Beyond High Heels: Women and Foot Conditions

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By News Team on July 14, 2022

With the heat of summer in full swing, there are a lot of ways we try to keep cool: Crank up the air conditioning, wear lighter clothing, and, of course, break out those summer shoes. Besides getting the occasional pedicure to keep your feet looking pretty, you may want to consider other ways to be friendly to your feet and keep them healthy during the summer months and all year long.

There’s a saying in fashion: "Pain is beauty." But what’s fashionable isn’t always the right choice, especially when it comes to footwear. While wearing high heels every day may complete your look, it can have a negative impact on your foot health over time.

“High heels generally do not cause primary foot problems for women,” said John R. Clements, D.P.M., a Carilion Clinic podiatrist. “But shoes can definitely be aggravators.”

Like with a lot of health conditions, genetics and aging play a major role in the condition of your feet. In general, women have narrower heels and weaker joints than men. Plus, diets lower in fat can decrease bone mass, putting women at a higher risk for sprains, dislocated bones and stress fractures.


“A common foot issue seen in women is stress fractures from post-menopausal osteoporosis,” said Carilion Clinic bone health coordinator Amelia Rode, P.A.-C. “An important way women can protect their feet is by preventing or controlling osteoporosis. Make your bone health a priority.”

Osteoporosis is a disease that weakens the bones and increases the risk for unexpected fractures.  

Amelia cautions that patients with osteoporosis at high risk for fracture should avoid flip-flops and open-toed sandals since they can get caught and contribute to falls. 

“Women who are active for most of their lives want to continue an active lifestyle as they age,” she said. “But unfortunately, sometimes their bodies can’t biologically keep up.”

Remaining active can prevent osteoporosis but adjusting activity level to include age-appropriate exercises can help. Remember, a healthy diet is also key. Increase your intake of vitamin D, which helps the body absorb calcium.

“I would also suggest proceeding with bone density testing, if it has been recommended,” said Amelia. “The test can examine your bone strength and is especially important for women.”

Find more information on bone health from Carilion Clinic's Orthopaedics team

Have an open discussion with your primary health care provider to find out if bone density testing may be a good option for you. 


Along with being aware of osteoporosis, arthritis can also be a major concern for women when it comes to their feet.

“The joints of the foot are no different than those of the knees, hips and hands,” Dr. Clements said. “Your feet undergo degenerative changes after years of walking and daily activities. The cartilage can wear down and arthritis develops.”

Fat Pad Atrophy

Another issue for women can be fat pad deterioration. As women age, the fat pad on the bottoms of the feet can thin. This means bones in the foot are more prominent and more at risk for injury.

“You’d probably notice the most discomfort in the shower or on tile or hardwood floors, where the surface is not cushioned,” Dr. Clements said. “I recommend people add a mat in the shower and wear thick slippers around the house instead of bare feet for better protection.”

Tips for Wearing Heels

So, while we can’t always control our health based on genetics and age, we can make smart choices when it comes to the footwear. As Dr. Clements said, shoes aren’t always to blame, but a bad pair can lead to irritations. High-heeled or tight-fitting shoes can lead to cramping, tingling, pain in the balls of feet or even more severe conditions like bunions (a bump on the side of the foot related to a deformity of the big toe) or hammertoes (unnatural bending when toes are forced against the front of shoes).

When wearing high heels, it’s recommended not to stand or walk around in heels higher than 2 inches for more than four hours straight. Help avoid discomfort and possible health issues by grabbing an extra, more comfortable pair of shoes to change into.

Also, using inserts for added cushion and support in heels or even in flat shoes can be beneficial. While women may stop growing in height, their feet are always changing with age. From year to year, foot size and width may vary, so it’s a good idea to get foot measurements every year, to ensure the correct size and fit. Issues with feet don’t happen overnight, they develop over time.

Feet are literally the body’s base support. If you take small steps now, you may be able to prevent foot problems later. 

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