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 Dr Balvinder Rana


Foot and ankle surgeons call wearing bad shoes, especially high heels, as shoe-icide.As online shopping grows in popularity, there is a greater temptation to purchase and wear shoes that look fashionable, but may not fit properly. Following are the general problems associated with wrong foot wear.

Tight, pointed Shoes

Women especially are more likely to purchase a shoe that is too small and tight in front like the pointed bellies. This type of shoe can cause corns, bunions, and other toe deformities such as hammer and claw toes, cross over toes, ingrown toe nails that may require surgery to correct.

High Heels

The American Podiatric Medical Association says high heels can lead to everything from ankle sprains to chronic pain in heels, knees, back and shoulders. A 2010 study found that women who wore high heels five times a week for two years had calf muscles that were 13 per cent shorter and Achilles tendons that were stiffer and thicker than those who did not wear heels.

Specifically, high heels can cause the following :

  •   Pump Bump: a painful knot or swelling on the back of the heel.
  •   Unnatural Foot Position puts stress on the ball of the foot and on the joints of the smaller toes causing foot strain and pain.
  •   Ankle injuries Sprains: All high heels boost the risk of an ankle sprain or ankle fracture. A severe sprain may tear the ligaments. The risk of developing osteoarthritis of ankle rises with recurrent severe sprain or fracture of the ankle.
  •   When we stand normally without shoes the body weight passes through our joints and spine through a fixed axis called the weight bearing axis. This axis changes dramatically in a person wearing high heels, with body weight passing through a changed axis causing the spine to bend forward to maintain the centre of gravity thereby causing low back pain and spinal deformity.
  •   Pain on the under surface of heel due to a disease called plantar fasciitis is common in women wearing high heels.

Ballet Flats

Wearing thin flats is like walking on cardboard. There's no arch support whatsoever and that keeps the feet from functioning optimally and can lead to knee, hip, and back problems. Poor arch support is also associated with a painful heel condition called plantar fasciitis.


Flip-flops offer very little protection. The risk of getting splinters or other foot injuries is higher when the feet are so exposed. People with diabetes should not wear flip-flops, because simple cuts and scrapes can lead to serious complications. In addition, many flip-flops provide no arch support. Like flats, they can aggravate plantar fasciitis.

Platform Shoes

Platform shoes and wedges tend to have rigid foot bed that throws off the biomechanics of walking. Your foot is trying to bend a certain way, but the shoe is fighting you because it's so rigid. If the heel of the platform is much higher than the toe area, the shoe also causes all the problems of high heel shoes.

Wrong Size Shoes

Nine out of 10 women are wearing shoes that are too small. The consequences aren't pretty – calluses, blisters, bunions, corns, and other problems. The constant rubbing can irritate the joints in the foot and lead to arthritis.

Tips for selecting proper shoes

  •   Ask the salesperson to measure the length and width of both of your feet to ensure a proper fit.
  •   Purchase shoes towards the evening time as feet can swell in the evening which can change the shoe size.
  •   One foot can be larger than the other. Always decide the shoe size according to the larger foot.
  •   Evaluate the shoe for its overall construction and look at the various parts of the shoe systematically:
        1. The toe box: The shoe should bend in the toe box, not the shank (arch). Make sure that your toes do not feel pinched or cramped, and that none of your toes are pushed over another toe. This means generally the toe box of the shoe should be broad enough to accommodate all the toes comfortably. Actually the shapes of the feet vary widely and you should determine if the toe box is appropriate for your foot. It is not just the shape of the toe box but also the depth. For example a deeper toe box will have more room to accommodate a wide forefoot.
        2. The shank: A good stable shank will provide you with more support. It should not be flexible. You should not be able to easily squeeze the heel counter in on a new pair of shoes.
        3. The sole: The insole should be well padded and soft to have enough shock absorption on impact. Rough or hard insoles can cause a lot of pain. The insole should also be shaped according to the shape of the sole of the foot. An insole with an inner arch to match the normal foot arch is recommended.
        4. The heel: It is generally recommended to have a shoe with a small heel of about half an inch and it should be continuous raise towards the heel and not an abrupt heel.
  •   Do not buy shoes that do not fit. There is no such thing as a "break-in period." With time, a foot may push or stretch a shoe to fit. But this can cause foot pain and damage. The goal is to find a shoe that approximates the shape of your foot - rather than for your foot to take on the shape of the shoe.
  •   There should be half an inch space between the tip of the longest toe (generally the great toe) and the end of the shoe.
  •   Try on shoes with socks that fit you well.
  •   Shoes that lace, buckle, Velcro or have some type of strapping mechanism will provide more support to your arch.


Dr Balvinder Rana
Additional Director- Foot and Ankle Surgery,
Fortis Bone and Joint Institute

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