Image: Stilettos
Francois Mori  /  AP
Three-inch heels can increase the pressure on your feet by 76 percent, podiatrists say. But you don't have to give up your stilettos entirely if you take some precautions.
updated 12/23/2010 12:51:05 PM ET 2010-12-23T17:51:05

Apart from the occasional pedi, women tend to use and abuse their feet — maybe because "foot care" has less-than-sexy (OK, geriatric) connotations. But hey, bunions and bone spurs happen ... a lot. Research shows that most people have a foot injury of some sort by age 40, and women undergo the majority of common-problem foot surgeries. Sidestep heinous maladies by treating your feet right.

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Foot Foes
Genes play a leading role in female foot woes. So does anatomy: "In general, women have narrower heels and weaker joints than men do," says Frank Valente, D.C., a chiropractor in Manhattan. "Plus, irregular menstrual cycles and lower-fat diets can decrease bone mass, putting women at increased risk for ankle sprains and dislocated foot bones." Also, wider hips mean that some women are predisposed to walking knock-kneed, which can throw off the body's alignment and stance, and potentially lead to foot injuries, says Eric Horton, M.D., an orthopedic surgeon in San Diego.

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High Times
Stilettos can make your feet hurt like hell for a reason. "One-inch heels can increase the pressure on your feet by about 22 percent," says orthopedic surgeon Steven Raikin, M.D., of the Rothman Institute in Philadelphia. "Two inches can add up to 57 percent, and three inches can add a whopping 76 percent." That pressure means toes are crammed into a tight area, and the long-term results can be very unsultry bunions or clawlike hammertoes. What's more, so much weight shifting onto the feet causes calf muscles to clench up and eventually tighten, making it hard to walk normally even on days you wear flats. Platform and wedge shoes are a bit kinder, but most still have an unnatural incline, says Catherine Cheung, D.P.M., a podiatrist in San Francisco.

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Happy Feet
No, you don't have to pack your closet exclusively with Crocs. Just follow these tips:

1. Try not to stand or walk around in heels higher than two inches for more than four hours straight, says Horton. (If you do wear way-high heels on a big night out, ice your feet when you get home to curb any swelling or pain.)

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2. Remember that feet can still grow and spread throughout adulthood (especially after pregnancy) and tend to be at their most swollen at the end of the day, so do your shoe shopping in the afternoon. Have your feet measured every year to make sure you're buying the right size.

3. For extra heel and arch cushioning, slip orthopedic inserts into your flats. Most won't fit into skimpy high heels, so use gel pads there instead. You can buy them at a drugstore for around $20, or spring for custom-made orthotics from a doc.

4. As your body's essential support system, your feet can take a lot of weight, but "every pound you gain means an extra three pounds of pressure in your ankle region," says Raikin. Yet another reason to always maintain a healthy weight.

5. To keep your feet limber, do stretches such as writing the alphabet with pointed toes; to massage your arches, roll your feet over a tennis ball for a few minutes a day; and to stretch your ankle and calf, extend your knee, place a towel around the ball of your foot, and pull toes toward you.

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