Kim Kardashian buys first flats: 'So uncomfortable!'

The pregnant reality star loves her high heels.

Kim Kardashian, out and about to promote her newTyler Perry's Temptation movie, hid her bump under a poufy, short beige dress as she visited Live with Kelly and Michael today. Kristin Chenoweth, who was filling in for Kelly Ripa, asked about her maternity outfits and why there's so much chatter about the reality star's pregnancy style.

"My sister Kourtney warned me when I wasn't pregnant," said Kim. "She said all of the criticism you get when you're pregnant or a new mom is insane. Just wait." She went on to say, "I wore this black leather skirt the other day. People are like why are you wearing black? Are you ashamed? Are you trying to hide it? It was tight! I was trying to show the bump. (They said) You're trying to suffocate the baby. I had this maternity skirt made for me, like specially!"
She added, "Everything I do it seems to be crazy."

What's really crazy is what she said next: "I just bought my first pair of flats the other day. And I wore them. They are SO uncomfortable. Like, my heels are so comfortable," she said, acknowledging that at 5-feet-2 she likes the added height.

When Chenoweth noted the beautiful high heels she was wearing on the show, Kardashian admitted, "My foot is so swollen. I will say. It really is. And I'm sad. You know, 'cuz all my shoes doen't really fit me anymore. But I heard it goes back. Hopefully."

Higher the Heels and Greater the Dangers

X-rays show how high heels stretch the foot’s arch. Doctors say long-term use has painful consequences.

Tamiko Woolfalk rattled off her list of high heels, beaming as if they’re achievement awards.

Boots, pumps, booties, the red ones ... and the gray ones that she still needs to find a shirt to match.In all, she counted 30 pairs in her closet, with heels ranging from 2 to 5 inches high.

“Do they hurt? Absolutely,” said the Far West Side resident. “The worst is the burn on the balls of the feet. But it’s worth it.”

Stiletto-enthusiasts such as Woolfalk say foot pain is the price you pay for the confidence that comes with wearing high heels.

Physicians, however, say the price is steeper than that. More and more, podiatrists and orthopedic surgeons are educating women about the long-term consequences of wearing the wrong shoes, particularly high heels. Aside from foot, lower-back, neck and shoulder pain, they say, high heels also can lead to foot deformities. And recently they have been linked to arthritis.

A recent poll by the Society of Chiropodists and Podiatrists found that 25 percent of women who wear high heels every day are more likely to get arthritis. Other studies from various medical journals this year show that walking on high heels increases bone-on-bone movement in knee and hip joints, increasing the risk of osteoarthritis.

A study released in March by Finnish researchers concluded that women who wear high heels for 40 hours a week over two years walk differently from women who wear them 10 hours a week. Those habitual high-heel wearers take shorter, more-forceful strides and walk less efficiently, the study found.

Many women who wear heels every day develop tight Achilles tendons, which can cause back pain and make it more difficult for them to walk barefoot or in flat shoes. Other conditions include bunions, hammertoes, calluses and Haglund’s deformity, also called a “pump bump.”

A recent survey by the American Podiatric Medical Association found that 53 percent of women experience foot pain.

“It’s hard to think, in general, that people are so accepting of pain that they don’t question it. Foot pain is not normal,” said Dr. Lori DeBlasi, a Columbus podiatrist who works at Specialized Orthopaedics & Sports Medicine.

DeBlasi said she cringes when she walks through department stores and sees all of the high heels on display.

Woolfalk, 34, a patient-care coordinator in DeBlasi’s office, said that, despite seeing the many foot conditions at work, she maintains a strong fondness for her shoes.

They’ve taken her to nightclubs, where they’ve carried her feet across dance floors for hours at a time. For years, she has witnessed the attention garnered by elongated legs and slim calves.

