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Study Confirms: Height of heel matters in prevention of foot pain

Posted on: December 5, 2009

For years orthopaedic surgeons specializing in foot and ankle care have been warning women about the perils of wearing high heels.  Now a new study by the American Orthopaedic Foot & Ankle Society (AOFAS) details the correlation between the heel height and amount of pain, pressure and strain it puts on your feet.

Twenty-one healthy men and women participated in the study, where each participant stood barefoot on wooden blocks of 2 cm, 3 cm, and 4 cm in height placed below the heel.  The study results revealed a significant increase in pressure on the metatarsal heads (the ends of the metatarsal bones that connect to the toes) as the heel height was raised.  This increased pressure contributes to pain, callous and bony deformities. 

The study authors suggest limiting heel height to no greater than 2 cm (.8 inches) as well as the use of padding at the ball of the foot can significantly reduce discomfort and risk of injury to the metatarsal heads.

The AOFAS website www.aofas.org contains public education resources on the care and treatment of the foot and ankle, including a section titled: Smart Tips for Wearing High Heels.  Tips include:

  • Wear a shorter heel. A 2-inch heel causes fewer problems than a 4-inch heel.  A shorter heel will give an elongated appearance if it is a thin stiletto type rather than a thick or chunky heel.
  • Try to save the use of high heeled shoes for functions where you will not be on your feet for extended periods of time; treat them as a limited privilege accessory.
  • Take your designer shoes to a pedorthist to have them custom fit to your feet. They may be able to stretch the toe box to better accommodate your feet.
  • Try wearing a larger size than usual and insert heel cups into the backs for a better comfortable fit.
  • Wear open toe shoes instead of a similarly styled shoe that causes discomfort in your toes.  Partially open toe shoes have become more acceptable in many work environments, allowing you to further customize your shoes to your feet.
  • Remember that however appealing high heel, high fashion shoes are, your feet need to carry you around for a lifetime.  Treat them kindly!

Following the above tips as well as the study data which suggests limiting heel height to no greater than 2 cm (.8 inches) will go a long way in reducing foot discomfort.

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