Podiatrist Interview : Greg E. Cohen, DPM

Greg Cohen, DPM is a graduate from a graduate from the New York College of Podiatric Medicine in Manhattan. He completed his residency program in podiatric medicine and surgery at Cabrini Medical Center in Manhattan. He is now in private practice in Brooklyn Heights, NY and is an attending podiatrist at Long Island College Hospital in Brooklyn.

A lot of women now feel they need to wear heels on a daily basis to work--or even just to look good. What are the dangers of having the foot and ankle in this type of position so often?

With long term high heel wear, the Achilles tendon in the back of the foot and leg tends to shorten over time. This may lead to Achilles tendonitis as well as heel and arch pain. Also, the higher the heel, the more pressure that is placed on the ball of the foot. This may lead to painful calluses and even nerve damage. Generally speaking, the higher the heel, the more damage they may cause.

Are all heels created equal? Do stilettos do more damage than the chunkier style heels? Is it true that, the higher the heel, the more damage it's doing?

Wedge type heels tend to be a little better than stilettos because the base of support is more stable. One is more likely to twist their ankle on a stiletto as opposed to a wider wedge heel.

What could happen to a woman who wears heels 5-7 days a week to work, out to dinner, dancing, etc? What type of risk is she taking? What problems could she develop in the near future or years down the road?

Other studies have shown that long term effects from high heels include chronic foot and ankle pain and arthritis of the feet, ankles, knees, hips, and lower back. This is the biggest risk that women take when wearing these types of shoes everyday for a long period of time.

What types of injuries do you frequently see involving high heels?

Women who wear high heels on a daily basis frequently have painful corns and calluses, blisters, bunions or hammertoes, nerve damage on the ball of the foot, and tendonitis of the foot and ankle. Frequent injuries include foot and ankle sprains, as well as stress fractures.

Do you have any tips for choosing a high-heeled shoe if a woman has to wear a pair?

If high heels must be worn, women should be standing or walking for no more than three hours if possible. Try to keep the heel height to no more than two inches. The toe box (front part of the shoe) should be round or square to allow more breathing room for the toes. Look for a soft leather material and one may add a felt or foam metatarsal pad into the shoe (can be purchased at most drug stores. Moleskin can also be a useful material to stick onto the inside of the shoe for more cushioning. Corn or callus pads (non-medicated) may be used to protect these tender areas in a tight dress shoe.

Can you think of any advice about wearing high heels? Should a woman try to limit herself to heels a certain number of days per week, hours per day, or choose a certain style?

I tell my female patients to wear a sensible shoe or sneaker when walking or standing a lot. Bring the dress shoes with you and change when you get to work. After the heels come off, perform Achilles tendon stretching exercises to prevent excessive tightening of the tendon.

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