Extreme High Heels

Extreme high heels seem to be the norm this year in women’s shoes.   Shoe store shelves are lined with them; women everywhere totter somewhat awkwardly and uncomfortably in them. 

Historically, women have had a love affair with high heels.  They will always be in fashion.  However, it seems that the heel heights of today are pushing the limits of comfort and safety.

The pictures in this blog post are the result of a visit to the local mall for an informal survey of what most shoe stores are offering for high heel aficionados.  Along with taking pictures, I tried on a variety of  shoes to find out what wearing these extreme heels feels like.

Some women argue that the platform sole in these shoes serves to soften the angle at which the shoe tilts (the pitch).  However, at heel heights of 5 and 6 inches, the pitch of the shoes is still high.

With each pair of shoes I tried, my body was thrust forward.  I could feel my toes being shoved into the front of the toe box even in shoes that were properly sized.  Balancing was precarious as I made a conscious effort to maintain proper posture.  I didn’t even attempt walking.  In the booties shown here, I overturned my ankle.

Fans of these heels often say that they are comfortable and easy to walk in when you get used to them.  Again, an informal survey watching women wearing very high heels indicates to me that they struggle to walk in them and facial expressions show some degree of discomfort.

In a previous high heel blog (here), I outlined the harmful effects of frequently wearing high heels.   These included bunion formation, hammer toes, crowding together of toes and ingrown toenails. As well, the calf muscles, knees, hips and back are strained as the body tries to maintain balance.

The McDermott Footcare client who agreed to have these pictures taken of her feet stated that she wore high, ill-fitting shoes for many years.  Now in her later years, she finds walking very difficult.

Note how the toes are permanently shortened and crowded together.  This is the result of toes being pushed forward in a narrow toe box for many years.  As well, the shape of the foot indicates that my client constantly wore shoes that were too small.

Realistically, women will continue to wear high heels.  This is understandable since a fashionable pair of shoes elevates an outfit and makes women feel attractive.

The same survey of shoes confirmed that there are many attractive, more comfortable options in high heels available at the same stores.  It’s not that women should stop wearing heels all together; it’s that we should be making more reasonable choices, keeping in mind the health of our feet, ankles, knees, hips and back.  We should also be alternating reasonably high heels with flatter shoes.

Fashion and health can co-exist quite well in the wardrobe of a stylish woman.  Many choices are available in a range of styles and prices.  There is no need to sacrifice comfort, health and safety for fashion.

.Copyright Terry McDermott. May not be reproduced in whole or in part without permission of author

Foot Care for Bunions (Hallux Valgus)

A bunion (or hallux valgus deformity) occurs when a bony growth develops at the base of the big toe.  As the growth becomes bigger, the toe becomes misaligned and starts to lean into the other toes.   The second toe often develops into a hammer toe due to impingement from the big toe.  The joint between the base of the big toe and the ball of the foot, called the first metatarsophalangeal joint, becomes inflamed and painful.  The bursa, which is the fluid-filled sac next to the joint, can also become inflamed, leading to swelling, redness and pain.  This condition is known as bursitis. 

Although bunions most often develop at the base of the big toe, smaller bunions sometimes develop at the base of the small toe.  This is a Tailor’s bunion.

What causes bunions?

Some statistics claim that the ratio of women to men who develop bunions is 10:1.  The biggest cause is footwear.  More specifically,  the shoes in question have a narrow toe box that push the toes together and high heels that put stress on the metatarsophalangeal joints.  For more information on the effects of high heels, read here.  Heredity can be a factor.  Medical conditions that affect the joints, such as arthritis, cause it as well.

Caring for bunions:

Shoes that accommodate the bunion are a must.  The toe box should be wide enough to comfortably fit the width of the forefoot and there must be wiggle-room for the toes.

It is never a good idea to cut a hole at the side of the shoe to provide more room for the bunion.  A hole in the side of the shoe can irritate the skin around the bunion or cause herniation of the inflamed bursa – ouch!

Padding can be cut to protect the bunion and make walking more comfortable.  At McDermott Footcare, I cut special padding specific to the size and location of the bunion that cushions it inside the shoe.

Toe spacers placed between the first and second toes keep them from rubbing against each other and realign the big toe.  A bunion brace or splint may be worn at night for realignment.

A person who has bunions often benefits from custom-fitted orthotics.  A podiatrist or chiropodist provides this service.

