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

Our smart, no-judgment guide to wearing cute shoes and sexy heels without too much torture.

I love my shoes. But they don't love me. Want proof? On the top shelf of my closet sits a sleek navy box. Inside are the gorgeous aubergine, crocodile-patterned high-heel pumps I bought to wear to my nephew's wedding. It was a lovely evening with family I rarely see, and I don't remember one bit of it. All I remember is sitting out the dancing because I couldn't feel my toes. They had gone completely, scarily numb. My comfy cork sandals don't love me, either. I've stumbled sideways off the platform so many times I'm surprised that I haven't sprained an ankle. Then there are the seemingly sensible leopard-print flats that carve a bump into my heels and the all-too-floppy flip-flops that make my arches feel as if they're on fire.

Chances are excellent that you've also worn a pair or two of cruel shoes and regretted it. Nearly 90 percent of women have suffered because of painful footwear, according to a survey by the American Podiatric Medical Association, and it isn't just minor annoyances like blisters and calluses. About two-thirds report heel pain and almost a fifth report pinched nerves, according to the study. And those are just two shoe-related maladies: Others include permanent deformities such as bunions and hammertoes.

These aren't just old-lady problems, either. Shoe-related foot trouble begins when you're young, develops over time, and has much to do with choices you make now. Still in her 30s, Victoria Beckham already has had bunions, brought about in part by the super-high heels she wears. She's paid the price, says Leora Tanenbaum, author of Bad Shoes & the Women Who Love Them. "Gorgeous shoes create ugly feet -- how ironic." Keep in mind that with 26 bones, 33 joints, and 100-plus muscles, tendons, and ligaments, your foot is the foundation for your entire body, so you don't want to screw it up.

Blame It on Gaga

It's easy to blame all of this on the skyscraper heels that have been in fashion for several seasons. Seriously, if Lady Gaga can wear 12-inch platforms onstage, how bad could your four -- or even five-inchers be? Even when they hurt, there's a reason you love them. "High heels make most women feel that they look better," says Valerie Steele, director of the Museum at the Fashion Institute of Technology in New York City and the author of Shoes: A Lexicon of Style. "They tilt your pelvis; your tummy is in, your bosom is out, and you look taller, thinner, and curvier." Not to mention they make your legs look longer, your ankles more slender -- and men adore them. There's no mistaking the seductive pull of a beautiful pair of shoes. "You're never too old or too fat to wear them," says Steele. "You slip them on and you feel like a new person."

The good news is that you don't have to pack away your sexy high heels. Just wear them less often, for shorter periods, and for occasions where you won't be on your feet too much. "It's about balance," says Amy Matthews, a New York-based movement therapist. "With just about any shoe my advice is, ?Great, wear it; then wear something else.'"

But even smart-seeming alternatives such as ballet flats and sneakers can do damage. If they don't fit properly or aren't built right, with arch support and other features, "you're trading one problem for another," says Alicia Galitzin, creative director at Taryn Rose, a line of stylish healthy shoes.

Your feet are adaptable, built to walk on a variety of surfaces. So to keep them healthy -- and the rest of your body balanced -- try switching regularly between a variety of low, supportive footwear. But finding a decent-looking shoe that fits, supports properly, and lets you stride easily and naturally -- sans pain -- is like searching for the Holy Grail. Luckily, most women enjoy the hunt.

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."

More Possible Problems

Problem: Plantar fasciitis
What It Is: Inflammation of the fibrous tissue that connects the heel bone to the metatarsal bones on the bottom of the foot. Symptoms can include a burning sensation and aching on the soles, and dull or sharp heel pain. "If, first thing in the morning, your heel is really painful, and then as you walk around it feels better, that is the classic sign," says Sheryl Strich, DPM, president of the American Association for Women Podiatrists.
Shoe Culprit: Surprise: "High heels are not the evildoer," says Dr. Strich. The most likely culprits are pancake-soled shoes with zero arch support, such as flip-flops, ballet flats, and some casual sneakers. And standing for long periods of time in any shoe -- say, if you work on your feet -- can also cause this common injury.
The Fix: Rest, ice, specific stretching exercises, oral anti-inflammatories, and supportive shoes usually do the trick. If not, your doctor may use steroid injections to ease inflammation and a boot cast or night splints over several weeks to gently stretch the tight tissue. She may also take an impression for custom orthotics to maintain your correct foot position.
Prevention: If you stand a lot or have either flat or high arches, special custom orthotic shoe inserts can help you avoid plantar fasciitis.

