The high heels and tight fits of today's shoes are terrible for women's feet (photo gallery)

Posted on:  The Plain Dealer (Cleveland.com)

Gallery: Shoes, heels and foot problems (7 photos) RSS

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Women's shoes have always been about the heels. And barring the brief Earth Shoes phase in the 1970s, style has usually trumped comfort.

Maybe it was "Sex and the City" and its fetishization of Manolo Blahniks. Whatever the reason, 4-plus-inch spike heels that would have been available only at Frederick's of Hollywood in the 1980s are now seen at every department store and major shoe retailer.

That's been great for orthopedic surgeons, says Dr. Randall Marcus, but terrible for women's feet, tendons and lower backs.

Heels are only part of the problem, however. Ballet flats and flip-flops don't offer the foot enough support or shock absorption, while platform wedges can be unstable and too easy to fall off of, resulting in a torn ligament or broken bone. Adding insult to injury: Many women's shoes, even flats, taper at the front, creating narrow toe boxes.

"No human has a pointed foot," says Marcus, chairman of the Department of Orthopedic Surgery at University Hospitals Case Medical Center. "So eventually, if you wear shoes that don't conform to the shape of the foot, they will deform your foot."

Dr. Marie Blazer, a podiatrist at the Cleveland Foot & Ankle Institute of the Ohio College of Podiatric Medicine, has run into resistance from patients unwilling to make changes.

Facts and tips about shoes and foot problems

"Just last week, I had a patient who told me she was willing to put up with pain because she has well over 100 pairs of shoes that have heels of 4 to 5 inches," says Blazer. The woman, in her 40s, "wanted me to advise her on padding. I told she's got to wear different shoes.

"She said she buys longer pants to accommodate her heels, and said this is what she needs to look good as a professional."

Sooner or later, though, a woman will pay the price -- perhaps surgically -- for choosing fashion over function. And it will probably be sooner if she's forcing her feet into an unnatural shape, at an unnatural height.

Men tend to wear shoes that are close in shape to their feet, so women are at least 10 times more likely to need surgery on their feet, says Marcus, who is also chairman of the Department of Orthopedics at Case Western Reserve University School of Medicine.

Marcus and his fellow surgeons don't see many young women as patients (unless they fall off their platforms or high heels and break an ankle, which does happen). It takes a few years for damage to feet and bones to manifest.

"Then, as women get older, there's also some fat atrophy," says Marcus, so the padding on the bottom of their feet diminishes. That comes with age, and it can make it even more uncomfortable to wear high heels or thin-soled shoes.

What isn't natural is what happens to feet that have spent too many years in heels -- because of the way pointy toe boxes push the toes together, which is aggravated by the downward pressure placed on the balls of the feet in heels.

Often, bunions are the result. A bunion is what appears to be a bony projection on the inner side of the foot below the big toe. Bunions, which in reality are misaligned big-toe joints, require surgery to correct, followed by a slow healing process. Continuing to wear unsuitable shoes will bring them back, though, Marcus warns his patients.

But that's not the only thing that can happen to feet. Women can get arthritic inflammation. Or they might get a condition known as hammertoes, in which the toes begin to buckle into a clawlike position; corns form at the bent joint where the toes rub against the tops of shoes.

High heels also create problems for the rest of the body, especially the lower back, says Marcus. Wearing heels forces the buttocks out -- which is often what men find sexy about women in heels -- but this position also causes pressure and strain on the lower back.

Less serious effects of high heels, but still irritating, are corns and calluses, often caused by ill-fitting shoes and underlying bone problems in the foot. Those problems combined cause excessive irritation.

These issues are so prevalent because 9 out of 10 women wear shoes too small for their feet and 8 out of 10 women say their shoes are painful, according to a study by the American Orthopaedic Foot and Ankle Society. The research also shows 7 out of 10 women develop bunions, hammertoes or other foot deformities, and 9 out of 10 women's foot deformities can be attributed to tight shoes.

Blazer says the first sign she sees, even in younger women, is discoloration of the tops of the toes. "I'll see 20-somethings and they'll ask me about that, and if there's a cream for it," she says. "I ask them if they wear high heels a lot and the answer is always yes. They'll be wearing a shoe with too small a toe box, which creates friction and then discoloration."

It won't go away unless they start wearing reasonably heeled shoes with a wider toe box, she says.

Spiky heels are more popular than ever, says Blazer. "It looks like we're in the age of Lady Gaga. That means we'll be seeing lots and lots of patients."

Please call the Foot, Ankle & Lower Leg Center office in Las Vegas anytime @702-878-2455 between Monday – Friday and we would be happy to set up an appointment for you.  Please visit our website @ www.FallCenter.com.   The Foot, Ankle & Lower Leg Center has Diagnostic imaging:  Digital X-Rays, Ultrasound or Advanced Imaging will be used to aid in the diagnosis.

Dr. Anthony Ricciardi at the Foot, Ankle & Lower Leg Center has completed training in endoscopic/minimally invasive surgery for chronic heel pain and nerve pain, foot and ankle joint replacement for restoring pain free motion, arthroscopic surgery, bunion surgery, fracture repair, flat foot correction, external fixation for complex deformities and extensive experience in peripheral nerve surgery including diabetic peripheral neuropathy and reconstructive surgery of previously failed foot surgical procedures.  In addition to his surgical training Dr. Ricciardi focuses on sports medicine of the foot and ankle through regenerative techniques using the patient’s own blood/platelets for healing chronic foot and ankle problems (pain) as a result of repetitive sport injuries.  This cutting edge technology enables patients to continue training with little or no down time.  Dr. Ricciardi continues to be active in teaching and training other podiatric surgeons on innovative surgical techniques in foot surgery.  Dr. Ricciardi is Board Certified by the American Board of Podiatric Surgery, a Fellow of the American College of Foot and Ankle Surgeons and Fellow of the Association of Extremity Nerve Surgeons.  Dr. Ricciardi’s vision is to bring each patient the most current state of the Art Technology and personalized treatment options to meet their Foot and Ankle needs (from conservative care to surgical options).  Dr. Ricciardi believes in quality service and puts his patients first!