Healthy Heels

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Shoes! There's a love-hate relationship at the bottom of every woman's closet. On one hand, who doesn't want to look movie-star chic in a towering pair of Manolo Blahnik pumps? On the other hand, ouch! As too many women know firsthand, those sexy stilettos aren't just impractical and painful; they can do serious long-term damage.

High heels pitch the body forward, so that walking becomes more like controlled falling and maintaining a healthy heel-to-toe stride is difficult. High heels also point the foot downward, which destabilizes the ankle and prevents it from flexing properly and absorbing the considerable shock — three times our body weight — of walking. Instead, that shock is transferred to the knee and hip joints, a condition that can aggravate arthritis.

The results over time are not glamorous. According to Dr. Carol Frey, an orthopedic surgeon in Manhattan Beach, Calif., 76% of American women suffer from foot deformities or afflictions such as bunions, hammertoes, pinched nerves, calluses and ingrown toenails as a result of wearing inappropriate shoes. More than 50% of U.S. women are limping around with a bunion — a bony bump at the joint of the big toe. Compare that with a rate of less than 10% for men and 5% among unshod populations like Fiji Islanders. "There's nothing wrong with the human foot," says Frey. "It does not need shoes. It doesn't want shoes. The only reason we have to wear shoes is to protect ourselves from our environment."

Narrow, pointed toe boxes crunch feet into improbably small spaces, and, says Frey, "the shoe wins the battle. The foot will deform." Tight shoes pinch or even damage nerves and compound existing problems, such as bunions and hammertoes, which happen when toes buckle in cramped quarters and curl under.

So, is there a healthy alternative for women who don't want to slog around all day in sneakers or orthopedic clodhoppers? Nowadays the answer is a resounding yes. Over the past three years, nearly every major shoemaker has begun designing with one eye on fashion and the other keenly fixed on comfort and health. DKNY and Amalfi of Italy have crafted dress shoes with new technology like Insolia, a system invented by a podiatrist that shifts weight from the front of the shoe back to the heel, making high heels feel more like flats. At the same time, old standbys in the comfort-shoe industry, such as Birkenstock, Rockport and Ecco of Denmark, have stepped up their styles, boosting heel height or introducing trendy animal prints.

Two decades ago, the typical comfort-shoe customer was a 50-year-old who wanted a pull-on number with a gummy sole. Today traditional comfort brands like Aerosoles count among their clients college kids drawn in by hip T-strap sandals, go-go boots with 3-in. heels and mock-croc peep-toes adorned with silver buckles.

Meanwhile, new companies are striving to take the comfort-shoe niche a step further by using technologies borrowed from the athletics and aerospace industries. Oh! Shoes, based in Portland, Ore., has been launched in a few test markets this fall, and features a multiple-contour foot bed and a six-part shock-absorption system in the heel. Company founder and CEO Greg Van Gasse says the heel technology took 1 1/2 years to perfect and reduces shock more than 30%. The shoes' aesthetic, however, still needs a little work.