Women inflict more punishment on their feet from improper footwear that can bring about unnecessary foot problems. Some of the problems result from high-heeled shoes (generally defined as pumps with heels of more than two inches). Our practice believes such heels are medically unsound because they can cause postural and even safety problems.

A study conducted by the American Orthopaedic Foot and Ankle Society found that:

• Nine out of 10 women are wearing shoes that are too small for their feet.
  
• Eight out of 10 women say their shoes are painful.
  
• More than 7 out of 10 women have developed a bunion, hammertoe, or other painful foot deformity.
  
• Women are nine times more likely to develop a foot problem because of improper fitting shoes than a man.
  
• Nine out of 10 women`s foot deformities can be attributed to tight shoes.
  

High-heeled, pointed-toe shoes can cause numerous orthopedic problems, leading to discomfort or injury to the toes, ankles, knees, calves and back. Most high-heeled-shoes have a pointed, narrow toe box that crowds the toes and forces them into an unnatural triangular shape. These shoes distribute the body`s weight unevenly, placing excess stress on the ball of the foot and on the forefoot. This uneven distribution of weight, coupled with the narrow toe box characteristic of most high heels, can lead to discomfort, painful bunions, hammertoes. and other deformities.

The height of the heel makes a dramatic difference in the pressure that occurs on the bottom of the foot. As heel height increases, the pressure under the ball of the foot may double, placing greater pressure on the forefoot as it is forced into the pointed toe box.

To relieve the abusive effects of high heels, women can limit the time they wear them, alternating with good quality sneakers or flats for part of the day.

There are comfortable and attractive "walking" pumps (also called "comfort" or "performance" pumps) for work and social activities, that blend fashion considerations and comfort, offering pumps with athletic shoe-derived construction, reinforced heels, and wider toe room. Low-heeled shoes (one inch or lower) with a wide toe box are the ideal choice for women. An ample toe box that can accommodate the front part of the foot is as important as the heel in determining fit.

Perhaps the best shoe for women is a walking shoe with laces (not a slip-on), a composition sole, and a relatively wider heel with a rigid and padded heel counter, no more than three-quarters of an inch in height.