High Heels have High Costs...Not Just to the Wallet

Despite stress fractures, torn ligaments and blisters, women still remain faithful to the perfect six-inch heels that top off the perfect outfit. Women feel like there's nothing like wearing heels to elongate their legs, but are they really worth it?

Marissa Lyman thought so when she put on her bright blue four-inch heels for her final sorority event at the beginning of May. Even though they were a little too small, she wasn't about to let size stop her from wearing them.

"I was determined to keep them on all night," Lyman remembers. "So I did keep them on and they started getting painful about an hour in."

Lyman woke up the next morning to an excruciating pain in her big toe on her right foot. She doesn't recall falling or tripping so she assumed the pain was from wearing the shoes for too long. Thinking it would get better, she continued to ignore the pain and wear heels. Six months later, Lyman finally saw a podiatrist

because the pain was only getting worse.

Her podiatrist diagnosed her with sesamoiditis, an irritation of the tiny bones in the tendons beneath the big toe called sesamoids. Sesamoiditis is also a type of tendonitis because the tendons around the tiny bones become inflamed as well. These bones and tendons are important when a person pushes off against the toe.

"Now I'm walking around in this big clunky boot and it's really annoying," Lyman said.

Doctors know women will continue wearing heels, regardless of the consequences.

"I've seen so much," Dr. Mark Weiss, a podiatrist at Century Park East Foot and Ankle Center, said. "I mean, I've seen so many different kinds of injuries."

According to Dr. Weiss, high heels affect the areas right under the big and little toes, exactly where Lyman was injured. These areas become irritated due to the high amount of weight they carry. Once the foot is in a heel, it becomes a locked device and there is very little shock absorption available with every step taken. Dr. Weiss warns not having enough shock absorption can cause many more problems.

"Every foot when it hits the floor flattens out because of the reactive force of gravity. You have to have that available in order to not put enormous amounts of shock in the system. People who wear high heels all day every day and are on their feet a lot end up having knee problems, hip problems and lower back problems."

X-ray of bare feet X-ray of feet wearing high heels (Courtesy of Dr. Weiss)

Dr. Weiss compares wearing heels to a play ground slide. While wearing heels, all of the weight slides to the front part of the foot and all of the pressure accumulates in a small surface area. Wearing anything below a two inch heel allows room to change the areas of pressure. But once the four-inch plus heels come out of the closet, redistributing the pressure becomes impossible.

In his career, he hasn't seen heels as high as they are now.

"This whole new realm of shoe fashion, they're great," Dr. Weiss said. "They're keeping us in business."

But high heels aren't anything new. FIDM Museum and Galleries Curator Kevin Jones said heels first appeared around the 15th century.

"As shoe technology developed, you know, higher shoes could be created, which of course then gave the wearer a sense of status of literally being a head over the rest of the crowd," Jones said. "Therefore they stood out and therefore they had a sense of importance."

Heel height has held a number of different statuses and meanings throughout fashion history, and today's fashion is no exception. Just like in any time period, women want to have the fashionable status by looking a certain way.

"We show much more skin that they did 100 years ago," Jones said. "And when you can see a woman's leg because she's got a mini skirt on, that heel helps to elongate her leg and look more like the ideal."

The designer has more shoe to work with when designing high heels. The spike, the platform, the body of the shoe can all take on a unique design of their own.

"Technology has allowed designers to morph their creations into things that have not been seen before and that continues today," Jones said.

But Dr. Weiss only looks at the practicality of shoes, not their status or innovative design.

"Shoes are made to protect the foot. Not to make it look better. They were made to protect our feet from the environment whatever the environment is."

Since women are going to continue wearing heels, Dr. Weiss recommends only wearing the heels for a limited amount of time, such as taking them off underneath the table at dinner. But on a night out, he recommends women to find a way to stay off their feet.

Even after his patients go through surgery, some patients continue to return because the fashionable appeal of wearing high heels counteracts their pain. And Lyman may be one.

"I really like the way they look and I feel like today's fashions kind of require that you wear heels especially when you're doing something formal or going out," Lyman admitted. "I'll wear this boot that's one thing, you know, for a while. But after I don't have to wear it anymore, you know, when a certain occasion comes around and I want to look a certain way or I'm wearing a certain dress, I'm probably going to whip out the heels again."

"The foot is a magnificent device, but you have to take really good care of it," Dr. Weiss warns. "If you don't take good care of it, it ain't going to take good care of you. And remember, you only have two feet and you're only born with two feet."