Ask the doctors
Q: What are long-term effects of wearing high-heeled shoes to work?
A: Wearing high heels changes your centre of balance and alters your gait. There is an increased risk of ankle sprains and fractures, but these are traumatic and not a consequence of chronic high-heel use.
When you wear a high-heeled shoe, the toe box (the area where your toes go) is narrow and squeezes your toes. The higher the heel, the greater the force. This can lead to bunions, hammer toes and toes crossing each other.
A stiletto has minimal medial arch support. Over time, this can lead to strain or injury of the plantar fascia (connective tissue on the sole of the foot) - leading to pain over the heel, arch and toes. Reducing the heel height reduces force on the toes. A wider toe box also helps. To prevent strain, alternate heels with high-heeled platforms.
If your ankle and foot are always in a flexed position, the Achilles' tendon will gradually shorten. You can end up with an almost tip-toe gait, even when you remove your heels. A shortened Achilles' tendon suffers extra strain when you wear flats, which leads to pain at the back of the calf. I have a patient who is so used to three-inch heels she cannot wear flats. To combat this wear sneakers and change shoes at the office. Remove the heels when possible to stretch the tendon. Dr Michael Soon is a consultant orthopaedic surgeon at the Centre for Orthopaedics in Singapore