Monday, December 15, 2008

Sky Scraper Stilettos: Sexy or Simply Insane??
Ultra High Shoe Heights can Cause Serious Problems

From Prada to Yves Saint Laurent to Steve Madden and L.A.M.B., soaring heel heights are hitting the stores! With this season's new, sky-high heeled shoes, women need to use extra care in selecting and wearing these sexy shoes. The five, six, and even seven and eight inch heights currently in vogue can lead to a multitude of serious foot and ankle problems, according to specialists in the field. With these ultra high shoes, your body weight shifts, gait pattern is affected and your feet tend to slip forward. This may amplify discomfort, especially if the shoes don't fit properly in the first place. Women should look for shoes with padding in the forefoot area, cushioning the toes and ball of the foot and stability of the heel.

Stilettos are obviously most dangerous and women run the risk of literally, falling off their heels and suffering serious injuries! Some of the designers are addressing this problem by making the heel wider or adding a platform. Even the chunky heels and platforms at these heights are dangerous. Platforms add the additional problem of not allowing the foot to bend as it needs to for normal gait. Women should walk in the high heel shoes before they make a purchase. And walk on bare floors, not just the carpeted floor in the shoe display area of the store.

High heel-related injuries I commonly see include sesamoiditis (inflammation and swelling), neuromas (nerve damage), metatarsalgia (pain in the ball of the foot). Ultra high heel related injuries include ankle sprains or fractures, deterioration of the natural padding, ligament damage to the ball of the foot and even bone fractures of the foot.

Many women ignore think foot problems won’t occur until they are much older. Such common maladies as bunions or hammertoes are accelerated by ill-fitting or excessively high heels. I always tell women in their 20’s and 30’s that foot problems may be just around corner! Shoe related problems are often permanent and start as early as your 30’s.

Fashion editors point to high heels as enhancing the appearance of your legs as your calf muscles contract and adjust to the angle of high heel shoes. I suggest women do some basic leg stretching exercises after wearing heels to avoid excessive tightening of these calf muscles and the Achilles tendon. Wearing high heels on a regular basis over the years can cause these muscles and tendons to permanently contract, making walking in flat shoes or even bare feet more difficult.

Here are some high heel shopping tips:

1) Purchase shoes with heels only as high as you are comfortable with. Some women can tolerate higher heels better than others.

2) Alternate the heel height so that you are wearing a slightly different height day to day.

3) Try several styles, a wider heel may feel more stable then a thinner heel.

4) Also take into account the length of time you'll be wearing the shoes at a given stretch – five inch heels are fine if all you are doing is sitting and looking sexy!

Thursday, December 11, 2008

Last week I had three patients with fractured toes who all said the same thing. "I didn't think there was anything to do for a fractured toe."

I am wondering why so many people think that there is nothing you can do for such a common problem. It is true that you really can't put a cast on a toe, but a fracture of any of the twenty eight toe bones is no different than a fracture of any other bone. The toes should be treated with the same respect as your other bones!

A fracture is a broken bone. Any fractured bone requires several conditions to heal. First of all, the bone fragments must be in proper position to heal. An X-ray will determine if a fracture is displaced (the fragments are left in an abnormal position) or non-displaced. Even a non-displaced fracture needs stability to allow the pieces of bone to adhere together and fuse. If a fracture doesn't heal, it can cause long term pain similar to arthritis. Injured bone, like any tissue, also needs proper circulation to heal. The blood vessels will be able to work more effectively and reach the damaged tissue better once the bone fragments are stabilized. Ensuring a bone fracture to heal is no different than ensuring a bone surgery to heal. The bone (or bones) needs to be stabilized and immobilized.

Immobilization is achieved by stopping the mobilization or movement of a body part. A properly applied cast will stop both the bones and muscles from their normal action and is often used in an ankle or foot injury. A cast can be used for a fracture of the long bones of the foot, but not for the toes.

However, immobilization of the toes can be accomplished. Proper tapping techniques and the use of a surgical shoe will prevent motion of the toe. A surgical shoe works so well, it is often used in place of a cast for bunion surgery. This special shoe limits any motion at the fracture or site of surgery. The combination of tapping and a surgical shoe will not only stabilize the bone and allow the swelling to go down, but will also dramatically reduce the pain that is felt. My last patient's husband was so surprised to hear how much better her toe felt once it was properly taped and immobilized!

All three patients with toe fractures waited several weeks to be evaluated hoping the problem would resolve on its own. I don't have a problem with waiting a few days to be sure that the injury is more than a simple bruise, but it is important to see a podiatric physician sooner, rather than later, for a possible fracture. Digital X-rays allow the x-ray images to be magnified and allow for a much more accurate diagnosis of toe fractures. If the fracture is displaced, it will be difficult (if not impossible) to put them back in place without surgery if treatment is delayed. Waiting several weeks also delays the healing several weeks and results in a much longer recovery time without returning to normal activities.

Wednesday, December 10, 2008


I am pleased to be able to bring my expertise in foot and ankle issues to the public with this blog. I am a podiatric physician and surgeon in private practice in Naperville, IL at Family Podiatry Center and a spokesperson for the American Podiatric Medical Association (APMA). My interest in helping the public stems from by work with the APMA as Chairman of the APMA Public Education and Information Committee. My professional interests include women's foot health care, tendon problems, orthopedic problems and deformities and heel pain.

I hope to be able to educate women on general foot problems and help people find additional resources that may be available.

I would love to hear what types of foot or ankle problems you may be having so feel free to post issues you would like information on!

I look forward to hearing from you.

Dr. Marlene Reid, FACFAS, FACFAO
Podiatric Physician & Surgeon