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Foot and Ankle Problems in Heel Wearers

Foot and Ankle

Christian Louboutin once said, ‘the higher the heels, the better!’ Well, not quite. Foot pain among women is a common phenomenon today and the problem can be attributed to the prolonged use of ill-fitting shoes that force the feet into unnatural shapes. Frequent and extended use of high heels are a major cause of foot problems in women.

High heels and muscle aches

OA is the most common form of arthritis. It is a degenerative (wear and tear) type of arthritis. Once seen as a problem affecting older people above 60, we are seeing more young patients with the problem. These are people who usually sustain injuries through sports or accidents and who leave them untreated for years until the pain drives them to seek treatment. By that time, irreversible damage has been done to the joint cartilage and their quality of life has been severely affected.

Think of our feet as the ultimate shock absorbers for our body, cushioning us from endless days of activities. Now think about squeezing these precious absorbers into an awkward pair of high stilettos for a big part of the day. High heels force the feet in an abnormally flexed (downward) position, straining the calf muscles and limiting ankle movements during activity.

In order to compensate for the awkward position, the foot muscles tend to ‘overwork’. Ladies may complain of feet and calve aches after a long day of wearing high heels. With the feet constantly pointing downwards in a flexed position, you tend to lean backwards to compensate for balance. This overarching of the back creates a lot of strain on the lower back, hip and knees.

High heels and toe problems

Most high heels have a narrow front. Ladies may find that they have to squeeze their feet into high heel shoes especially if they are flatfooted or have a broad forefoot. This constricts the toes into a narrow space. A common foot ailment amongst ladies would be painful callouses (hard skin) over the sole of the foot and toes, and bunion deformity. Occasionally, some ladies may even develop claw toes, with the toes digging down into the soles of your shoes and creating painful calluses

High heels and heel pain

When a lady is walking around on high heels there is lot of point pressure on the heel, giving rise to plantar fascia inflammation. The plantar fascia is a structure on the sole of our feet that’s helps to maintain our arch and help with toe push-off. Some women may experience heel pain. With repeated walking and pushing off on heels, there may also be chronic stress injury to the toes. These are stress fractures and patients may experience foot swelling and pain.

High heels and ankle problems

With the heel and ankle high off the ground, walking on uneven surfaces may be a challenge to some women on high heels. They may easily sprain their ankle. This is particularly so for women who may have lax ligaments or pregnant ladies. There is also a lot of force passing through the ankles and repeated loading on the ankle may lead to cartilage overload and injuries to the ankle cartilage.

Do you have to give up heels?

Wearing of high heels occasionally for meetings or dinner outings is fine if balanced with an appropriate use of other comfortable footwear. There is generally no rule on the advisable high heel height as it depends very much on the individual’s height, build and foot shape. Alternating the shoe choice from one day to another is another option. If you are regular high heel wearer, take time everyday to stretch your calf muscles and feet.

If you have to pick a shoe, it is best to choose a pair of low heel shoes that is stable and comfortable. Some stretching of the calf muscles and the plantar fascia can help in relieving aches and pains.

It is advisable to get an assessment with a foot and ankle specialist if you have painful hard skin in the foot, or if you think that you have flat feet or high arched feet. Getting the appropriate shoes or insoles after an assessment can go a long way in taking care of the bones and tendons of your foot, and in keeping you comfortable.



Dr Kannan Kaliyaperumal

Article contributed by Dr Kannan Kaliyaperumal, orthopaedic surgeon at Parkway East Hospital, Singapore


Dr Kannan Kaliyaperumal is an orthopaedic surgeon practising at Parkway East Hospital. His special interests are in using minimally invasive surgery for the treatment of lower leg, and foot & ankle disorders.

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