I am going to try to keep this brief, letting a few pictures be worth my usual thousand words.
This is an x-ray, taken from above, of a normal bare foot. Notice the space between the metatarsals and phalanges aka long foot bones and toes. The bones are nice and straight and the toes are extended to their full lengths. This is a good looking foot. And it seems to be happy too. And free.
These are images of a foot in a three-inch heel with a very narrow toe box, viewed from the top and the side. There is no longer space between foot bones at the proximal end. The great toe is deviating in towards the others and a bunion is forming before your very eyes. All of the toes are smashed together and none of them are extending to their full lengths, but are shoved up against an unforgiving toe box. I see Morton’s neuroma, which is a thickening of tissue around the nerve between the third and fourth toes that causes pain and numbness, in this gal’s future. A narrow toe box, like this one, pushes the smaller toes into a bent position at the middle joint and eventually their muscles become unable to straighten. Can you say
And oh that heel. That
glorious goriest heel. The bones of your feet are small and frail, like bird wings. Luckily, your foot is a biomechanical genius, madly engineered so that it can support and locomote you even with its small bird parts. But, those bones were designed to lie flat, not inclined to nearly 90 degrees. That changes everything. The list of conditions and degenerations caused by alignment-altering positive heels is so long, I can’t bear to type it, so I will hit some highlights: excess forces on the inner knee (as much as 26% higher for high heels) causing osteoarthritis; misaligned pelvis, hips and spine; increased pressure on the forefoot, which is a main ingredient for creating bunions, plantar fasciitis, and metatarsalgia; shortened calf muscles; Morton’s neuroma; achilles tendon and heel pain; pump bump; calluses, corns, and greater risk for sprained or broken ankles.
Understand that this x-ray is showing only bones and not flesh, so this crammed foot is an even hotter mess than the imaging shows. This is a foot in danger of lifelong pain and perfectly positioned to wreak havoc on the rest of the body, particularly the positioning and viability of the pelvic floor. The wearer of this shoe better have some adult diapers on hand, cause she’s gonna need em.
If you think this post does not apply to you because you do not wear high heels, I guarantee that unless you intentionally chose a zero drop or negative heel that your “flat shoes” have a positive heel. The average athletic shoe has a minimum 1 inch heel. And as the
function fashion pendulum is beginning to swing away from “barefoot” shoes, the trend is for even higher heeled athletic shoes. And speaking of fashion? Who designs shoes with toe boxes more narrow than most toe sets? Who? Who?? Uh, almost every shoe maker on the planet. Shoes that don’t fit the width of our feet abound. While your resulting conditions and issues may not end up as as severe as the wearer of a 3 inch heel, chronic wearing of any heel higher than your bare foot will eventually lead to foot problems. It’s been proven by the largest, unplanned, completely natural study ever conducted. According to the American Podiatric Medical Association, the majority of Americans (77%) have experienced foot pain and half of all adults say that foot pain has restricted activities like walking, exercising, working, or playing.
This is a tale of two feet. Which do you choose?
I credit the xray images to Theresa Perales, DPM, from a recorded presentation.