INDIANAPOLIS (WISH) - Women have a love-hate relationship with high heels: more height in the heel gives the illusion of longer legs and a slimmer figure, but leaves its wearer with blisters, and often in pain.
“Probably the most common (problem) is just going to be skin problems -- rubbing and blisters," says Jeffrey Wu, MD, an IU Health Orthopedic Surgeon with a specialization in feet and ankles. “If you're really an extreme heel wearer, and you're doing a lot of walking, and if you're foot is at such an abnormal angle, you're prone to fractures and things like that.”
In a study published in 2010 in the Journal of Experimental Biology, scientists in the United Kingdom found that women who wore high heels five times a week for two years had calf muscles that were 13 percent shorter and Achilles tendons that were substantially stiffer and thicker than those of women who wore flat shoes. The distance the high-heel wearers could flex their feet up and down was also drastically reduced.
"If people say 'I wear heels and I don't have any trouble,' then fine! But the people who wear heels and have pain, those are the ones who really have to take a closer look and say 'why do I have pain and what can I change?"
If you feel pain across the top of your foot and the inside of your big toe, chances are good you are developing a bunion. A bunion is an abnormal, bony bump that forms on the joint at the base of your big toe. The big toe begins moving outward toward the other four toes, forcing the joint to protrude out and creating a bump.
Bunions can occur for a number of reasons, but a common cause is wearing shoes that fit too tightly. Bunions can also develop as a result of an inherited structural defect or stress on your foot or a medical condition, such as arthritis.
"How do you treat that,” Dr. Wu asks rhetorically, “Well, you can either have painful surgery or change your shoes."
Another issue that can develop over time is a problem on the back of the heel, below the Achilles tendon.
"They used to call it the pump bump,” says Dr. Wu. “Where basically it’s rubbing on the back of the heel, causing Achilles tendonitis or bursitis in that area."
Researchers are narrowing in on what makes for a perfect shoe. In a study published in the journal Arthritis Care & Research, rheumatologist Naija Shakoor of Rush University Medical Center in Chicago and colleagues found that walking barefoot or wearing flat, flexible shoes were best for knee joints. In the study, flip-flops and basic sneakers put lower loads on the knees than clogs or running shoes with added stability.
"I think in general, we would say just eliminate heels completely," says Dr. Wu.
But if you can't escape from wearing heels, Dr. Wu suggests always wearing flats, first, and bringing heels with you in case you need to wear them to complete a professional look. When choosing a heel -- look for one that puts your foot at the most natural angle. Platform shoes can work because the front of the foot is elevated to create a more natural angle throughout the foot. Wedge shoes work, too, as long as the angle of the shoe isn't too high.
Medical help for your feet
If you experience a lot of foot pain, you have options for treatment that begin with seeing one of two types of specialists, an orthopedic surgeon or a podiatrist.
An orthopedist is a medical doctor with up to 9 years of schooling who specializes in bones, joints and tendons – basically the parts of the body that allows individuals to move. A podiatrist is a doctor with at least 4 years of schooling who specializes in issues relating to the feet, ankles and lower legs.
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