What wearing high heels does to your feet

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Most high heels are uncomfortable. Even your best, most luxurious pair will leave your feet aching after a couple hours of walking. Sure, beauty is pain, and we make sacrifices for the sake of fashion. But wearing high heels all day every day can actually cause some serious problems with your feet.

"The reason heels are bad is because when you are in any kind of shoe that has elevation or a heel, your weight gets shifted forward to the ball of the foot," Jackie Sutera, D.P.M., a podiatric surgeon at City Podiatry in NYC, tells SELF. "The higher the heel, the more weight and pressure get shifted forward. Your knees and hips then have to push forward and your back has to hyperextend backwards to counterbalance," she explains. This can translate to leg, hip, and back pain. "It misaligns the whole skeleton and that's in a nutshell why it's really bad for you."

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LONDON, UNITED KINGDOM - APRIL 23: Taylor Schilling seen at The Soho Hotel on April 23, 2012 in London, England. (Photo by Neil Mockford/FilmMagic)
BEVERLY HILLS, CA - JUNE 01: Actress Reese Witherspoon attends the Second Annual Kidstock Music and Art Festival at the Greystone Mansion June 1, 2008 in Beverly Hills, California. (Photo by Frederick M. Brown/Getty Images)
Karlie Kloss attends the 2015 CFDA Fashion Awards at Alice Tully Hall on Monday, June 1, 2015, in New York, (Photo by Charles Sykes/Invision/AP)
Danielle Rose Russell seen at a Special Screening Of Columbia Pictures' "ALOHA" on Wednesday, May 27, 2015, in Los Angeles, CA. (Photo by Dan Steinberg/Invision for Sony Pictures/AP Images)
NEW YORK, NY - MAY 08: Vanessa Hudgens spotted in SoHo on May 8, 2015 in New York City. Photo Credit: mpi67 / MediaPunch/IPX
Actress Kate Bosworth attends the Lilly Pulitzer for Target launch event at the Bryant Park Grill on Wednesday, April 15, 2015, in New York. (Photo by Evan Agostini/Invision/AP)
Gabourey Sidibe attends the 2015 Tribeca Film Festival opening night premiere of "Live From New York!" at The Beacon Theatre on Wednesday, April 15, 2015, in New York. (Photo by Charles Sykes/Invision/AP)
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Sigourney Weaver attends the SNL 40th Anniversary Special at Rockefeller Plaza on Sunday, Feb. 15, 2015, in New York. (Photo by Evan Agostini/Invision/AP)
Viola Davis arrives at the Disney/ABC Television Group 2015 Winter TCA Party on Wednesday, Jan. 14, 2015, in Pasadena, Calif. (Photo by Richard Shotwell/Invision/AP)
Actress Quvenzhané Wallis attends the "Kahlil Gibran's The Prophet" premiere during the Toronto International Film Festival on Saturday, Sept. 6, 2014, in Toronto. (Photo by Evan Agostini/Invision/AP)
Lily Aldridge seen at MBFW Spring/Summer 2015 - Ralph Lauren Polo 4D fashion show at Central Park on Monday, Sept 8, 2014, in New York. (Photo by [Mark Von Holden/Invision/AP)
Mary Lambert arrives at the MTV Video Music Awards at The Forum on Sunday, Aug. 24, 2014, in Inglewood, Calif. (Photo by Jordan Strauss/Invision/AP)
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On top of all that, heels cause more noticeable damage to the feet and ankles. Here's what you need to know before stepping into that gorgeous new pair of stilettos.

High heels can cause all sorts of cosmetic problems for your feet.

The pressure your toes experience being pressed forward can lead to hammer toes (when the toe becomes bent downward permanently), bunions (a swollen, bony bump that forms on the side of the big toe), and ingrown toenails. "If you already have them it gets worse. If you don't have them, they can develop, especially if you have a genetic component," Sutera says.

They can also leave you with real injuries.

Similarly to how overusing muscles can lead to injury, repeatedly wearing high heels can cause all sorts of painful problems. Straining your ankles and other tendons surrounding the foot can lead to tendonitis. "Because your foot is elevated and the weight goes forward, a lot of tension gets taken off the Achilles tendon and it shortens over time," Sutera explains. "That's why a lot of women who are a little older don't feel good in flats, because the tendons are so tight from overuse of high heels their whole lives" that it's uncomfortable when they're stretched to their original length. Extra weight and pressure on the front of the foot can even cause a stress fracture. Heels can also cause pinched nerves. "The most common is called Morton's neuroma," Sutera says. It occurs on the ball of the foot, usually between the third and fourth toe. "You can get heel spurs [a calcium buildup on the bone], arthritis, and heel pain, as well," she adds. If your feet are ever seriously hurting you and it won't ease up, see a podiatrist to figure out what's wrong.

Repeatedly wearing heels can actually wear away your foot's natural cushioning.

"What ends up happening with overuse is the fat pad on bottom of the foot starts to become a lot thinner over time," Sutera says. "When you don't have a natural cushion anymore, you can get generalized pain on the bottom of the foot." This pain is called metatarsalgia. The rate at which these fat pads atrophy depends on the person, but over-wearing high heels and even walking around in crappy flip-flops can contribute to the process over time.

For the clumsy among us, heels are a twisted ankle just waiting to happen.

Whether you have terrible balance naturally or are going to be drinking in those stilettos, an ankle twist or sprain is a real concern.

If you're going to wear heels, there are some things you can do to minimize and mitigate the effects.

The best thing to do is to not wear heels, and if you do, buy ones that are made with cushioning and a proper arch from brands like Vionic. But let's be honest: Knowing heels aren't great for our feet isn't going to make all women just stop wearing them. Sutera recommends some things you can do to make wearing heels a better experience for your poor feet:

1. Massage and stretch your legs at the end of the day. "The Achilles tendons and calf muscles get really tight, so doing calf stretches and massages can undo that," Sutera says. Downward dog or a runner's calf stretch against the wall will suffice. If you have a pinched nerve or other pain in your toes, massage in between the thin bones. "That usually helps to open up the space, promote circulation, and calm everything down," says Sutera. Simply spreading and stretching your toes apart will help, too.

2. Ditch shoes that are worn out or no longer fit. "I don't care how much money you spent, they will hurt you if they're not in good shape and don't fit you well," Sutera says. (BRB, mourning the loss of our trusty go-to nude pair.)

3. Choose wedges and platforms over a thinner heel. "There's a greater surface area to distribute body weight across, and it gives you much more stability as well."

4. Alternate heel heights throughout the week. You should also switch shoes throughout the day so you're not in heels all day long. That way, your feet aren't always forced into the same angle day in and day out.

5. Wear commuter shoes. It's difficult to grasp this idea when you've worked to perfect your outfit before leaving the house, but your feet will thank you later. "If women in their 20s started doing this now, they would have fewer problems when they get older," says Sutera. Wear shoes with a thick sole, arch support, and shock absorption, and wait to change into those sky-high heels until you arrive at your destination.

6. Pump in moderation. Heels aren't good for your feet. But no one expects you to just stop wearing them (especially when they make your butt look so perky). If you make better shoe choices most of the time and wear high heels minimally, Sutera assures that you'll be fine.

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