Men like them, women wear them. A pair of high heels can transform an individual's personality, silhouette and health – in an adverse way. Health experts across the world agree unanimously about the perils associated with slipping feet into that gorgeous pair of Jimmy Choo's. Yet few of us are able to resist that temptation, which is not just about looking taller. Dr. Khalid M. Edrees, a consultant podiatric foot and ankle surgeon in Jeddah, said his clinic gets a lot of patients, especially young women, on a daily basis complaining of ailments related to the use of high heels, with the numbers going up during the holidays - especially summer - when a lot more parties and weddings take place. He presents an interesting argument on why women in specific are crazy about heels. “Perhaps ladies wear high heels because they feel taller and with the pelvis being tilted backwards and the torso moved forward, they appear more attractive to the opposite sex. So then are men the real culprits behind the suffering of ladies' feet?” he asked. Dr. Edrees said the only positive about wearing high heels is their obvious attractiveness and appeal to both sexes, but warning that the negatives are too many. “In the long run, their impact is usually felt first on the feet, from where the problems can spread to other joints such as the knees, hips, neck and lower back,” he explained. “The most common complaint is metatarsalgia, characterized by pain under the ball of the foot. High heels are unnatural in the sense that they alter the normal pattern of pressure distribution on the sole of the feet. By wearing them, the foot is put in a severely plantarflexed position (pointing downward) with most of the pressure on the ball of the foot. This position of the feet causes a major shift of the pelvis and the center of gravity of the human body resulting in pain under the ball and the lower back.” He added that complaints of keratosis or calluses in the same area, which are also a result of the increased pressure, are also frequent. Another minor condition, but an equally painful one, is the pump bumps. “This is a boney or hard bump on the back of the heel that is caused by the rubbing of the shoe edge on the area, sometimes accompanied by blisters and scarring,” explained Dr. Edrees. And that's not all. “The Achilles' tendon and the hamstrings (tendons in the back of they legs) can get inflamed and can become short, causing permanent damage.” For women who wear high heels on a daily basis, add this to the average 10,000 steps per day a person walks, and you can imagine what your feet are actually going through. “The more deformity a person's foot has, like the flatter the foot, the worse is the effect and the faster the damage,” he added. Talking about the toes, Dr. Edrees remarked that women who wear high heels for a long time can also suffer from bunions and hammertoes, which are unsightly painful deformities of the toes, where they are basically out of shape and position. Almamoun Al-Shingiti, an exercise physiologist and nutritionist in Jeddah, told Saudi Gazette that the degree of harm caused due to high heels depends on the fitness level, weight and size of the wearer. “If the fitness level is high and muscles and joints are stronger, the person sustains less injury and will be able to regenerate and recuperate at a faster rate. Moreover, men have stronger skeletal and muscular systems, which makes them less prone to ailments,” explained Al-Shingiti. Frequency is a strong denominator, as is the elevation of the heel, though the latter is not as big an issue as the former, he said. “Using high heels sparingly – for occasions that last two-three hours maximum once a month – is safer than using them every day for example.” The damage inflicted due to high heels, which can happen over a period of one day or 40 years, can be lessened to an extent through exercise, which “strengthens the leg and back muscles,” he said. Al-Shingiti also recommended stretching exercises to “loosen up the muscles that are involved when high heels are used.” “Calf muscles are highly affected, so are the anterior muscles of the tibia. I suggest calf extensions to relax the area along with leg massage and hot water treatment. Regular aerobic exercise like walking, swimming, etc. and weight training strengthen muscles, thus minimizing the harm.” A study featured in the November issue of Foot & Ankle International (FAI), an American Orthopedic Foot & Ankle Society (AOFAS) journal, details the biomechanical changes that occur in feet during high heel wear and the link between the heel height and the damage caused. So does the doctor recommend shunning the stilettos for good? “If you are obsessive about high-heeled footwear, make sure the heels are not more than about 5 cm (2 ½ inches), anything more will be hazardous,” advised Dr. Edrees. The answer, he points out, is not flat footwear either. “Stay away from flats and slippers as they will damage your feet just as much as the high ones. Each person has a different type of foot with its own set of conditions. Extremes are not good, which means neither flats nor high heels are good for your feet, it's somewhere in the middle that will balance your posture,” he said. Dr. Edrees added that there are steps any of us can take to limit the harm high heels cause. “Enjoy but don't indulge. Always wear the right shoe for the right occasion,” he said. What about the ideal shoe? “A sports type walking (pair of) shoes with a good arch support.” With the likes of even the glamorous Victoria Beckham - who once said she just couldn't concentrate when she did not wear heels - now falling flat owing to her alleged bunions, perhaps it's wise to suggest to all the lovely ladies to rethink their use of those towering heels and take a step towards healthy feet. After all, it is your feet that carry you around for years. – SG Want help choosing the right footwear? Dr. Edrees offers some tips (for both men and women): • Closed shoes are better than open ones • Rigid heel counters are better than flexible ones • Shoes with heel counters are better than open heels • Natural materials are better than synthetics • Heel height anywhere between 1 ½ to 2 ½ inches is good for the general public • If you insist on wearing pumps, try putting a silicone pad or cushion under the ball of the foot. • Remove shoes frequently to stretch your toes and limit the time you are wearing them.