“You can’t go to the club with sneakers — it’s about the height of the shoe, the sexiness of the calf. It’s a good time and a nice picture,” she said. “Nothing can change my mind about these shoes. ”In some cases, the loyalty to foot fashion goes to extremes. Some women go as far as amputating toes to fit into shoes. It’s called toe tucking.

There have been reported cases in New York City when women pay as much as $2,000 to have part of or all of a pinkie toe removed so they can better fit into pointy shoes.

“These are extreme cases, but it shows you this is the same as the Chinese foot-binding,” said Dr. Judith Smith, an surgeon in Springfield, Mo. “It is a fashion statement and a status symbol.”

Smith, a member of the board of directors of the American Orthopaedic Foot and Ankle Society’s outreach and education fund, performed a survey in the 1990s that found that 88 percent of women wore shoes that were too narrow, and 76 percent had some sort of foot deformity. Over a 15-year period, 87 percent of forefoot procedures were in women, according to her report.

Smith said she has had patients who were told their surgeries would be ineffective if they continued wearing high heels, yet they still did.

“There’s almost a disconnect there. They just can’t imagine life without these shoes.”

Woolfalk said she has worn her beloved heels less over the past few years but doesn’t plan to cut them out of her life. She said she hasn’t had any lasting consequences from her years of foot pain.

Predicting who will develop foot problems is like trying to predict which cigarette smoker might get cancer, Smith said. “Our job is to educate them on the problems that can arise.”

Some tips from medical professionals:

• If you must wear heels, stick to a wedge rather than a stiletto to maximize stability and keep your feet from rocking side to side.

• Try to keep heels to 1 to 2 inches high, and don’t wear them for more than a few hours at a time.

• Buy shoes at the end of the day, when feet are at their largest.

• Leave enough room in the toe of the shoe to slip in a finger.

• Buy shoes with good arch and heel support. Ballet flats and flip-flops can be just as harmful as high heels if they are too flexible and don’t support your feet.

9 Footwear Do's and Don'ts

Our poor feet. They withstand lots of abuse, quickly carrying us to last-minute outings, pounding the pavement on mind-clearing runs, and being squeezed into impractical (but fashionable) shoes. But we need to take care of them to avoid foot pain, injury, and other ailments. So do your tootsies a favor and follow these healthy tips.

Don't wear high heels for too long. We've all been there: out on the town in an amazing pair of pumps ... with achy feet and knees. A 2010 study found that over time, wearing heels higher than 2 inches can put you at risk for joint degeneration and knee osteoarthritis, and a new study finds that high heels are a leading cause of ingrown toenails, which can lead to infection and permanent nail damage. But we're not telling you to stop wearing heels--that's unrealistic. "I wouldn't recommend walking miles in heels, but a comfortable heel can be worn to work all day if it has the right features and/or orthotic," says Michele Summers, a California-based podiatrist and shoe designer. (You can pick up arch-support inserts at drug stores.) Try saving your sky-high heels for short-lived occasions like dinners, says John Brummer, a New York City-based podiatrist.

Don't wear flip-flops everywhere. They're easy, and as temperatures heat up, you're likely to slip them on often. Cool it, say experts. "Flip-flops give your foot basically no support, and the constant rubbing of the thong between the toes can cause a friction blister," says Summers. Not to mention they make stubbed toes, cuts, and sprained ankles more likely, according to the American Podiatric Medical Association (APMA). Limit flip-flops to settings like the beach or the pool. And when you do wear them, invest in a supportive leather pair, or a pair that carries the APMA seal of acceptance, the association advises. (If you have diabetes, you should never wear flip-flops, since the disease can dull your sense of pain, allowing minor wounds to become major problems--infected, for example--without your knowledge.)

Do exercise in shoes designed for your sport. It's "extremely important" to find gym shoes designed for your sport of choice because they'll accommodate the actions needed for the specific activity, says Brummer. If you're a runner, consider going a step further with a professional fitting, since your gait and range of motion affect the shoe you need, advises the American Academy of Podiatric Sports Medicine. For example, overpronators--runners whose feet rotate too far inward--are steered toward shoes that offer more support.

