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By Jane Langille
FOUR YEARS AGO, Dr. Marlene Reid of
Naperville, Illinois, had increasing pain in
the ball of her foot. Magnetic resonance
imaging showed she had ruptured a toe ligament. Ironically, she’s a podiatrist, and plantar plate tear, the scarring or tearing of a toe
ligament, is one of the most common issues
she sees in her patients.
The culprit? High heels, which come
with a host of health risks.
“The ball of the foot is actually a series of
joints that correlate to each toe, and each of
those joints has ligaments at the bottom.
Constant pressure on the ball of the foot from
the angle of a high heel pushes the natural fat
padding forward, and, over time, the ligaments can tear,” says Reid, a Costco member
and a spokesperson for the American
Podiatric Medical Association ( apma.org).
Reid’s foot healed with physiotherapy
and ultrasound treatments, but recovery
took a long time.
Hammertoes
In addition to plantar plate tear, high
heels can cause hammertoes, a common
condition where the toes become buckled
in an upside-down V-shape, causing pain,
pressure, corns and calluses.
Dr. Mark Myerson, an orthopedic surgeon, medical director and founder of the
Institute for Foot and Ankle Reconstruction
at Mercy Medical Center in Baltimore, says as
the heel lifts up, weight is put on the front of
the ball of the foot, toes get pushed back and
small muscles inside the foot start to
weaken. Over years, the toes no longer bend correctly and hammertoes can develop.
“It’s a vicious cycle,” says
Myerson, a Costco member.
“Think of the toes as a pul-
ley system in balance. If
muscles on one side of the
toe are pulling harder than
the other, you end up with
an imbalance and deformity over time. And
once you have hammertoe, there’s nothing
that’s going to stop it from getting worse.”
Surgical repair can help, but the necessity
is based on symptoms, not on how feet look.
Some people with significant deformities have
no pain and can happily wear their choice of
footwear. Surgery may involve straightening
the toe and fusing it so it does not bend, or fix-
ing it so it can still move slightly.
Orthopedic surgeons have a range of new
high-tech implant devices to choose from to
repair hammertoes. One of the newest
implants is made of nitinol, a nickel-and-tita-nium alloy that expands when it is inserted
into the bone and holds it in position. Patients
are able to walk on the foot the next day.
Gait, knee and back issues
The trouble with high heels doesn’t stop at
the feet. Wearing them affects gait and strains
joints, ligaments, tendons and muscles all the
way up the legs to the lower back.
Walking in high heels makes it harder to
straighten your knees compared with striding in flat, everyday shoes, putting more
strain on kneecaps. A recent study at Stanford
Fancy feet follies
High heels can hurt more than your feet
for your health
CONTINUED ON PAGE 78
In our digital editions
Click here to watch Dr. Todd
Sinett talk about back pain.
(See page 13 for details.)
Well-heeled
history
FUN FACT: Men originally wore high
heels. As early as the 10th century,
Persian horseback-riders used heels to
help their feet stay in stirrups. The trend
spread to Europe, and heels became
fashionable for the upper class, including
women (hence the expression “
well-heeled” applying to the wealthy). By the
18th century, high heels were for women
only. After the French Revolution in
1789, heels went out of style for a long
time but were revived with the invention
of the camera and the advent of pinups.
For more on the history of high heels,
listen to the popular free podcast
99% Invisible, episode 119, “Feet of
Engineering,” available on i Tunes or
your favorite podcaster.—JL
