High-heel shoes continue to be popular in women’s fashion. However, despite the social and cultural acceptance of high heels, injuries and pain can result from this type of shoewear. Here are some of the common injuries and ailments associated with high heels.
Metatarsalgia and Stress Fractures
High heels are designed to point the toe down. This position is what gives the leg the attractive slender look. However, this position also causes excessive pressure on the ball of the foot. Furthermore, the toes must pull up to meet the ground. This moves the padding out from under the ball of the foot and adds to the pressure placed on the metatarsal bones. The pain created at the ball of the foot is called metatarsalgia.
The higher the heel the worse the metatarsalgia. In fact, the strain in the bones over time could be so great that they break. This is called a stress fracture.
Some tips on avoiding metatarsalgia and stress fracture:
- Consider a lower heel height – the higher the heel, the more how to wear heels with bunions pressure on the ball of the foot
- Consider a wider toe box – the more pointed the toe of the shoe, the more crowded the toes will become, and as a result the more pressure on the ball of the foot
- Consider using high heels for only a limited amount of time – the more time in high heels, the more pressure on the bones of the feet and the more likely a stress fracture is to occur
Heel pain is less commonly associated with high heels when compared to metarsalgia. Usually the wearer doesn’t complain of heel pain while in the high heels, but rather after frequent long wear.
The heel pain is a result of the shortening of the muscles of the calf while wearing high heels. Daily use of these shoes will create tightness. When the wearer then goes barefoot or into flat shoes the tight muscles will be stretched. This can create a painful pulling sensation at the rear or bottom of the heel.
A tip to avoid heel pain associated with high heels:
- Consider using high heels for only a limited amount of time, and not everyday – the more time in the high heels, the more likely the calf muscles will become contracted
The toenails are at risk for damage in high heels. High heels typically allow the foot to slide downward into the shoe, only stopping when the toes jam in the front. The toe box is often pointed, further crowding the toes and toenails. As the toenails rub the shoe, damage occurs. Not only can this cause deformity, but it also makes the nail prone to fungal infection. This fungal infection is called onychomycosis, and it is very difficult to treat.
Some tips to avoid toenail damage when wearing high heels:
- Consider a lower heel height – the higher the heel, the more pressure on the toes and toenails
- Consider a wider toe box – the more pointed the toe of the shoe, the more crowded the toes will become, and as a result, the more the toenails will rub on the shoe
- Consider a more open, strappy, sandal-like shoe – these shoes do not touch the toenails
- Consider using high heels for only a limited amount of time – the more time in the high-heels, the more the toenails will be damaged
Sprains and Fractures
Some of the most common problems with wearing high heels are sprains and fractures. Those in high heels can more easily twist the foot or ankle. The higher the heel, the more the body weight is pushed forward. This causes the wearer to then lean backward. Thus a tremendous amount of lower leg muscle power is needed to maintain balance. As a result, the higher the heel the more unstable the situation, and the more likely an injury is to occur.
When wearing high heels an ankle sprain can occur as a twisting injury as the wearer loses balance. Ankle sprains are familiar to most people. But not all ankle sprains are simple. An ankle sprain can be a serious injury with lasting effects. Twisting injuries can be so severe that a broken bone can occur in the foot or ankle.
Some tips to improve your stability when wearing high heels:
- Strengthen your lower leg muscles to improve balance
- Consider a lower heel height – the higher the heel, the more unstable
- Consider a heel with a wider sole – the more narrow the heel, the more unstable
- Practice walking in high-heel – some shoes require more balance
- Be cautious when in crowded conditions, when drinking alcohol, and when fatigued
Bunions and Hammertoes
Bunions and hammertoes describe crooked toe positions associated with wearing any style of closed-toe shoe. Many populations around the globe have seen an increase in these deformities when they have adopted Western (closed-toe) shoes. It is suspected that frequent use of high heels at the very least exaggerates these deformities.
Bunions and hammertoes are not only cosmetically ugly, but are also associated with pain. Once these deformities become painful, surgery is often the only treatment.
Some tips on avoiding the development of bunions and hammertoes:
- Consider a lower heel height – the higher the heel, the more pressure on the toes, pushing them closer together
- Consider a wider toe box – the more pointed the toe of the shoe, the more crowded the toes will become, leading to deformity
- Consider a more open, strappy, sandal-like shoe – these shoes do not push the toes together as much as a pointed toe shoe
- Consider using high heels for only a limited amount of time – the more time in the high-heels, the more the toes will be damaged
The American Orthopaedic Foot & Ankle Society (AOFAS) offers information on this site as an educational service. The content of FootCareMD, including text, images and graphics, is for informational purposes only. The content is not intended to substitute for professional medical advice, diagnoses or treatments. If you need medical advice, use the "Find an Orthopaedic Foot & Ankle Surgeon" tool at the top of this page or contact your primary doctor.
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