10 Reasons Why Your Heels are Hurting You

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


So many of us love wearing heels, but we don’t love the rolled ankles, trips and falls that often come with wearing these elevating shoes. I realize heel lovers are becoming too attached to their feisty footwear, completely disregarding the probability of high heel foot pain or an ankle injury. Especially as the weather warms up more and more heels come out of hibernation. With that in mind it's my mission to educate women on heel side effects and eliminate high heel pain as much as possible. In doing so some on TV have called me “The Stiletto Whisperer.”

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

We don't want you to injure yourself though. So here are 10 reasons why your heels are hurting you and some tips for high heel pain relief.

10. 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.

The solution to this high heel shoe problem? Wider heels: 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 so the entire area is supported across the width of the bottom of the heel.


9. 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.

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.

8. 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 the higher likelihood high heel foot pain. So the thicker the heel, the better.

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.


7. Crying Calves

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

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

6. Cramp Crisis

The combination of tight muscles, tight heel cords and loose tendons in the front of the foot means more instability and irritation. If you wear heels you’ve probably met a horse named Charlie and foot cramps may have your dogs barking.

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


5. 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.

4. Toes Jam Out

Even though there’s less weight on the forefoot, there is still pressure that can lead to jamming of the toes (in closed toe heels), or 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 give your toes room to breath.

3. 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 plantar flexed (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.


2. 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 are stretched or contracted properly while walking. In turn the muscles tend to shorten leading to tightness in the calves and plantar fascia. Even wearing high heel shoes and knee pain have been shown to be related. Boo hoo!

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

1. Stiff Strides

Teeter tattering with high heels obviously limits natural strides. With more tension all around, the reduced stride length can lead to stiff knees and hips.

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.

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. 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 website or app to find ActiveCare Physical Therapy and hundreds of other quality clinics in your area today to get back into your stride. 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.

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