7 Questions You May Be Afraid to Ask About Stylish Shoes

How heels, flats, flip-flops and wedges affect your feet

7 Questions You're Afraid to Ask About Stylish Shoes

Contributor: Gina Hild, DPM

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In my practice, women often ask me which shoes will help or hurt their feet. Here are my answers to some of the most common questions.

1. Can wearing heels or stilettos give you bunions?

Not necessarily, but heels can tighten your heel cords and increase pressure on the front part of your foot. This causes pain by overloading the metatarsal heads (the bones under the ball of your foot) — a condition called metatarsalgia or capsulitis.

Although heels will not cause bunions to develop, they can often hasten that development.  Bunions are a condition you inherit and often occur when you have a flat foot and a tight heel cord. If you have a neuroma (thickened nerve tissue between your toes), wearing heels will worsen the pain.

2.  Are shoes with pointed toes bad for you?

Yes. It’s wise to avoid buying any shoe that feels tight around your toes —whether it’s a heel, flat or sneaker.  Wearing tight shoes even one time can cause debilitating neuromas or bursitis (inflammation of the protective sacs surrounding the joints in your feet). I have seen this time and again in my practice.

Tight shoes can also aggravate bunions on the inside or outside (called a tailor’s bunion) of your feet.  Bottom line: avoid shoes that are narrow and constrict your forefoot.

3. Are ballet flats better than heels?

Some ballet flats offer decent arch support, depending on the brand. You need to inspect all shoes carefully to make sure they have a good arch and good side-to-side stability.  If they don’t, I would not buy them.

You can add an insole to supplement the arch of a shoe, as long as you buy  shoes with removable insoles. They are tough to find, but they are out there! I prefer a full-length insole that has a firm arch that won’t easily collapse.

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It’s better to buy insoles at a shoe store familiar with them than to buy over-the-counter insoles at a drugstore. Always buy the insoles first and bring them with you to try on shoes. This will ensure that you get the right size to accommodate the insoles.

A word of caution: If you have flat feet or high arches, ballet flats will never give you the good side-to-side stability you often need. Thin, flimsy ballet flats will also exaggerate pain in your arch or forefoot, because they do not offer the stability you need.

Related: How to Choose the Best Shoes for Your Feet

4. Are thong shoes OK for your feet?

I am not an advocate for thong-style shoes. They don’t provide the necessary support under your arches.

There are some newer styles that have arches built into them that are much better than they used to be. But, like many ballet flats, thong styles do not offer medial-to-lateral stability. That’s especially important if you have flat feet, high arches or tight heel cords.

5. When you want height, are wedges better than heels?

Yes, wedged heels are far better than heels or stilettos. They offer much more stability and can even be helpful for those with Achilles tendon problems or plantar fasciitis (inflamed tissue on the bottom of the foot).

In fact, heel lifts are one of the treatments we offer for these problems.

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6. Will shoes without arch support make your feet flat?

No, you’re either born with a flat foot deformity or you’re not. While genetics are the biggest factor in developing flat feet, shoes with poor arch support may contribute to progression over a very long period of time.

Good supportive shoes may slow the progression of flat feet but generally won’t stop the process completely.

7. Is your body affected by the shoes you wear?

Yes, wearing heels shifts the center of your body mass toward the front of your body. This can add extra stress to your knee and hip joints in addition to the front of your feet.

Flats or flip-flops without support have the opposite effect, shifting the center of your body mass backward. This also affects your hips and knees, and can cause arch pain, tendonitis and Achilles tendon problems.

The shoe takeaway

It’s OK to indulge in trendy shoes occasionally. These shoes — even the fashion sneakers appearing on the runway — should be worn for short periods of time. Don’t make them your footwear mainstay.

If you’re at risk for foot problems or you already have foot problems, I recommend finding good walking shoes with plenty of room in the toes and good side-to-side stability. They’ll keep your feet from rolling in or out, and you’ll feel a whole lot better.