The Worst Shoes for Your Feet

Heels, flats, flip-flops -- some of the trendiest shoes can be the riskiest.

From the WebMD Archives

Every woman probably has at least one pair: those shoes that you absolutely adore. Some perhaps have dozens.

The problem is your feet may not love those shoes.

Whether they’re skyscraper stilettos, open-backed clogs, pointy-toed pumps, or just ballet flats with no arch support, problem shoes can cause everything from nerve damage to hammertoe to calluses.

Worst Shoe Offender: Flip-Flops

You might be surprised at the winner of the Worst Shoe trophy. According to podiatrist Andrew Shapiro, DPM, a spokesman for the American Podiatric Medical Association, it’s also likely the most popular.

"Women are wearing flip-flops as everyday shoes!" says Shapiro, who practices in Valley Stream, N.Y. "They’re meant for the beach and the pool, not for everyday walking. They don’t give you any arch support. And they don’t protect the foot at all, so it’s prone to injuries."

Flip-flops might be fine if you don't overdo it, John Anderson, MD, co-chair of the American Orthopaedic Foot and Ankle Society’s Public Education Committee, says.

"But a lot of people get caught up in the moment and try to do things flip-flops aren’t designed for: running for a train, jumping, or playing Frisbee or touch football in the backyard," Anderson says. "We see a lot of injuries from improper use of flip-flops, and Crocs as well.”

The woes of improperly worn flip-flops? Shapiro says the list includes scraped feet, strained ankles, and broken toes from falling right out of the shoe as well as chronic problems such as tendonitis and plantar fasciitis due to lack of support.

The solution: Unless you’re on the beach, wear real sandals, not flip-flops -- the kind with a strap in the back that at least holds your foot inside the shoe.

Spike Heels

It’s pretty obvious that the higher the heel, the more misaligned your foot is. So how high is too high?

"Anything higher than about two inches causes a problem," Shapiro says. "The Achilles tendon shortens when the foot is in a high heel. So if you wear them too much, that tendon can become chronically shortened and you have Achilles tendonitis."

Continued

Spike heels also put an abnormal amount of pressure on the ball of the foot. "The fat under the ball of the foot starts to thin out from the pressure, and that’s the one place on your body that you want a nice chunk of fat," Shapiro says. "You can end up with something called metatarsalgia -- an acute pain in the ball of the foot that can become chronic -- or even stress fractures from all the pressure and hammer toes from the abnormal positioning."

It’s not just your feet that can pay the price. "If your feet hurt, you’ve lost your foundation," Anderson says. "So if you find yourself limping because your feet hurt, everything above the foot will be affected too. Your gait will be changed, and because of that, you’ll stress your knees, back, and hips. Everything above the foot has to adjust to what’s going on down below."

The solution: Wear your highest heels in moderation -- only for special events -- and slip them off on the way home. You can also relieve some of the pressure on the ball of your foot by wearing an over-the-counter or custom-made gel cushion. "Don’t combine sky-high heels with a pointy toe," Shapiro says. "Look for something that’s wide and roomy in the toe box."

Pointy-Toed Pumps

These beauties can cause some of the same injuries as high heels -- even more so when the shoe is both high and pointy.

"In addition to metatarsalgia and hammer toes, pointy-toed shoes can cause neuroma, an inflammation of the nerve between the toes," Shapiro says. "It’s most common between the third and fourth toes, but it could happen between any of them. The pinched and inflamed nerve causes pain and burning and may need to be treated with injections, physical therapy, or even surgical removal of the neuroma."

The solution: a wider toe box. There’s really nothing you can do to improve a shoe that squeezes your feet into an unnatural shape, Shapiro says. If you must wear them, as with sky-high heels, make it only on special occasions and not every day to the office.

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Ballet Flats

In ballet flats, you’re not teetering on spiked heels and pressing your foot into tight toes. Your feet are planted firmly on the ground in a shoe that has a lot of give. What's not to like?

The "give" is precisely the problem.

"Ballet flats generally lack support, lack cushioning, and don’t allow the foot to function the way it should," Shapiro says. "They’re an improvement on the flip-flop in that they protect the foot, but they carry the same risk of tendonitis, plantar fasciitis, and all the other things you see with lack of support. They’re just not meant for everyday wear."

The solution: You can choose a flat that resembles a ballet flat but has a real sole and support around the heel counter (the part of the shoe that wraps the heel). A good test: If you can fold it up and stuff it in your purse, it’s a shoe that doesn’t give you much support.

Backless Mules

"I see a lot of problems with backless shoes," Shapiro says. "The toes start to grab the shoe to get support, and a lot of women wind up with hammertoes because of that. You can also develop calluses or breaks in the skin because the shoe is constantly tapping the heel.

Well-designed, well-fitted athletic shoes are always good, of course, but for daily office wear, Shapiro recommends either a dressy flat or a pump with no more than a 1-1.5 inch heel. "You’re looking for good support around the heel counter, a good arch support, and a wider toe box," he says. "Ideally, there’s also a lace or buckle closure to support the foot."

"Hundreds of millions of dollars of research come down to the fact that if shoes feel comfortable when you put them on, they’re probably OK. But if they hurt, you shouldn’t wear them," Anderson says. "It’s really that simple."

WebMD Feature Reviewed by Louise Chang, MD on November 14, 2012

Sources

SOURCES:

Andrew Shapiro, DPM, podiatrist in Valley Stream, N.Y.; spokesman, American Podiatric Medical Association.

John Anderson, MD, associate professor, surgery department, Michigan State University College of Human Medicine; spokesman, American Orthopaedic Foot and Ankle Society, East Lansing, Mich.

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