How to Wear High Heels Pain-Free

Woman wearing polka dot high heels

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.

Okay, maybe not. But as an ER doctor, I’ve treated women with injuries related to their heels – including a recent one who fell after getting her heel caught in cobblestones. A recent study showed that not only are high heels prone to cause foot pain and ankle injuries, they can lead to foot and ankle sprains, fractures, and other injuries related to falls. ER visits for high-heel-related injuries have doubled since 2002 to an estimated 14,140 injuries in 2012.

So, there are fashion emergencies and fashion emergencies. Darling, I don’t want you to be either one, so I won’t tell you to avoid heels, but I will tell you how I make them wearable.

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 say stick 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 personally find three inches to be okay –- but I prefer shoes 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 keeping your foot from shifting forward. Lastly, make sure the heel of the shoe is perpendicular to the ground, not sloped.

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. Give the shoes a good test drive. Walk around in the store. The best shoes will nicely hug and support your own arch. And they definitely shouldn’t hurt.

After You Buy

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

Make them no-slip: Why do designers put slippery material on the soles? To avoid biting the dust as I strut, I put nonslip pads on the bottom. A cobbler can do this, or you can buy nonslip sole pads at a drugstore. If you’re taking them to the cobbler, I also suggest having him 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 (if your foot slides forward). Put the tongue pad either under the ball (for cushion) or on the undersurface of the top of the shoe (to prevent forward-sliding). 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

It’s all about 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:

Single-leg balances



Lateral tube walks

Ease Aches With Daily Stretches

Tight 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.

Heel 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. Place a tennis ball on the ground and roll your foot back and forth over the sore spot to loosen the plantar fascia (the tissue that runs along the bottom of your foot). And if your shoes don’t fit well, buy new shoes!

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