This one’s for you ladies out there, and you know who you are. Of course my hombres can listen too, and you might even learn something about the more feminine gender, well, in most cases anyway (holding back the obvious joke about a certain 70’s Olympian). This is one you may already know, but I have to state the obvious, once again for my NYC podiatry patients: women’s shoes are not made for real feet.

It doesn’t take a podiatrist, and in fact many bipedal humans have discovered the basic structure and function of the human foot. The heel is the object of first contact with the ground, followed by a middle portion of the foot, the arch, which may or may not contact the ground, and finally the front of the foot which typically is slightly to significantly wider than the rest of the foot. However shoes, particularly women’s dress shoes, are not shaped in a similar fashion. The heel is a narrow bit of soft or hard leather, followed by an arch that does not make much contact with the arch of the foot. And then we have the front of the shoe, which is shockingly narrow and in no way representative of the shape of real feet, more like skinny model feet.

Now as I have stated many times before in the most solemn and hallowed annals of this sacred blog, high heels are not bad per se, depending on the foot type, but they just don’t seem to be made for real feet, which is easily tested by holding the bottom of the shoe against the bottom of the foot while pressing down to achieve maximum weight bearing width. And dress flats are just not designed for the foot that has been molded and shaped by centuries of natural selection in which the non-shod foot remains in the pre-Darwinian days of antiquity. The ideal women’s shoe relieves the pressure in the arch, decreases the load on the heel and accommodates a wider forefoot. This is generally best accomplished by a 1-2” heel, and wide forefoot, such as found in a platform or wedge. Yes kids, heels are better for you than flats, but if the heel is too high the ankle becomes unstable and it’s just hard to walk- as evidenced by the gait of most women in 4” heels. And no kids, high heels don’t cause bunions or hammertoes- your genes do that- although the shoes can exacerbate the problem.

So after stating the obvious, the conclusion is stick to a low heel or flat with- wait for it- a really good orthotic, from a really good orthotic dude, and not the one in the drug store kiosk. For my male brothers out there, you have it a bit easier as men’s shoes are sort of actually designed for real feet, but don’t forget your orthotics, and yes, you know where to get them.

See you in the office.

Ernest Isaacson

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Ernest L Isaacson DPM PC
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