doesn't go away. You may feel a sensation kind of like an electric shock in the ball of your foot, or the sensation that you have a rock in your shoe. You may also feel occasional numbness in your toes.
Shoe Culprit: High heels can torment the nerve by shifting your weight to the ball of your foot, creating pressure. Shoes with a pointed toe can make things worse by squeezing from the sides. (High-impact exercise, such as running and jumping, and genetics can also contribute.)
The Fix: Rest, ice, and aspirin or ibuprofen can help occasional flareups. For chronic cases, your doctor may prescribe a series of steroid injections to the foot. If all else fails, she may surgically remove the affected nerve, which ends the pain but can leave you with permanently numb toes.
Prevention: Choose lower shoes with plenty of arch support and a roomy toe box. "You need to fit the dimensions of your foot," says Dr. Berkowitz. To illustrate his point, he says, "I have my patients stand on a piece of paper and trace the outline of their foot, and then trace the outline of their shoe next to it. They often see that their foot is wider than the shoe."

Continued on page 4:  More Possible Problems

 

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