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Taking the Hurt Out of High Heels: Understand Structure So You Can Function

By AOA Media Team


CHICAGO June 20, 2016—Performing arts physicians tell their patients it’s not the height of the heel that causes them pain, it’s the slope of the shoe.

Sajid A. Surve, DO, who sees patients experiencing pain or injuries from high heel use on a weekly basis, advises the dancers and actors in his practice to focus on the angle between the ball of the foot and the heel when selecting performance footwear. The more acute the angle the shoe creates, the greater the discomfort while wearing.

Dr. Surve, co-director of the Texas Center for Performing Arts Health and an associate professor at the University of North Texas Health Science Center – Texas College of Osteopathic Medicine, notes that a five inch heel with a two inch platform will cause less pain than a four inch heel and no platform.

“Our bodies aren’t built to bear weight on the ball of the foot. They’re designed for weight to be dispersed from the ball through the arch and heel. A comfortable heel has a more gradual slope down to the ball of the foot so that weight is more evenly distributed,” Dr. Surve explained.

While debate continues about whether employees should ever be required to wear heels in the workplace, it is possible to avoid the blooded, blistered feet that sparked an international outcry against employer-mandated high heels.

Comfort First Buying Guide

  • Say yes to platforms, which create a gentler slope between the ball of the foot and the heel.

  • No squeezing! A narrow, pointy shoe is the worst choice for comfort and can cause bunions.

  • Don’t go big. Loose shoes cause friction, blisters, bleeding and toe nail ripping, so maintain a bit of snugness in the fit.

  • Stay away from stilettos. A thicker heel spreads your weight more evenly and decreases the risk of ankle injuries.

Occupational Considerations

  • Arch support is critical for servers and others who mostly walk at work. Avoid flats and heels whenever possible.

  • For those who stand for long periods, it’s all about the sole of the shoe. Look for maximum cushioning.

  • If you mostly sit at a desk, the sky is the limit. Just take your heels off and stretch out your foot a few times a day.

  • Regardless of type, if you need to wear high heels for significant portions of your day, then it’s really important to perform calf stretches regularly to counteract the long-term effects of the shoes.

Additional information to help frequent high-heel wearers avoid pain and injury is available at

About the American Osteopathic Association

The American Osteopathic Association (AOA) represents more than 123,000 osteopathic physicians (DOs) and osteopathic medical students; promotes public health; encourages scientific research; serves as the primary certifying body for DOs; and is the accrediting agency for osteopathic medical schools. More information on DOs/osteopathic medicine can be found at

Media Contact:    

Sheridan Chaney
(312) 202-8043 (Office)