Heels: How High is Too High?!

By Dr. Garrett Harte –

The shoes we wear say a lot about us. The color, the style and the height! Women’s high heels have been a fashion statement for centuries. What also has been an issue for centuries is the pain inflicted by those same shoes. High heeled shoes can cause a myriad of problems including but not limited to ingrown toenails, metatarsalgia, capsulitis, hammertoes with associated painful corns, bunion pain and neuromas.

Most Common Problem
Women often experience ingrown toenails as their most common problem. This tends to be caused by the pressure of the toes being forced in a relatively tight shoe with the height of the shoe shifting the foot forward, leading to pain and infection. This can be addressed by increased width, increasing the height of the toe box and reducing the height of the heel.

And Then There is…
Metatarsalgia is pain in the ball of the foot. Without question, this can be directly attributed to the height of the shoe. The forces are increased to the ball of the foot as the height increases. This can lead to callous development which can be painful. If the pressure is consistently born on the metatarsal heads, stress fractures can develop as well. If the joints at the ball of the foot become inflamed, this is called capsulitis. This feels like a bruise initially and becomes more painful over time. Chronic capsulitis can lead to tearing of the capsule and dislocation of the toe can result. When the heel is raised, there is also a natural reaction to grip the ground with our toes. This gripping over many years can lead to hammering or contracture of the toes. This causes the joint on the top of the toe to become elevated and may rub on the toe box. This rubbing leads to the development of corns or thickened skin, which can also be painful.

And the List Continues…
The width of the shoe is important as well. If the shoe rubs on the side of the foot, this can lead to blistering. If there is a bunion already present, the pain can be magnified and a bursitis can also develop. Tight and high shoes can lead to a pinching of one or more of the nerves in the ball of the foot. The nerve can become enlarged and cause a lot of pain. This is called a neuroma. Problems associated with high heeled shoes are not limited to only the foot and leg. Knee, hip, back and neck problems can also be associated with wearing high heels.

So What is Too High and What is Just Right?
Some people have feet that actually need some height to prevent pain. Those with tight Achilles tendons can be more comfortable in a 1 – 11/2 inch heel. The increased height reduces the tension of the tendon on the heel bone reducing the chances of tendonitis and spur formation. Some people have a forefoot that is naturally lower than the heel and again are more comfortable in a low heel. This helps reduce the wear and tear of the joints which can prolong the development of arthritis.

Once the heel height goes above 11/2 inches, the benefits become minimal to none. The chances of injury tend to increase along with the height of the heel. Spraining or rolling of the ankle is increased in higher heeled shoes, especially those shoes with a narrow or spiked heel.

A Good Rule of Thumb
A good rule of thumb regarding high heeled shoe wear is to limit the amount of time they are worn. If you can avoid anything over 11/2 inches, most of the above mentioned problems may never occur. If they do occur, then treatment for these problems may be necessary. If that is the case, your local podiatric physician and surgeon is the logical choice to seek treatment. Your podiatric physician will assess your condition and give you recommendations on shoes as well as address the problem you are having which may include padding, trimming a callous or corn or even surgical correction.

The Easiest Way to Relieve Pain
The easiest way to relieve pain may be to just reduce the heel height you are currently wearing to a more reasonable height. So if a special occasion requires that you wear a high heeled shoe, shop for one that is wide enough to accommodate all the toes and is well padded in the ball of the foot area. Looking good can be comfortable too!!!

For assistance with your foot care or someone you love, please contact us at 941-758-8818 or visit us online at www.cortezfootandankle.com. We’re open 8 am to 5 pm, Monday through Friday and have 4 locations to serve you in Bradenton, Parrish and Sarasota.

Dr. Garrett Harte
Dr. Garrett Harte received his B.S. from the State University of New York at Stony Brook and received his doctorate at Pennsylvania College of Podiatric Medicine (Temple University). He completed his 2 Year surgical residency at West Jersey Health Systems and Wound Care Center in Camden, New Jersey. Dr. Harte is board certified in foot surgery by the American Board of Podiatric Surgery. During his residency he volunteered his time with a team of fellow surgeons in Guatemala to perform reconstructive foot and ankle surgery on children. He found his mission, and pediatrics as a whole, very rewarding. He enjoys lecturing to the public and to his colleagues on topics such as common foot deformities, wound care, limb salvage and surgery and diabetes. He currently is the vice president of the Manasota Podiatric medical society. He also sits on the Surgery committee and the credentials committee at Manatee Memorial Hospital.

Dr. Harte is an exercise enthusiast and has been running in local marathons, half marathons and triathlons for the past 8 years. He completed the Florida Ironman in 2009 and enjoys treating fellow athletes. His wife Christine is a personal trainer here in Manatee County. He spends most of his free time with his 3 children, Jonathan, Patrick and Kaylee. His philosophy is to treat all his patients as if they were part of his own family and give them the best care he can at all times.

Dr. Harte joined Cortez Foot and Ankle Specialists in 1998 after practicing in the Fort Myers area.

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