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Heels may look good, but they carry lots of risks. (Photo: Corbis/Yves Herman)
The Cannes Film Festival suffered a serious foot-in-the-mouth moment when it came to light that some women were not allowed to step onto the red carpet because they were wearing — wait for it — rhinestone-encrusted flats.
The director of the festival, Thierry Fremaux, has since apologized for the “over-zealousness,” and denied that Cannes had an official heels-only policy in place.
But still, the news that some women were turned away from a screening of Carol on Sunday night has drawn ire from celebrities and the public alike. Actress Emily Blunt told Variety, “I think everyone should wear flats, to be honest. We shouldn’t wear high heels anymore. That’s just my point of view. I prefer to wear Converse sneakers.”
According to health experts, Emily is on to something — a Converse-wearing world would certainly be better for our health.
The Dangers of Heels
High heels may make your legs look gorgeous, but it comes at a cost to your body. Just-published research from the University of Alabama shows that the number of high-heel-related injuries doubled between 2002 and 2012. What are the hazards?
First up: stiff, painful tendonitis. “When you wear heels for extended periods of time, the fibers of your Achilles tendon, which connects your calf muscle to your heel bone, shorten and tighten,” says NYC-based podiatric surgeon Hillary Brenner, a spokesperson for the American Podiatric Medical Association. Think about it: When you’re walking in flat shoes, your calf naturally stretches with each step. If you wear heels, the back of your leg is truncated and you don’t get that lengthening effect.
You’re also at risk for ankle sprain. “Wearing heels puts your foot in an unnatural angle called plantar flexion, where your toes are pointed downward,” Brenner explains to Yahoo Health. “This throws off your center of gravity — your upper body tends to lean back too far, while your lower body tips forward.” The misalignment causes a wobble in your walk, leading to falls, twists, strains, and sprains. And if you have either flat feet or very high arches, your chances of tumbling are even greater. Your foot overcompensates to reach a neutral position, increasing instability.
That’s not all: The plantar flexion position can wreak havoc on the balls of your feet. In shoes with a level surface, the entire sole of your foot absorbs the impact from walking. In heels, the ball bears the brunt of the work, which can give you stress fractures — small cracks in the metatarsal bones from repeated trauma over an extended period of time.
“Wearing heels puts your foot in an unnatural angle called plantar flexion, where your toes are pointed downward.” (Photo: Corbis/Vincent Kessler)
“You’re constantly banging against the ball, plus the toe box of high heels often lacks padding, exacerbating the effects,” says Brenner. Not only are stress fractures incredibly painful, but they’re also a harbinger of arthritis and bone calluses.
In addition, pumps squeeze your toes together, which puts pressure on the thin nerves that run between your foot’s five metatarsals, the long bones that attach your toes to the rest of your feet. This friction can lead to an uncomfortable condition called a neuroma, or pinched nerve. “Your toes may tingle, burn, or go numb,” Brenner says. It might also feel like “you’re standing on a pebble, or a fold in your sock,” podiatric surgeon Suzanne Fuchs tells Yahoo Health. An advanced neuroma can require cortisone injections, prescription orthotics, or even surgery.
High heels also have an effect on the rest of the body. “Our entire system is connected, from the feet to the knees to the hips to the spine, so how we treat our feet affects everything else,” points out Emily Splichal, a podiatrist in Manhattan and author of Every Day is Your Runway: A Shoe Lover’s Guide to Healthy Feet & Legs. “High heels throw your alignment off balance, putting lots of stress on your knees. To compensate, your lower spine arches, which compresses the lumbar vertebrae.” As a result, you wear down the cartilage in those joints, which can potentially induce arthritis and permanent chronic pain.
If You Must Wear Heels…
Although there’s no such thing as a “healthy” high heel (sorry!), some pumps are definitely better than others.
As you might expect, the taller your pump, the more strain it puts on your soles; if you can, make sure your heels are three inches or shorter. “Research has found that heels that exceed three inches start to defy natural foot biomechanics and drastically increase the force on your feet, knees, and lower back,” Splichal tells Yahoo Health.
To minimize the risk of tumbles, look for heels with more stability: a chunky heel, espadrille, or wedge are safer bets than skinny stilettos. “It’s like the difference between walking on a narrow stick versus a wide plank,” explains Brenner. Ankle straps will also help keep your foot firmly in place.
