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Published on September 06, 2017

womans legs and feet with variety of heels

High Heels – How High is Too High?

High heels make a powerful fashion statement, and standing tall may make you feel confident and a head above the crowd. But how do you know when you’re going too far?

High heels can lead to some issues in your feet, your ankles and in some cases, even your knees. Avera Medical Group Orthopedic physician Michael Zimmerman, DPM, says if you’ve suffered foot problems you think are related to shoes, it might not totally be their fault.

“Many foot conditions, such as bunions, hammertoe and bunionettes are related to a genetic disposition more than the shoes themselves. Some of it is genetic,” he said. “So if you got that disposition from your family history, it could create more of a risk for those conditions if you wear footwear that could make it more likely.”

Zimmerman explained that the condition known as hammertoe occurs in the four smallest toes; bunions occur in the joint of your big toe. Bunionettes can occur in the joint of the fifth toe, too. All three are painful and in some cases, debilitating realities that make normal life activities like exercise or even walking difficult.

“Shoe fit is crucial, from the heel to the toes, and the thing that occurs with high-heel shoes is that people who purchase them tend to get a bad fit because they want them tight,” he said. “They tend to get a size smaller than perhaps they would with other shoes. That tightness in the toes makes the ill-fitting shoe even worse”

The Age-Old Question

Heels are parts of almost all shoes, and the taller ones are often associated with fashion and fun. But on the other hand: they can cause arthritis.

“The angle of the foot with a heel that is three-and-a-half inches or higher can affect the tendons in your foot and ankle, and they also provide an unstable platform,” Zimmerman said. “All that can lead to ankle tendonitis and one study found that heels of that height or higher can actually contribute to arthritis in the knee. So there’s evidence of a limit to the height of a heel.”

Zimmerman said his personal recommendation is to stay with heels that are at their maximum two inches in height, and to remember this key idea.

“I’d remind everyone: get an accurate and complete measurement of your foot. It helps for all things foot and ankle health,” he said. “Ill-fitted shoes that do not provide proper support – be they too small or too large – are going to lead to pain or problems.”

Proper Fit is More than Length

To make sure you know your proper fit, remember volume. Our feet are not just long or short, some are thicker than others. Proper fit figures in many factors and can save you a lot of heartache and pain.

“Duration matters too, and if you love your ‘cute shoes’ – wear them, but not all day or every day if you can manage it,” said Zimmerman. “If deformities develop, get to your doctor and look at treatment options. The sooner you address them the sooner you can get back to comfortable walking or other activity.”

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