Medical Treatment of Bunions:

The pain and discomfort from an inflamed bursa next to the metatarsophalangeal joint may be relieved by oral anti-inflammatory medication such as ibuprofen.  Before taking anti-inflammatories,  check with your doctor first if you are taking any other prescription medication.  And always take them as directed.  Ice packs provide relief as well.

For persistent bunion pain, surgery is an option to discuss with your doctor.  An osteotomy realigns the joint.  Arthrodesis surgery removes damaged parts of the joint.  The most common procedure is a bunionectomy which shaves off the bony growth.  This surgery is not always successful and the big toe may return to its deviated position post-surgery.

Preventing bunions:

The best way to care for bunions is also the best way to prevent bunions.  Proper footwear is the first line of prevention.  A wide toe box, wiggle room for the toes, a low heel; these are what to look for in an everyday shoe (read here for more on shoes and socks).   While this advice applies mostly to women, men would do well to use the same guidelines for footwear.

Copyright Terry McDermott. May not be reproduced in whole or in part without permission of author

High Heels vs. Foot Care

This is my daughter taking great delight in her brand new , fashion-forward sandals.   With 4 inch heels.  And a teeny tiny platform.  I have to admit, she looks really good in them.

That’s the dilemma of high heels, don’t you think?  They make our legs look great, kick our outfit up a notch, and they make us feel confident, attractive, even  powerful.  On the other hand, high heels wreck our posture and eventually, our feet.

High heels pitch our posture forward and put most of our weight on the metatarsals, a.k.a. the forefoot or the ball of the foot.  Over time, this can result in metatarsalgia, a constant strain and pain over the forefoot.  Morton’s neuroma is a potential problem between the third and fourth toe that produces a sharp, burning pain over the ball of the foot and numbness in the toes.

As well, shearing friction along the ball of the foot creates calluses.  Pressure from weight concentrated on the forefoot creates corns.  Both conditions can be very painful.

Our hips, lower back and knees have to realign to maintain balance and posture.  This causes lower back, knee and hip pain because of the stress and strain on these areas.  We’ve all seen pictures of pregnant celebrities wearing stilettos……….do I really need to comment?

What happens to the toenails in high heels? Here’s my daughter again to illustrate the point.  Since the entire foot pushes forward in high heels, toenails are jammed against the top of the  narrow toe box.  The pressure on the toenails damages them and can lead to fungal, involuted, and/or ingrown toenails.

Toes crammed into a narrow toe box and pushed forward by the pitch of the shoe can develop hammer toes, claw toes and overlapping toes.   There’s also the potential for forming a bunion, a painful, bony prominence along the outside of the big toe.  The picture (not my daughter!) clearly shows these conditions.  Note the callus on the raised hammer toe.  This is due to the hammer toe rubbing against the top of the toe box.  Yes, it’s painful.

So, what’s a girl to do?  Give up high heels?  That’s unrealistic.  I don’t wear heels at work but, like most women, I have a wardrobe of high-heeled shoes and boots that I enjoy wearing when possible.  Admittedly, none of them have 4-inch heels.  My limit is 3 inches.

I think the key is moderation and common sense.  Leave the 4 -inch stilettos for very special occasions.  Don’t wear them every day – that’s just asking for trouble.

Wear a moderate high heel with a wider toe box on a daily basis.   A 2 -inch heel with a wider base is comfortable and fashionable.  Women who wear heels at work can change into them while sitting at their desk but can put on walking shoes or low-heeled dress shoes when commuting to and from the workplace.  I’ve recommended black, loafer-style nurse shoes to foot care clients who want something more fashionable than a typical walking shoe.  I wear them when I’m visiting McDermott Footcare clients.  Vary your heel heights from day-to-day by alternating low heels with moderate heels.

High heels are part of our culture and for many women, part of our self-image.  We will never give them up but that doesn’t mean we have to fall victim to their harmful effects.  We can continue to enjoy them as long as we take measures to reduce potential problems.

I would like to thank my daughter (and her stilettos) for inspiring this blog and for being such a good sport.  May you have many wonderful years enjoying your heels.

For more tips on proper footwear, read my McDermott Footcare page , above, on “Socks and Shoes.”  Let me know how you feel about high heels.

Copyright Terry McDermott. May not be reproduced in whole or in part without permission of author