Risky Foot Fashion: Stilettos



IF YOU’RE STILL WALKING tall with stilettos and pretty polished toes, yay for you.  But if your feet are complaining, those great heights and glamorous hues — either separately or in combination — may be at the root.

About 75% of Americans have foot pain at some point in their lives, mostly caused by shoes that fit poorly or that force the feet into unnatural shapes.  The impact of each step exerts force on the foot equal to about 50% more than the person’s body weight, due to the small size of the foot in comparison to the body.  Based on the average daily standing time of four hours, feet can support a combined force equal to about several hundred tons a day.

Stilettos reached dizzying heights in their day, with a record-breaking 20 inches from an Indian designer to Alexander McQueen’s Fall 2009 12-inch platform boots.  In 2010, the highest heel available to regular customers was the Sky Heel at nine inches.  For every inch in height, body weight bearing down on the front of the foot increases, according to what Neal Blitz,  a foot surgeon at Bronx-Lebanon Hospital, told Huffingtonpost.com

In a Hotter Shoes survey of 3,000 women wearing high-heeled shoes (HHS), nearly 50% had twisted their ankles, but 60% of the total planned to continue wearing HHS.  Studies have shown impaired functional mobility starting at a 7 cm (2.75 inch) heel, which can increase fatigue and cause misalignment of bones and joints.  These also heighten the risk of falling and of injury to lower-body muscles, notably causing the medial calf injury (known as “tennis leg”) resulting from the foot’s frequent forceful push-offs.

While a poll of 3,000 women found broken ankles and twisted knees, and women of all ages suffer up to five times the number of bunions as men — Lady Gaga once stumbled in her enormous platforms while high-heel queen Victoria Beckham has  large bunions visible when she wears sandals— six in 10 said they wouldn’t give up the heightened wobblers.

Stilettos will always be the “Beyonce of all shoes,” according to thefashiontag.com.  But increasingly popular block heels, even at four inches, are easier on the feet — though some have dubbed them ’70s-inspired boho.  With high-heeled booties, material around the ankle helps hold the foot steady to put you at less risk for injury, according to Blitz.

Wearing heels three inches and higher for long hours increases the risk of shortening the Achilles tendon, especially for those with flat feet, although this can be countered by calf-muscle stretches — best done on the edge of a step, with heels extending off the edge and dropping down to stretch.  Also riskier for flat feet are ballet flats, with inadequate arch support and cushioning, though their flexibility can help strengthen hard-working muscles.  Finally, flip-flops, with even less arch support or cushioning, can cause toe muscles to overgrip or if the big toe hangs over the edge, increase the risk of toe fractures.

Crowding the toes — wearing either high heels that push them against the front of the shoe or shoes that fit too tightly —runs the different risk of nail fungal infections.  These have a variety of other causes, in particular nail polishes applied in layers that prevent the nail from breathing.  Toenail fungus, or onychomycosis, is also more prevalent in those who work in a humid or moist environment, in people with circulation problems and/or family histories, and in older men.

Toenail polish can prevent moisture in the nail bed from evaporating through the nail.  The risk of fungus can be lessened by drying toes completely before applying polish and by disinfecting pedicure tools, even if they are your own.

The foot-enhancing option warned against most vociferously by podiatric medical associations is cosmetic surgery to improve the fit of high-heeled shoes.  Procedures include surgically shortening the toes and narrowing the feet, and injecting silicone into the pads of the feet.  These are all likely to lead to severe foot pain, a major cause of general disability in women, especially as they age.

For the rest of us, in addition to wearing slightly lower heels with slightly more toe room and using slightly less polish, one unanimous suggestion: alternate shoes every day to avoid wearing the same pair day after day.

— Mary Carpenter
Mary is the Well-Being Editor of MyLittleBird. Read more about Mary here.
Her last post was about too-tight pants and Spanx. 

2 thoughts on “Risky Foot Fashion: Stilettos

  1. Mary Carpenter says:

    Sorry to give a standard medical answer, but:
    I suggest you go to a podiatrist to discuss options. I know people who delay bunion surgery for those reasons, and I understand that long recovery is a common experience, but I bounced back quickly from mine. Before surgery I also recommend a second opinion from an orthopedist. Between the two, you’ll get the whole picture on your situation. Meanwhile, you’re joining a lot of very cool women with your sore feet…

  2. So. What do we who are now crippled after decades of heels to do? I’m currently trying the scoffing method: women look ridiculous in heels, scoff scoff. Meanwhile, I trudge along in my Birkinstock Gizehs, which thankfully come in everything from biblical brown leather to silver metallic, for formal wear. These are the only shoes that don’t leave my ballerina toe (also known, less glamorously as turf toe) and bunion (a double footer!) screaming for mercy. I’ve heard that surgery doesn’t work (and in any case, I’d be laid up for a couple of months, no doubt drowning my misery in jelly beans, which is unacceptable) … so? so?

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