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| The Foot Doctor
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| No wonder women suffer more foot problems than men, accounting for 80% of all reported complaints. Although most orthopedic surgeons and podiatrists deplore them, women show no signs of breaking off their love affair with high-heels.
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“What we do know about the effects of high-heels is that they increase the incidence of foot deformities such as neuromas, hammertoes and bunions. They also increase the pressure placed on the ball of the foot during ambulation, causing pain and joint inflammation. We also know that long-term wearing of high-heels leads to tightness or the contracting of the Achilles tendon. Over time, this will lead to increased pain and difficulty with ambulation,” says Dr. John Giurini, chief of podiatric surgery at the Beth Israel Deaconess Medical Center in Boston.
When it comes to their feet, women clearly choose fashion over function and are willing to sacrifice daily comfort and long-term health concerns for the elegant shapely silhouette of a high-heel.
Further complicating the conflict between science and esthetics, a recent study contradicts earlier findings of a Harvard research project linking the wearing of high-heels to osteoarthritis in the knees. The new study exonerates high-heels, citing smoking and obesity as the real culprits. In fact, according to some researchers high-heels may even protect against osteoarthritis.
So what’s a girl to do?
“Women should try to wear heels one-and-a-half inches or lower whenever possible. Of course, sometimes a special occasion calls for a fancy shoe that has a higher heel. I recommend avoiding over 3-inch heels altogether, but I tell my patients that if they’re going to wear a higher heel, they should treat those shoes as ‘dessert shoes.’ You wouldn’t have dessert every night if you’re watching your weight, similarly, one should save higher heels for special ‘dessert’ occasions. A low to one-and-a-half-inch heel is not usually a problem,” says Dr. Nancy Kadel, an orthopedic surgeon and foot and ankle specialist at the University of Washington Medical Center.
Choosing a Healthy Fit:
- Wear comfortable shoes that have been properly fitted.
- Buy shoes in the afternoon when your feet are swollen.
- Wear as low a heel as possible.
- If you wear a heel, wear it for as short a time as you can manage. “Keep a pair of low heels in the car, at the office or in your bag to change into once the event is over!” says Dr. Kadel.
- Avoid walking any distance in heels.
Some women are even opting to have cosmetic foot surgery, in which bones from the toe are removed in order to better fit the narrow confines of fashionable shoes.
“Along with most orthopedic surgeons, I strongly disagree with cosmetic foot surgery. Any surgery or procedure has risks and the risks of nerve damage and chronic pain that can occur with foot procedures can be disabling. If you have some numbness on your face after a facelift it may be a slight bother, but we have to walk on our feet! I wouldn’t consider surgery to help a person fit into a shoe or to wear high-heels,” says Dr. Kadel.
That’s a point of view echoed by Dr. Giurini.
“While most surgeons will argue that it’s ultimately the patient’s decision, I believe the physician should serve as the patient’s advocate,” he says. “The surgeon has years of experience in performing these procedures and is familiar with all that can go wrong. Sometimes, the physician must protect the patient from themselves.”
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