Heal Your High-Heeled Troubles: Want to stop the pain, but can’t stop wearing your stilettos? Doctors offer advice on how to avoid the pain and consequences of high heels.


High-heeled shoes make your legs look better, but is this worth the pain?

Some of the conditions that can be related to heel use are ankle sprains; metatarsalgia, which is a pain in ball of foot where the pressure is applied; and occasionally stress fractures in the foot. Some doctors advise a complete switch to flats, but if you still want to sport high-heeled shoes, local doctors offer tips on how to do so safely.

Sizing and comfort

Make sure you’re purchasing the correct size, says Dr. Kris A. DiNucci, Doctor of Podiatric Medicine, FACFAS, with Foot and Ankle Center of Arizona. She adds that “you want to make sure the shoe fits the foot. Just because it’s on sale and it’s half a size smaller doesn’t mean you should buy it.”

Additionally, there are shoe makers in different countries which have different sizing, says Dr. Mark Forman, D.P.M., F.A.P.W.C.A., Arizona Foot and Ankle. Just because you’re usually a certain size doesn’t mean you stay that same size in every brand or style, he adds.
The ideal shoe is one with good arch support to decrease stress through the mid- and forefoot, says Dr. Doug Meyrose, D.P.T., owner and physical therapist at Foothills Sports Medicine Physical Therapy. Forman and Steen Johnsen, M.D. of The Orthopedic Clinic Association, also suggest breaking into your shoes before a night out.

Comfort is extremely important, Forman adds, and breaking the shoe in first will help with comfort.

Foot and shoe shape

“The shape of your foot should be considered when deciding on what style of shoe would fit your foot appropriately,” DiNucci says.

Look at the shape of your foot. Is the end of your foot more tapered or do you have square-shaped feet? When choosing between shoes with rounded toe heels or those with a more square shape, keep the shape of your foot in mind, DiNucci adds.

If you’re planning on being on your feet for a longer period of time, you need a good heel that isn’t too narrow, Foreman says. The narrower the shoe, the more bones are compressed, he adds.

Also, look at the shoe to check if it has worn down. With heels, when the sole of the shoe starts exhibiting significant wear, it wears unevenly, oftentimes on the outside, so your foot tilts inwards and there is a higher propensity to roll your ankle, DiNucci explains.

Stability

Stability is key. Ask yourself how stable the heels are and if you can walk in the shoes safely, DiNucci says. Oftentimes, people roll their ankles because they don’t have a stable platform in their shoe.

According to both Meyrose and Johnsen, look for a shoe that has a wider heel base, has a lower height and a does not constrict the toes too much. Opt for a lower heel with a wider base.

All four experts agree that wedges are the better option.

“With wedges, you get more stability and the height without the pressure on the ball of your foot,” Foreman says.

Stretching

According to DiNucci, Meyrose and Johnsen, stretching is important. Because long-term use of heels can cause your Achilles tendon to shorten, stretch your calves regularly, especially after wearing heels.

“Stretching helps to counteract the negative effect heels have by potentially shortening the musculature in the backside of the leg,” Meyrose says.

Johnsen goes on to say that stretching the calf muscle on a step can also help prevent calf muscle and plantar fascia issues.

Women should also vary the height of the heels; this will help calf muscles work through their entire range of movement, DiNucci adds.

Be cautious of a sudden and drastic change in shoes, Meyrose says, especially if transitioning into flats or gym shoes. This could have harmful effects on shortened muscles that may then become overstretched.

Surface

Think about the surface you plan to walk on. If you’re going to an event with a desert landscape, don’t wear high heels. You want to make sure that you can walk from place to place safely, DiNucci says.

Avoid walking on uneven surfaces, especially if you have had a drink or two. This will help avoid injury, Johnsen adds.

For more information about prevention the pain of wearing high heels, visit:

Foothills Sports Medicine Physical Therapy
(480) 706-1161
foothillsrehab.com

Ankle Center of Arizona
(480) 342-9999
arizonafoot.com

Arizona Foot and Ankle
(480) 423-8400
arizonafootandankle.com

The Orthopedic Clinic Association
(602) 277-6211
tocamd.com

Scottsdale Living Magazine Winter 2013