The High-Heel Hiatus: Podiatrists Explain Why Stilettos Really Are That Bad for You

Victoria Beckham recently confessed that she “can’t do heels anymore” — and that revelation, from a style icon known for her sky-high stilettos (especially at the airport, where they were an essential part of her travel uniform), rocked the fashion world.

Look, no one is pretending that heels are comfortable. They make us contract our calves, balance on our toes, and stick out our backsides — which happens to be a pretty sexy look. That’s why about half of women opt for high heels, even though the majority of wearers (71 percent) complain these shoes hurt their feet, according to the American Podiatric Medical Association. We asked some fashionable foot doctors to help us understand exactly what’s so bad about heels and how we can wear them without wincing and mincing.

Hell on heels

The unnaturally ultra-feminine body position that heels force us into isn’t how we’re designed to walk, says Jacqueline Sutera, a surgically trained doctor of podiatric medicine and spokesperson for the APMA. “Your entire skeleton is affected by heels but the issues start at the feet,” she says. Wearing high heels day after day puts you at risk for a long list of foot problems, including calluses, ingrown toenails, hammertoes, bunions, sesamoiditis, tendonitis, a permanently shortened Achilles tendon, stress fractures, and sprained ankles.

Not only do the problems get worse over time, but our bodies also become less able to handle heels. In our late thirties or forties, the fat pad on the bottom of the foot starts to atrophy and we lose some of our natural cushioning, explains Elisa Kavanagh, a clinical professor of orthopedics at the Mount Sinai Medical School and a board certified podiatrist in Scarsdale, N.Y. Wearing high heels hastens the fat loss, increasing the chance of developing painful neuromas (nerve inflammation between the toes) and inflammation in general. When high-heel devotees hit their 40s, like Victoria Beckham and Sarah Jessica Parker (who claims that running around Manhattan in her Manolos ruined her feet), they may find that they can’t stay in heels as long as they used to.

Happier feet

Fortunately, there are some things we can do to make heels more comfortable and buy our feet some time.

The APMA-recommended heel height is just 2 inches, says Dr. Sutera, but you can stretch this rule with the help of a platform or wedge. “These styles not only add height but also help distribute your body weight across a greater surface area, decreasing pressure on the forefoot,” she says.

Change your shoes around three times a day to shift your weight and release some of the pressure, advises Dr. Kavanagh. Even just switching from 3 inches to 2 will take some of the pressure off the ball of your foot. Also switch shoe shapes so you’re not always cramming your toes into the same pointy styles.

If you often walk on unforgiving surfaces like asphalt, concrete, or marble, put some distance between your foot and the ground, says Dr. Kavanagh. Look for cushioning in the toe box and limit your steps on paper-thin soles. Drugstore cushions may help, as may custom orthotics designed specifically for heels, but only if your shoes are wide enough to fit them comfortably. Squeezing toes together can worsen problems like hammertoes, bunions, and neuromas.

During the time it takes to change the shape of leather or canvas, you could develop incurable issues. Buy a wider pump or a shoe stretcher, says Dr. Sutera.

Tingling and numbness could signify a nerve problem; swelling and redness are usually signs of inflammation — both are good reasons to take a break from heels. If you’re still experiencing intense pain after two days in comfy shoes, Dr. Sutera suggests seeing a podiatrist. (Note that sharp, shooting pain in the back of the heel could be Achilles tendonitis, and pain radiating from a toe joint could be a stress fracture — see a doctor ASAP).

Keep your feet, ankles, and lower legs flexible and strong by doing toe grip exercises and calf stretches. And reward your feet for their sacrifices. “Massage is super important,” says Dr. Sutera. (Hey, doctor’s orders!)

Even with an injury, you can usually wear heels for short periods on special occasions, says Dr. Kavanagh. That’s why we’ll still be seeing VB in her signature stiletto style — but with a sneaker or a pump thrown into the mix, to boot.


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