Feet suffer for high-heel fashion

Women will suffer for fashion and images of them walking barefoot with high heels in hand from Melbourne Cup and Perth Racing events are testament to the price our feet can pay for looking fabulous.

Even style icon Sarah Jessica Parker - the woman famous for her Manolo Blahnik stilettos in Sex and the City - reportedly advised fashion followers going to the Melbourne Cup to "slip the heels off under the table" whenever the chance arose because "heels are not our friend".

Yet apart from the 1970s when some women shunned heels along with bras, high heels have survived the generations to come out even higher as a fashion necessity.

Head of the famous Italian fashion house Donatella Versace reportedly was more concerned about giving up her high heels as required while undergoing rehabilitation for a cocaine addiction in 2004 than she was about the withdrawing from the drug.

"She said 'I can give up anything but not my high heels'," Italian Vogue editor-in-chief Franca Sozzani told Newsweek magazine.

And as fashion outlets spruik the beginning of the party season and the need for heels as an accessory that will, among other claims, "lengthen legs and enhance height", podiatrists are pointing out the perils.

Wearing high heels for extended periods of time could contribute to multiple foot complications, said University of WA's Associate Professor of podiatric medicine Virginia Bower.

The big problem created by wearing high-heel shoes was abnormal weight distribution, she said.

Instead of the foot bearing the weight of the body in the heel and the ball of the foot, all the weight fell on to the ball of the foot when wearing high heels, especially narrow, pointy-toed shoes.

The increased pressure could make corns and callouses develop on the ball of the foot, increase the likelihood of developing ingrown toenails, bunions and hammertoes and contribute to neuroma, a painful thickening of the nerve between the toe bones.

Acute injuries, such as sprained ankles from falls could be another risk, Professor Bower said.

In some habitual heel wearers the calf and Achilles muscles could shorten into a tighter position leading to strain and an increased risk of tendonitis or tendon rupture when reverting to walking in a flat shoe or barefoot. Foot problems typically started to present for women in their 40s, with pain limiting their ability to function, she said.

She rarely sees younger women with foot problems. Although they were still likely to experience soreness, corns and blisters from ill-fitting fashionably high heels, their younger bodies were more resilient and able to repair.

"Most foot conditions are chronic and develop over a period of time," Professor Bower said.

As we age our joints, ligaments and tendons loosen and the foot will lengthen slightly and incrementally because it is no longer toned. The fat pad under the heel and ball of the foot that cushions the foot from birth declines and the bones and joints become more prominent.

The older foot, with less naturally occurring support and padding, was therefore at an increased risk of problems from wearing high heels, she said.

She warned parents to resist pleas from their young daughters to buy from a growing range of high- heeled children's shoes marketed specifically to young girls.

Forcing a young foot into the unnatural position created by a heel could change the way the bones and joints developed, she said, likening it to Chinese foot binding that permanently altered the anatomy of the foot.

Heels could also put stress and strain on the lower part of the spine because body weight was thrown forward.

Churchlands Regenerate physiotherapist Adam Floyd said the position of the foot in high-heel users forced the pelvis into an anterior tilt that was the same as standing bending backwards and as such compressed the lower joints of the spine. In the long term this might encourage slackening of the tummy muscles and compromise core stability, he said.

Mr Floyd said high heels could also potentially contribute to problems further up the spine and into the neck and cause headaches.

According to Professor Bower, although we all know heels are not ideal footwear, as long as they remain fashionable women would continue to wear them. The lesson to be learnt was about getting the balance right between fashion and function.

She advised wearing appropriate footwear for the occasion and reserving heels for special occasions. If heels were necessary for the office, she suggested changing to a flat shoe when sitting at a desk or when commuting to and from work.
"Ultimately, if they are part of your daily wardrobe for long periods of time, that's when they become a problem. If you save them for just going out of an evening, then it is not such a critical issue," Professor Bower said.