Since pointy styles are the worst for neuroma, it’s smart to stick to shoes that are roomy in the toe.
And give your feet a little lovin’: Be on the lookout for soft materials — buttery leather, interior padding — that will pamper your tootsies. “Although wearing heels can’t give you bunions or hammertoe, they can worsen pre-existing conditions like these,” affirms Brenner. “Make sure the straps and seams of your shoes aren’t hitting against any bony prominences, which could cause irritation, blisters, or even infections.”
Finally, make sure you’re buying the right size. “You should always shoe shop in the late afternoon or evening,” Brenner advises. “Your feet swell during the day, and you want to account for that.” It’s also worth getting measured for both length and width the next time you’re at the store. Wearing a too-big or too-small pair ups your chances of injury.
How to Minimize the Damaging Effects
In an ideal world, women would swear off heels for life. In reality, most of us are going to dig our heels in and pick fashion over foot fitness. But there are measures you can take to minimize the negative effects.
Start by slashing the amount of time spent strutting in stilettos. Wear flat shoes while commuting and stash your pumps in your purse. “Avoid walking in high heels for more than three hours at a stretch,” suggests Brenner. “Take 30- to 60-minute breaks between heel-wearing intervals. Sit down and remove your shoes, if possible.” The University of Alabama study found that nearly half of heel-induced injuries took place at home — entirely avoidable.
Brenner also suggests investing in supportive accessories: Foot Petals (sticky pads that you can stick in your shoes to cushion the ball and heel, decreasing pain and inflammation), and custom orthotics designed especially for heels if you have flat feet or super high arches.
Then, dip a toe into foot aerobics. Some people swear by the idea of “training” yourself to wear heels by doing exercises intended to stretch out your arches or reform your foot so the structure is more suitable to heels. But Brenner asserts this is all a myth. “The shape of your foot is out of your control,” she says.
“Still, balance training improves leg strength and ankle stability, while techniques that target your core and pelvic floor help take pressure off your feet,” says Splichal. “Just think about ballroom dancers and how light on their feet they appear. It’s all thanks to their impressive core strength.” If your abs and pelvic floor are in shape, they’ll absorb more of the impact of striding in heels, rather than all of your weight funneling to your feet. Consider signing up for yoga or Pilates classes, which focus on core and balance work.
Here are some exercises you can try to strengthen your feet and core:
Stand with your body weight evenly distributed over one foot. Press the tip of your big toe into the ground, and hold for 10 seconds. This will strengthen the muscles that lift the arch of your foot. Do five sets on each foot.
Lie on your back with your knees bent, feet flat on the ground. Engage your pelvic floor muscles and hold for 10 seconds, while breathing steadily. To make the move more advanced, lift one heel or foot, tip your knee out slightly, or slide one leg out on the floor straight in front of you at the same time.
Balance on one leg, knee slightly bent, big toe pressing into the ground. Lift your pelvic floor, engage your glutes, and hold for 10 seconds. Repeat 5 times on each side. Next, try some variations: While balancing on one leg, squat down five times on each side. Or, bend down and touch the ground with your opposite hand.
“You may also want to see a physical therapist who can recommend exercises to strengthen the arches of your feet and tendons and muscles around your joints in order to support your feet and ankles,” adds Fuchs.
At the end of the day, do a few simple stretches to relieve foot tension and reverse the damage of high heels. Splichal recommends standing on a golf ball for five minutes to release the bottom of your feet, followed by a two-minute runner’s stretch (lunge) on each side to lengthen your calf muscles. Then do a hurdler’s stretch for a couple of minutes on each side to target your hip flexors.
Brenner’s tootsie-recovery toolbox includes picking a towel up off the ground by scrunching your toes to restore mobility, writing the alphabet with your foot to loosen up the ankle, and standing with your toe against the wall for a deep calf stretch.
At the first sign of pain, take a sabbatical from your stilettos and opt for supportive shoes instead. Soak your feet daily in Epsom salts, apply ice packs, and indulge in a light massage. If you’re feeling better after two weeks, slowly wean yourself back to occasional heel use. And if you’re still not back on your feet after all that? See a doctor.
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