Let’s face it, high heels are not built for speed…or comfort. Even though they add glamour, they represent the dangerous lengths (or heights) women will go to for beauty. Not only are these towering pumps torturous to wear for any amount of time, they can have serious consequences to the health of your feet—and beyond.

“High heels throw the spine out of alignment and cause stress fractures, tendonitis and ligament sprains,” warns Jacqueline Sutera, DPM, a podiatric surgeon at City Podiatry in New York City. What’s more, the painful condition Morton’s neuroma, in which an enlarged nerve occurs between the third and fourth toe, is more common in women than men. While the exact cause is unknown, many experts surmise that a leading culprit is high heels, which put added pressure on the nerve.
Another factor: tight shoes, which women tend to favor. These further exacerbate the problem of non-supportive footwear. A survey conducted by Carol Frey, MD, of the University of California School of Medicine in Los Angeles, found that 88 percent of women wear shoes too small for their feet. The American Academy of Orthopaedic Surgeons (AAOS) reports that more than 7 out of 10 women have developed a bunion or other painful foot deformity, and 9 out of 10 women’s foot deformities can be tied to bad shoes.
This doesn’t mean you can never wear your high heels again, but Sutera advises moderation. “Feet carry all our body weight, plus purse and whatever bag we carry,” says Sutera. Wear the appropriate shoe for the activity, and even the right sneaker for the right sport. Alternate heel heights and be practical about when you really *need* to wear them—do you really need to wear heels while eating lunch in your office? Don’t be afraid of commuter shoes, which are sensible shoes (not necessarily sneakers) that offer support and shock absorption. Below we outline the three most pernicious shoe bugaboos, and what you can do to hit your stride—comfortably.
High heels
The problem: High heels shift weight forward, changing the way women walk, says Sutera. The tendons can shorten permanently.
The fix: Avoid heels that are higher than two inches, says Sutera. Wedge or platform shoes are a smart choice, as there is a greater surface area to distribute body weight versus a stiletto or a pump. (Wedge shoes also let you go higher than the recommended two inches, as you can subtract the height in front from the height in back.) Sutera suggests alternating heel height not only throughout the day, but also throughout the week.
Flats
The problem: Thin-soled shoes, especially flimsy ballet flats that fold in half, offer no arch support or cushioning, says Sutera. Flat shoes can lead to plantar fasciitis, shin splints and heel, hip and back pain.
The fix: Look for flats that have a thick sole and arch support. You can also try adding an orthotic insert. Start with an over-the-counter orthotic for relief. You can invest in a custom-made one if the prefabs don’t do the trick.
Flip-flops
The problem: The lack of support stresses the foot, and the thong style encourages the toes to over grip so the flip-flop stays on. Strains, sprains, hammer toe and stress fractures are often the consequence of long-term flip-flop wear.
The fix: Wear flip-flops only at the beach or pool, rather than every day, says Sutera. Try styles with a thicker sole and straps instead of a thong. “The straps are best,” says Sutera, “as they offer the most support.”
For specific shoe recommendations, check out this list of products that earn the American Podiatric Medicinal Association seal of acceptance.