High price of wearing heels

For a quarter-century, Catherine Ange has worked as a seller of high-end furniture at the Atlanta Decorative Arts Center. Before computers became a mainstay of the job, a typical day could find Ange bending down, standing on tiptoe or moving furniture across 22,000 square feet of showroom space — all while wearing shoes with a 3- to 4-inch heel.

“I thought, ‘I feel so good in these heels. I can sell anything. I am invincible,’ ” said Ange, 47, of Buckhead. Her feet, unfortunately, were not so resilient.

By the time she reached her 30s, Ange was feeling the pain — a sharp, stabbing pain in the ball of her foot. She tried alternating heels and flats, but soon even flats were uncomfortable. She went to a doctor for injections of anti-inflammatories. Eventually, the only thing left to treat her Morton’s neuroma — a condition that causes thickening and pain in the nerves between the toes — was surgery.

After four surgeries in three years, heels are a thing of the past. “It is no laughing matter when you can no longer wear your Chanel pumps,” said Ange, who mostly wears custom orthotic inserts in her boots or sturdy tennis shoes.

The kind of debilitating foot pain that Ange experiences is a common problem for high heel wearers, particularly women who have been wearing heels for many years.

About 25 percent of women older than 40 have severe foot problems related to shoe choice, said Katy Bowman, a biomechanics expert and author of “Every Woman’s Guide to Foot Pain Relief: The New Science of Healthy Feet” (BenBella Books, $17). The problems can range from short-term issues such as blisters and calluses to long-term structural damage to the feet or body, such as shortening of the calf muscles.

“There are a lot of people trying to work themselves out of foot pain,” said Bowman, whose book helps women understand the mechanics of the foot and explains how to transition from heels to more sensible shoes.

“We know barefoot is natural, but you can’t just take off your shoes and start running,” she said.

Bowman’s advice includes exercises to help ward off foot troubles — at least for a while, because some women seem unable to resist the lure of high heels.

“No matter what I say, they are going to [wear heels],” said Dr. Jay Spector, of Northside Podiatry, who advises wearing no more than a 2-inch heel ... ever. Serious foot pain related to high heels can develop in as little as one night or a few weeks, he said. If you must wear high heels, Spector said, wearing them for shorter periods of time, then switching to a shoe with a lower heel can help.

Margaret Lisi of Midtown, a marketing manager who’s in her mid-40s, learned just how quickly heels can hurt when a pair of new gray pumps did a number on her feet.

“I felt like my feet had been cut open,” said Lisi, describing the pain. “I walked out of my building to go home and didn’t even make it across the street. I took the shoes off and tiptoed all the way to my car.”

The next day, Lisi shoved her scarred feet into a pair of boots. “[My feet] were like little loaves of bread rising in the warm environment of my cowboy boots,” Lisi said.

Women may take such isolated experiences lightly, but anyone who consistently wears heels can experience more severe problems over time, said Dr. Jason Morris, of Primera Podiatry, a new practice opening in February that offers advanced podiatry services such as a laser center and medical foot spa.

“The most common problem for patients who wear high heels daily or more than two to three times per week is thinning of the fat pad at the ball of the foot,” Morris said.

The abnormal positioning of the foot in high heels creates pressure on the ball of the foot, which thins the protective layer of fat and leads to a painful condition called metatarsalgia, he said.

Morris uses a new treatment — an injection of the filler Sculptra — to replace the fat pad and plump the area. The treatment can last 12 to 18 months, he said.

Morris also has treated heel wearers for stress fractures and another problem, bunions, which are caused by weakening of ligaments that hold the foot bones together. Bunions are genetic, but wearing heels can speed their development, Morris said.

Bunion surgery landed Michele Caplinger, senior executive director of the Atlanta Chapter of the Recording Academy, in the operating room just over a year ago. After more than 20 years wearing 3-inch heels on a regular basis, Caplinger had developed painful bunions on both feet.

“The pain was gradual, but I would literally end up in tears an hour into wearing a pair of heels,” Caplinger said. “In my line of work, I have many events, and I have to dress up, so I was constantly in pain.”

She went to foot doctors at least once a year and all recommended surgery, but Caplinger was terrified. When Caplinger met Dr. Perry Julien, the pain had become unbearable. She consented to surgery and has since been pain free.

The experience made Caplinger more thoughtful about her footwear choices but not quite ready to leave heels behind. “I am back in heels,” she said. “I do find myself in better-made, more reasonable shoes. That is an easy choice to make when vanity is not a priority.”