10 Reasons Why Your Heels are Hurting You

By: Dr. Karena Wu, Physical Therapist –ActiveCare Physical Therapy

So many of people love wearing heels. However, they don’t love the rolled ankles, trips, and falls that often come with wearing these elevating shoes.

It’s true that heel lovers are becoming too attached to their feisty footwear. But this means that they completely disregard the probability of high heel foot pain or an ankle injury. It’s important to consider this as the weather warms up more and more heels come out of hibernation.

With that in mind, educate yourself about heel side effects and eliminate high heel pain as much as possible. There are some so good – and knowledgeable on the topic that they’ve been given nicknames, like “The Stiletto Whisperer.”

The good news is that if you do sprain your ankle, develop tight calves or get any other high heel shoe problems, they can be treated through direct access to physical therapy.

The overall goal, though, is to prevent chronic pain whenever possible. This is done through a variety of methods, one of which is called orthopedic physical therapy.

So here are 10 reasons why your heels are hurting you and some tips for high heel pain relief.

1. Achy Ankles

When wearing heels, the chances of a high heel ankle injury increase drastically. They are not aligned in the most stable position, which means there is more movement in the joint. Basically you might be the next Bambi on ice.Severe heel pain often leads to issues in other parts of the body, too. You may think it’s only your feet and ankles that will suffer – but sometimes, your lower back is impacted, too.

The solution to this high heel shoe problem? Wider heels. Your base of support is larger with a wide heel.  That means the ankle joint doesn’t have to balance the heel over a small surface area. The entire area is supported across the width of the bottom of the heel, making it easier to walk and balance.

2. Unlucky Ligaments

There are three ligaments on the outside of ankles versus five on the inside, making the outside areas of the ankles more prone to give out.

One solution to avoid a high heel ankle injury? Heels with ankle straps. The shoe stays on comfortably, so you don’t have to put in extra effort for balance.

3. Pointy Problems

Any point digging into the foot isn’t comforting, but the stiletto point is the least comforting. It has less surface area under the heal than other heels. With less surface area comes more instability and a higher likelihood of high heel foot pain. So the thicker the heel, the better.

A solution? Wedges. Wedges offer more mid-foot support for high heel pain relief. The more support under the entire foot, the less the small, intrinsic foot muscles have to work when you stand and walk. This leads to fewer instances of severe pain from wearing heels, as well as less lingering future discomfort.

4. Get High Heel Pain Relief From Crying Calves

Calf raises are excellent workouts. However, when your calves are permanently raised all day, they’ll start to cry out. Wearing heels leave calves in a shortened position. This causes the muscles to tighten more and for longer than they should.

So what can you do to relieve high heel pain in your calf? Wear lower heels. Being lower to the ground means you don’t have to worry about balance as much. If you do wobble, it’s not a far fall to hit the ground.

5. Cramp Crisis

The combination of tight muscles, tight heel cords, and loose tendons in the front of the foot means more instability and irritation. Severe pain like this is distracting, and makes it difficult to want to do anything, including seeking treatment. If you wear heels you’ve probably met a horse named Charlie and foot cramps may have your dogs barking. This pain is normal – but it doesn’t need to be.

Give yourself the gift of high heel foot pain relief: Stay in good shape. Your legs need to have the muscle to support heels properly. Keeping your legs in tip-top shape with regular exercise helps you from tipping over and keeps the cramps away.

6. Bones and Balls of Feet Hurt in Heels

Since there is more weight on the bones in the front/ball of the foot, the bones in the forefoot are more susceptible to high heel pain.

Address the fact that the balls of feet hurt in heels: Test out your shoes before you leave the shoe store. This doesn’t just mean trying the shoes on, this means walking the sales floor several times to get a real feel for the pair. Does it feel like your foot is pushing forward? If so those aren’t the shoes for you. Instead, try to find a shoe that makes your foot feel like the weight is evenly distributed. This helps to prevent other issues like lower back pain and joint pain at the same time.

7. Toes Jam Out

Even though there’s less weight on the forefoot, there is still pressure that can lead to jamming of the toes. This happens with closed-toe heels), as well as with slippage of the toes in opened toe heels.

The ultimate way to experience high heel pain relief is to choose a shoe with a wider front that gives your toes room to breathe.

8. High Plat”form” Falls

Super high platform heels in particular reduce control in the forefoot.

This high heel shoe problem means that movements aren’t as accurate or stable, which leads to more stumbles and falls. Runway models…how do you do it?

Solution? Low platforms (reasonably high, not the 5″+ heels!).

You can still wear platform heels, just choose a lower option.

If you do, the platform in the front of the heel actually allows you to be less plantarflexed (toes down). Also, there’s less weight in the ball of the foot, which addresses the problem of when the balls of your feet hurt in heels. Low back pain is often the result of poor posture, as are issues with the arms and shoulders, neck, and knees.

9. Heels Strike Out

When you walk in regular, flat shoes, your heel hits the pavement first. This gives you support and stability.  In high shoes, your “heel” alone can’t support you because it has such a small surface area. This basically means your muscles aren’t stretched or contracted properly while walking. In turn, the muscles tend to shorten. This leads to tightness in the calves and plantar fascia. Even wearing high heel shoes and knee pain have been shown to be related. Boohoo!

Solution? Wear wedge heels. They have a larger surface area, and more support and stability for foot/shoe contact with the ground. This in turn provides high heel shoe foot pain relief – from toes to knees.

10. Stiff Strides Prevent High Heel Pain Relief

Teeter-tottering with high heels obviously limits natural strides. With more tension all around, the reduced stride length can lead to stiff knees and hips for women and those that choose heeled footwear.

Save yourself from the high heel shoes and knee pain with this solution: Okay folks, let’s face it, the only way to truly avoid all these issues is to wear flats.

These days there are so many great options out there so you don’t have to sacrifice style for safety.

Choosing Physical Therapy For Severe Pain

If you’ve already experienced high heel shoe problems or want to prevent future ones from occurring, you can book an appointment with a physical therapist. If you feel pain, finding a way to treat it quickly is recommended. Severe pain doesn’t have to be the norm, but unfortunately for some that don’t seek treatment, it is.

A qualified PT can help you enhance the effects of the solutions listed above so you can get back to walking in a healthy and happy way without worrying about high heel pain. Use the BetterPT clinic location tool website or download the app to find ActiveCare Physical Therapy and hundreds of other quality physical therapy clinics in your area today to get back into your stride. Another simple option is to utilize the availability of virtual visits through the BetterTelehealth platform.

Happy walking!

Dr. Karena Wu is Owner and Clinical Director of ActiveCare Physical Therapy® in NYC and Mumbai with over 19 years of experience. Dr. Karena Wu has a Bachelor of Science in Biology from the University of California at Riverside and a Masters Degree in Physical Therapy from the Program In Physical Therapy at Columbia University and received her Clinical Doctorate in Physical Therapy from Temple University.