Don't wear the same shoes every day. It's tempting to always throw on your trusty flats. But alternating shoes can help keep your feet limber, says Summers. Plus it's good to air out shoes every other day to avoid bad smells. (Your significant other will thank you.)

Don't wear hand-me-downs. Reconsider those thrift-store sandals. "Each foot imprints a different wear pattern into the shoe," says Summers, so a used pair may not be the best fit.

Do discard worn-out shoes. Speaking of old shoes, it might be time to pitch yours. (Sniff.) If the sole is worn down more on one side than the other or is separating, let the pair go, says Summers. And replace athletic shoes that are beyond their shelf life; running shoes can last about 300 to 500 miles before causing problems, depending on the athlete, Brummer says.

Do change out of sweaty footwear. Fungal infections aren't just a consequence of barefoot showering at the gym. (By the way, don't do that.) You could get athlete's foot if you hang out in damp hosiery. Change your shoes and socks regularly, wash your feet daily, and dry your feet thoroughly to help prevent infection, advises the APMA.

Do have your feet measured. It's not your imagination: Your shoes may no longer fit. "Our shoe size can change from anything such as weight gain, hormonal activity, circulation disorders, or simple aging," says Brummer. "It is best to try on shoes at the end of the day when your feet are most swollen." You should have your feet measured at least once a year, especially if you're an older adult, adds Summers. (If you have diabetes, you should also see a podiatrist at least twice a year, Brummer says.)

Don't buy shoes that hurt. Sorry to break it to you, but you're probably not going to break in those painful shoes. "A shoe should feel comfortable when you try it on in the store," says Summers. "If it feels too tight in the store, it will be too tight at home and may even feel worse after being worn for a little while." That said, shoes can be stretched and modified for certain foot deformities such as bunions and hammertoes, says Brummer. Use good judgment--and walk away if you have any doubts. Your (happy) feet will thank you later.

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.”

How to Wear High Heels Without Pain

Discover the "healthy" way to wear heels. Plus, our favorite pairs for the holiday season.

The Best "Healthy" High Heels for the HolidaysThat pain that you feel at the end of a long night—no, it's not a hangover and it's not exhaustion. We're talking about something worse—the pain that's caused by a seemingly evil and malicious pair of high heels. But, believe it or not, not all high heels are created equal. In some cases, they can actually be healthier for your feet than flats. "Excess pronation is a condition that affects 75 percent of the population and has been related to many conditions, such as heel pain (otherwise known as plantar fasciitis), knee pain, and even lower-back pain," says podiatrist Phillip Vasyli.

In this case, doctors actually recommend wearing shoes with a slight heel, as opposed to our trusty flats. "The popular trend of ballet flats has caused us to see an increase in many of the aforementioned conditions due to a lack of overall support and flimsy shoe construction," Vasyli says.

Generally, there are a few things to look for when you're shopping for stilettos. First, make sure the heels are of moderate proportions, not the towering Lady GaGa variety. Save those for dinners out, where you'll be sitting for most of the evening.

Vasyli recommends opting for well-constructed "quality" shoes, especially those that have shock absorbing materials in the ball of the foot, and using an insert like Orthaheel, which he invented. He also suggests wearing your highest heels for only short periods at a time and giving them a little bit of closet time now and then."If you feel the need to wear higher-heeled shoes daily, then take a more comfortable shoe to get to and from work and wear the higher shoes while you're sitting at your desk," he adds.

Also, while you're having a ball, be conscious of the weight that's being distributed onto the ball of your foot. "The higher the heel, the more the shoe increases the arch height and also changes the 'arch position'," Vasyli says. He suggests looking for shoes that "contour" to your arch and distribute your weight over the entire foot, not just the ball of the foot.

By Jené Luciani