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Heel thyself

Jean-Christophe Destailleur

This week on Take Care, an interview with Dr. Neal Blitz on the negative effects wearing high heels can have on posture, the spine, and the wearer’s over-all orthopedic and podiatric health. Dr. Blitz is chief of foot surgery and associate chairman of orthopedics at Bronx-Lebanon Hospital in New York City, and a leading authority on bunion surgery.

(click on "Read more" for the podcast of this interview and more information)

For many women, wearing high heels hurts and they make walking difficult. But because so many women believe they look better in high heels, they put up with the pain thinking it is only temporary. But Dr. Blitz says what many don’t know is this pain is often an indicator of the occurrence of long term damage.

The pain, Dr. Blitz explains, is most typically caused by a shortening of the Achilles tendon which adds strain to the back by throwing off the wearer’s natural walking stride, a process called destabilization.

“Typically, when you walk without heels, you walk heel-to-toe. When you walk in heels, the foot is put in the point position. And first off, that puts more pressure on the ball of the foot,” he said. “In general, just to walk, your ankle isn’t able to move in its normal excursion so what happens is you end up having to do a steppage-like gait…almost like a galloping gait…and that shortening [of the Achilles tendon] is what causes all the problems in the foot.”

Dr. Blitz also offers advice to help cure what he calls a “high heel hangover,” or the pain that lingers after wearing these shoes for long segments of time. He recommends a six-step process to help high heel wearers fully recover from a high heel hangover – a term he coined to describe the beat up, bruised foot that you experience the day after wearing heels.

  1. Yoga. Stretching your muscles, particularly those in your legs, will help counter the shortening of the Achilles tendon. Dr. Blitz particularly recommends the Downward Dog pose.
  2. Mineral bath. Minerals such as magnesium (found in Epsom salt) are absorbed into your body through the skin and can help build and repair tissue.
  3. Pamper your feet.  Get a pedicure, keep feet relatively callus free, and keep your toenails short.
  4. Moisturize. High heels cause pressure points and pressure points can cause skin breakdown and calluses so it is important to keep your skin supple.
  5. Deep massage. Massaging your feet will relieve muscle anxiety and spasms caused by trying to maintain the abnormal position caused by high heels.
  6. Wear sneakers. Let your feet rest and recover. If you commute to work, wear supportive shoes on the way and then change into your heels after you arrive. If you can, kick off your heels whenever you are sitting down and allow your feet to stretch out and relax throughout the day.

Dr. Blitz says following these steps will not only alleviate immediate pain, but will also help prevent long-term damage to the body. In extreme cases, long-term damage can lead to the need for surgery.