Busy Woman's Guide: How to Wear High Heels Pain-free

high heel ankle boots

Medically reviewed in June 2019

The higher the heel, the closer to God, I say. My husband (an orthopedic surgeon), on the other hand, says the solution to high heel pain is to not wear them. 

I’m keeping my heels. But, I’m considering a new husband.

Let's face it—my telling you not to wear heels won't convince you to stop (I wouldn't listen to me say that either), but how can you do so comfortably—and safely? As an ER doctor, I’ve treated many women with high heel-related injuries—including one who fell after getting her heel caught in cobblestones. In fact, a recent study showed that ER visits for injuries caused by heels have doubled since 2002, leading to foot and ankle sprains, fractures and other injuries. 

So, there are fashion emergencies, and fashion “emergencies.” Darling, I don’t want you to be either one, which is why I'd never tell you to avoid heels. However, I won't wear heels that hurt, and you don't have to either. 

Before you buy
Even fairy godmothers can’t make every glass slipper comfortable (note that Cinderella had ditched hers before the end of the night). So, choosing the right shoes is crucial. Here’s what to look for:

  • Style: Foot surgeons advise sticking to a height of two inches or less. Sky-high heels shift your foot forward, putting pressure on the ball of your foot—and more pressure equals more pain and chance of injury. I'll wear a little higher heel, but then I'll look for ones with a little platform in the toe-box to make the angle less steep. Styles with a T-strap or Mary Janes have the extra benefit of holding your foot in place. 
  • Size and shape: When was the last time you had your foot measured? If you’ve had children/gained or lost weight/or just plain can’t remember, it’s time for a recheck. Too small and your foot doesn’t sit well in the arch. Too big and it slides forward. The best fit will nicely hug and support your arch, and it definitely shouldn't hurt. Also, opt for wider toe boxes for best comfort and less long-term injury.

After you buy
Before I wear my heels, I always make a few minor adjustments:

  • Make them no-slip: Don't ask my why designers put slippery material on the soles—to avoid biting the dust as I strut, I combat this with non-slip pads on the bottom. A cobbler can do this, or you can find them at a drugstore. If you’re taking them to the cobbler, I also suggest having them replace the little plastic heel tip with a rubber one.
  • Add footpads: I then Frankenstein my own orthotics into every shoe, depending on the fit. Consider one of these: a very slim insert with a heel cup and slight arch (if you need arch support), heel cushion (for heel pain) or a foot “tongue” pad (use under the foot for cushion, or put on the underside of the top of the shoe to prevent sliding forward). A podiatrist can help you with custom inserts, or you can do as I do, which is buy them in bulk at the drugstore or online.  

Keep your feet in shoe-shape
Because it’s all about the legs, ‘bout the legs. Having strong legs improves your balance and decreases your chance of falling or developing knee and lower back pain. If you’re a regular heel-wearer, make these exercises a part of your workout routine:

Stretch It Out - after a long day in heels, do a few stretches to restore your muscles.

Sore heels and calves: If you experience heel pain after a long day in heels, it’s probably due to a stiff calf muscle. 

  • What to do: Periodically take off your heels and flex your foot (against a wall or pulling it back with a towel) to stretch tight calves. 

Foot Pain: If you feel sharp, tingling pain in your foot, it may be the start of plantar fasciitis, which can be caused by ill-fitting shoes. 

  • What to do: Give your foot a tennis ball massage by placing a tennis ball on the ground and roll your foot back and forth over it to loosen the plantar fascia (the tissue that runs along the bottom of your foot). 

And because you're so busy, and sometimes every Wonder Woman has to be able to run in her heels.

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