Highs of the well heeled

Try choosing stilettos with cushioning in the ball of the foot and support around the arch so body weight is more evenly distributed. Photo / Chris Skelton

Stilettos can look fabulous, and with some simple tips to care for your feet, don't need to come with the ouch factor, writes Susan Edmunds.

They might look amazing but as every woman who has stumbled around in eight-inch stilettos knows, comfort is not something you generally associate with high heels. But in the Christmas party season, they are almost as ubiquitous as the silly earrings and Santa hats that start cropping up on your prematurely merry work colleagues' heads.

The good news is that podiatrists say high heels may not be as much of a concern as some of us have been led to believe.

Simon Speight, of Speight's Podiatry, says high heels are a product of corporate culture and women will continue to wear them, no matter what the medical world tells them.

He says that from a clinical perspective heels could precipitate some conditions, and over many years of wear cause problems with toenails if toes are squished into a narrow shoe. In women who always don heels, calf and achilles muscles could tighten, and a strain be put on the spine.

"But I haven't seen anyone in a wheelchair because of them yet ... Girls are going to do what they are going to do," he says.

In some cases, well-designed high heels could actually be better for feet than flat shoes, such as ballet slippers, which have no support. There have been reports of increasing incidence of plantar fasciitis, or heel pain, as a result of shoes with minimal sole support.

Speight says he has noticed an increase in the number of young women coming to him worried about the appearance of their toes, possibly as a result of media attention on the bunions of stiletto-sporting stars such as Victoria Beckham. "I want to tell them that no one is looking at their toes."

The key to comfort is to reduce the length of time high heels were worn, Speight says. He suggests wearing practical, comfortable shoes to work during the day before a function, to give feet a break. Applying a lot of moisturiser to feet will also cut down the likelihood of corns developing and applying ice for five minutes after an evening out will reduce the pain and swelling in little toes that is common in high-heel wearers.

High heels cause problems because they create an unnatural body weight distribution on the feet. Shoes generally have to be quite tight to prevent slipping.

The most comfortable stilettos are those with cushioning in the ball of the foot and support around the arch, so body weight is more evenly distributed.

Tim Halpine of Active Feet Podiatry says he is seeing more complications as a result of high heels.

"Shoes are getting ridiculous again ... they are higher than ever."

He says high heels are quite detrimental and can cause problems such as a pinched nerve in the ball of a foot, corns, callouses or bunions. "But they do look good. I like the look but I know they cause problems."

Halpine recommends anyone contemplating a Christmas party season perched on top of stilettos try to minimise the time spent in them, and the distance walked. Women can sport higher shoes at an event where they will be seated than at a cocktail party where they would be on their feet all night. "If you are at social events where you are on and off your feet all night, you can probably get away with [higher shoes]." Gel cushions and pads could provide a short-term solution to discomfort.

He says aside from the foot problems, anyone who falls off a high shoe risks doing some damage to their ankles.

But Halpine says the best advice is for women to listen to their bodies. "Don't ignore pain. It would be nice if you could look and feel good, too."