We all have them, those adorable, had-to-buy-them, high heel shoes hiding in our closet. In fact, some of us may have hundreds of pairs! They are torture devices made by men for women because they make our butts look good. We also like the way they make us feel tall, in charge, and yes, sexy! High heeled shoes are seen as a career woman's six-gun, but what are we doing to our feet?

High heeled shoes have been linked to many foot ailments like bunions, hammer toes, neuromas, metatarsalgia, Achilles tendonitis, ingrown toenails, and corn and calluses. Chronic knee pain and back pain can also be linked to high heeled shoes. Is this the price we have to pay for cute shoes? What is a fashion conscious woman to do?

As a podiatrist, I see twenty-something-year old women every day complaining of pain in their feet. Often, they attribute their pain to their exercise regimen or running shoes. After a thorough history examining their pain, we often realize that the shoes they run in are not the problem. It's the shoes they wear to work everyday.

Wearing high heels changes the biomechanics of walking and can have an impact on the entire structure of the foot and the relationship of the knee to the ankle, as well as your lower back. But there are steps you can take to minimize the damage from your killer heels!

  1. Buy shoes that fit! Sounds like a no-brainer, but most women wear shoes at least a half a size too small. Measure your feet every time you buy shoes, even just a few extra pounds can make your shoe size larger. Remember that the number is just a suggestion, different brands can size completely differently.
  2. Wear a wider shoe than you think you need. The shoe is not going to stretch that much when you "break it in". Most women also but their shoes too narrow!
  3. Always buy shoes in the afternoon or at the end of the day. Your feet swell throughout the day, so you will get a better, realistic fit if you buy in the afternoon.
  4. Buy leather shoes, not synthetics. Leather is more forgiving.
  5. Beware of the pointy-toed, high heeled shoe! These are a double-whammy! Try to avoid the severe point and go for more of a taper or square toe box.
  6. If you have bunions and hammertoes, a silicone protective sleeve can help your pain from rubbing in your shoes. Make sure your toe box is wide enough to accommodate the padding.
  7. Buy the bigger pair! If you have two different sized feet (and most people do), buy the larger size. Shoe stretchers could also be used to stretch the toe box if one foot is only a little bigger than the other. If you have significantly different sized feet, some stores and websites will sell you two different sized shoes.
  8. Try to avoid really high heels. Your feet (and knees, and back) will thank you if you adjust your heel height to lower than 3 inch heels.
  9. Try to wear a consistent heel height. Going up and down in height can be quite a pain in your Achilles tendon.
  10. Chunky heels are much more stable than stilettos. Try to wear a wider, more supportive heel or even convert to platforms!
  11. If you have to wear heels and have a flexible flat foot, try "Insolia" insoles. They are relatively inexpensive and can make a 3 inch heel feel like a 2 inch heel by distributing stress from your forefoot to the middle of your arch.
  12. If you have constant knee pain, avoid heels all together! One study showed a 26% increase in stress on the knee joint in heels higher than 2 inches. Osteoarthritis in the knee has been linked to chronic wearing of high heel shoes.
  13. Always have a pair of running shoes or casual shoes in the car or in your desk. You never know when you need to make a mad dash for the airport or get stuck running errands. Always have a pair of comfortable shoes on hand for emergencies.
  14. Applying lotion to your feet daily can help with corns and calluses. An emollient lotion with an exfoliant can help with thick, hard skin caused by shoe pressure.
  15. Get a regular pedicure. Having a regular pedicure and keeping your toenails in tip top shape can help with ingrown toenails, also caused by shoe pressure. Make sure your pedicurist is using sterile instruments and never let them cut your corns and calluses with a sharp blade!
  16. Never perform bathroom surgery on your corns and calluses. Also, never use those over-the-counter corn removers; the acid plaster in these products does not know when to stop and can cause nasty sores and infections!
  17. Get a regular massage. Massage can really help with delayed muscle soreness and fatigue from the abnormal stress from high heeled shoes.
  18. Toe stretching exercises can be very helpful after taking off your shoes. This helps increase the circulation to the poor little tootsies that are cramped in your shoes.
  19. Stretch your Achilles tendon and calf muscles at least every day if not twice a day. Regular stretching can help combat the shortening of the Achilles tendon that occurs from chronic wearing of high heel shoes. This shortening can lead to tendonitis and heel pain!
  20. Core strengthening exercises can help stabilize your feet and decrease the stress from high heeled shoes. Every woman should do core exercises at least three times a week. They help with back pain, knee pain and foot pain caused by instability.
  21. See your podiatrist if you have any pain that last more than five to seven days. A few aches and pains are normal from high heeled shoes, but if you have pain, numbness or burning that persists for more than 5-7 days, you have an injury. Simple solutions are available at your podiatrist if you seek help early. A delay in treatment can lead to needing surgery or worse......

Women have been wearing high heeled shoes for a long time, but there are a few things we can do to make our feet more comfortable if we are slaves to fashion....and aren't we all?