The Center for Podiatric Care and Sports Medicine

For the Love of Fashion: Choosing the Lesser of Evils with Regard to High Heels

Posted by on Tuesday, June 24th, 2014


Did you ever walk into a shoe store and feel paralyzed with indecision? You hear it all the time: high heels are bad for your feet and your body. Yet, you have a fancy social function to attend and don’t want to wear shoes that will dress down your entire outfit. Perhaps you feel just a little bit taller, sexier, and more confident in those high heels — and that alone is worth the discomfort. A recent survey by the American Podiatric Medical Association found that 71% of heel wearers suffer from foot pain. The good news is that “it is possible for women to find a happy mid-point between great looks and great pain,” says Dr. Matthew G. Garoufalis, past president of the APMA.

how to buy heels
You can still wear stylish shoes, without having a “heel hangover” the next day.

High Heel Shopping Tip #1: Sacrifice Some Height.

If the balls of your feet hurt all the time, then your heels are probably too high. Ignoring this pain for long enough can lead to Morton’s Neuroma, which is characterized by nerve thickening and the sensation that you’re always walking on marbles. At Shoes of Prey’s website, you can design your own shoe and choose a cute 2-inch (or less) “kitten” heel slingback or a classic 3-inch heel with a rounded toe. If you go any higher, you may be able to get away with adding a platform, although the APMA recommends sticking to heels that are two inches or less high.

You may have heard that wedge style shoes are a better alternative, but our New York podiatrists find that wedge shoes can compromise balance and stability just as much as stilettos. They also change the biomechanics of how you walk, leading to an awkward gait. A lower platform or wedge (with ankle straps to prevent falls) would be the lesser of the evils, but really the kitten heel is your best bet.

View How to Pick a Shoe on Howcast

High Heel Shopping Tip #2: Seek a Rounded Edge.

High stilettos with pointy, closed toes are the worst offenders for foot pain. We see a lot of women who wear these styles come in with a condition called “hammer toe,” which is where the foot muscles tighten and the toes can no longer stretch out. Often, our only recourse for fixing this chronic condition is to either surgically transfer tendons from the bottom of the foot to the top of the toe, cut toe ligaments and insert temporary straightening pins, or fuse the toes straight with hardware until the bones heal properly.

To avoid all of that, the APMA recommends shopping for rounder shoes with extra cushioning in front. Sandal-style, open-toe high heels can also prevent trouble. According to, open toe shoes are especially great for shorter women because they give the illusion of “long and lean” legs. You may think peep toes will give your feet more breathing room, but these shoes cause toes to slip forward and overlap, which often causes ingrown toenails, so we do not advise that you choose this style of heel.

High Heel Shopping Tip #3: Remember Less Is Not Always Best.

Some shoes offer little more than a bit of material across the toe and ankle straps. There is not enough support, which can lead to ankle sprains, fractures, or torn ligaments. The foot tries hard to stabilize your body and offload the pressure of your body weight, but sore feet are inevitable. Instead, a contoured shoe, high-heeled boot, or shoe that includes straps across the arch will better hold your foot in place. Check out the dress shoe brands that have earned the APMA Seal of Acceptance for comfortable design.

Visit a New York Podiatrist for Help

Remember, there is a time and a place for everything. Maybe your commute is not the time to wear heels, so wear more supportive shoes until you get to your destination and minimize the time spent in heels. Treat them like a fine wine, and wear your favorite heels sparingly, rather than every single day. If you would like more specific pointers on how to pick the best dress shoes, we’d love to help. Make an appointment and visit The Center of Podiatric Care & Sports Medicine in Manhattan or Westchester to talk about foot pain and shoe choices.


If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.