Problem: Haglund's deformity
What It Is: Commonly known as "pump bump," it's a bone spur that develops at the back of your heel, where the Achilles tendon attaches. The protruding bone irritates the bursa -- a small, fluid-filled cushion between the tendon and the bone -- leading to a painful condition known as bursitis at the back of the heel.
Shoe Culprit: It's not just your pumps -- any shoe with an overly stiff heel counter (cobbler-speak for the back of the shoe) can dig into that tender area and result in a bony overgrowth. Shoes that are too short make it worse. Genetics also play a role; high arches or a prominent heel bone can make you more prone to pump bump.
The Fix: Rest, ice, and ibuprofen or aspirin can help, as can sticking to backless styles, like clogs, while you heal. In more serious cases, steroid injections or physical therapy can ease inflammation. Surgery can also permanently reduce the size of the heel bone so it's less prone to rubbing.
Prevention: Again, be sure you're wearing the correct length shoe. When you try on both shoes at the store, pay attention to the heel counters: If they're already digging into you, the problem is only going to get worse when you wear them on the street.

Your Body on Three-Inch Heels

  1. Back and neck. The exaggerated curve in your lower spine puts you at risk for achiness in your upper and lower back.
  2. Hips. The angled-down position of your foot makes your hips work harder when you walk, leading to pain.
  3. Knees. Your knees hyperextend, putting increased pressure on the joint, which can contribute to arthritis.
  4. Calves. Wearing high heels frequently can shorten calf muscles over time, so it hurts to wear flats or go barefoot.
  5. Ankles. Your center of gravity shifts and you're thrown off balance -- a twisted ankle waiting to happen.
  6. Feet. A three-inch heel puts seven times as much stress on your foot as a one-inch heel.

Painful Hazards

Manmade materials such as plastic and vinyl don't stretch easily or breathe, causing blisters and putting pressure on bunions.
Try choosing shoes made of leather or flexible fabric, such as nylon mesh.

Skinny straps on sandals or slingbacks can rub or cut into skin.
Try adhesive strap cushions to help with friction. Adjust tightness or look for wider straps next time.

Too-small shoes can lead to ingrown toenails.
Try making sure there's room between the end of your longest toe and your shoe and that toes aren't pinched together. Be sure to try both shoes on; most women have one foot that's longer than the other.

Too-big sandals can cause foot slippage, toe overhang, and blisters.
Try ball-of-the-foot pads to stop feet from slipping.

Too-small clogs, sandals, or mules can leave you with heel calluses.
Try making sure heels don't hang over the back edge.

Cutting Remarks
Don't assume you can wear the shoes you want now and have corrective surgery to fix your feet later. Risks of foot surgery include chronic pain, numbness, and the return of your original problem if you continue to wear bad shoes. For these reasons, even surgeons view going under the knife as a last resort.

Sexy Shoe Confessions

I love that they're totally hot...hate that since they're high, my feet slip down in them and cause my toes to feel mushed!
- Ree Richardson
Hollister, North Carolina

I met them a little over a year ago -- it was love at first sight. They put a smile on my face every time I look at them, which is why I keep them out on display in my bedroom.
- Christine Carnago
Mount Clemens, Michigan

My sexiest shoes are very high, sparkly, and to die for but über-painful. I guess there is always a downside.
- Alissa Marie Tschetter-Siedschlaw
Des Moines, Iowa

My sexiest shoes are my Brooks Ghost 4 running shoes; nothing beats how awesome I feel in them before, during, and after that run. And the hubby saying nothing beats how toned they are making my legs.
- Betty Jane Reece-Weaver
Mountain Home, Idaho

The Shoe Matrix

Let's face it: The perfect shoe -- drop-dead sexy, healthy, and comfortable -- doesn't exist. Most styles fit somewhere on this spectrum. But designers are rising to the challenge, offering options that, while not exactly Sex and the City, don't scream "I have bunions!" either. Where do your favorites fall?