As a foot and ankle specialist, it can be a prickly struggle to enforce function over fashion when it comes to high-heeled shoe wearing patients. Rather than attempting to triumph over style, I spend time educating my patients on suitable support, optimal fit, and improved stability of their high heels during my consultations. In addition, I suggest modifications to existing shoe gear to strike a balance between chic and comfort in high heeled footwear. [more]

I make it clear that bunions, hammertoes, neuromas, capsulitis, ingrown toenails, sesamoiditis, and ankle sprains can result in those patients who remain resolute on wearing ill-fitting high heel shoes. My job is to educate my patients about these truths and guide them toward styles and features appropriate for their particular foot type.

A precise fit is vital to avoiding problems in high heels. A shoe that is too tight can result in blisters, bursitis, and crowding of the toes while a shoe that is too large promotes increased friction from movement of the foot within the shoe causing the forefoot to migrate forward and the heel to slip out of the rear counter. The more surface area in contact with the shoe—the better. High heels with an adjustable strap can help fasten the foot within the shoe to prevent excessive movement, and various over the counter pads can go a long way to help prevent needless movement within a shoe.

Dr. Michael B. Canales
Foot & Ankle Surgery
St. Vincent Charity Medical Center

It’s also important to note the most accurate size for high heels is the heel-to-ball measurement due to the noteworthy discrepancies in the lengths of the toe-box in many high heels. Consequently, the traditional heel-to-toe measurement is not a dependable size for high heeled shoes. The conventional Brannock measuring device can be used to determine both heel-to-toe and heel-to-ball measurements.

It’s astounding how many women have not had their feet measured since their adolescent years. Several women in my practice have not taken into account significant weight gains or losses or changes in foot architecture over the years when they shop for shoes. It is not rare to see to see a woman wearing a size 8 when in actuality her up-to-date size is 9 ½. As a foot and ankle specialist, I’m pleased when I get my high heel wearing patients to analyze their shoes from an anatomic perspective in an effort to select the right shoe for them.

These easygoing suggestions are intended to create a collaborative connection with my patients rather than an uncompromising or condescending association with my high heel wearing folks. I understand that high heels are here to stay, and contrary to traditional belief I believe that women’s shoes can be both fashionable and comfortable with the proper advice.