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Saturday, September 1, 2012

Your Feet On X-Ray: Barefoot vs. Pointy-Toe High Heels...

X-Ray of a Patient's Foot
After a Lifetime of Improper Shoegear...

X-Ray of an eighty year old patient's foot who wore "pointy-toe high heels" for years.

 X-Rays of My Feet in

Barefoot vs. Pointy Toe Shoes...

The first questions I always get when I first show patients their x-rays is: what are those two 'circle things'? Those are bones called 'sesmoids' and they are normal and are located under the ball of your first toe joint. The first x-ray of my foot is me standing barefoot. The second x-ray is looking straight down on my foot in a high heel pointy-toe dress shoe. 

I've labelled the 'medial cunneiform' bone as #1 and the 'navicular bone' as #2, which gives you an appreciation of the angle that the foot in a three inch high heeled shoe. I also cut the second x-ray in the shape of the actual shoe that my foot was in and I outlined the bones on x-ray with a Sharpie pen so that the bones could be more easily visualized. My photos don't do the x-rays justice but, hopefully, they will give an appreciation of what happens to your toes inside of pointy-toe shoes.

I always recommend that if you wear high-heeled shoes - try to find shoes with a wide, soft toebox. Pointy toed shoes can cause hammertoes, bunions, corns, calluses, Morton's Neuromas and osteoarthritic joint changes that are painful and cosmetically unpleasing. 

If you are looking for a comfortable high heels - look for a shoe with a thick, rigid wedge sole, rearfoot strapping and, of course, the soft and wide toebox.

Check out my list of
"Top 20 Comfortable Women's Dress Shoes"
by using the 'search' box at the upper right of the blog.

Hope all is well,

Dr. Cathleen A. McCarthy


Bianca said...

Thank you so much Cathleen for posting this! I love it when you post x-rays of what happens to your feet. I remember a few years ago, I bought a pair of Jessica Simpson pumps (mostly because of the leopard inside...which nobody would ever see anyway). I wallked around in them at home and noticed my feet were going numb in places!! I immediatly took them back and purchased a different pair. They didn't cause numbness but the toe box was a tad too narrow. After a few years of discomfort, I found your blog and am now a Dansko girl! No more Cathy Jean boots or Jessica Simpson pumps for me. I'll take the Dansko Nat :)I'm glad I found your blog now while I'm still in college. I can't imagine going even half of my life with horrible foot pain and a lifetime of foot problems.

Doctor of Podiatry Discusses and Recommends Shoes. said...

Hi Bianca,
I'd love to say that I've never worn a Jessica Simpson pump but - *sigh* - I have a pair somewhere in my closet! Pre-podiatry, I wore all sorts of crazy heels and, now that I'm older, I do see my feet (especially my toes) subtly changing. Once you get used to wearing only comfortable shoes, it's impossible to go back to bad shoes. I love the Danskos too and I feel like the Dansko clog was custom made for my foot! Thanks for reading!!
Hope all is well and you are enjoying the holiday...

Anonymous said...

Hi Dr.,
How can I tell when a shoe is too small or too large? - I know that sounds stupid, but sometimes I'm between sizes and I'm not completely sure which size would be best... Also, do you have any thoughts about shoes by Aquatalia? - Are the toe boxes on their pumps large enough?
Thank you Dr, McCarthy - your blog is great!

Doctor of Podiatry Discusses and Recommends Shoes. said...

Dear Anonymous,

Thanks so much for the kind words!

I recommend shopping later in the day when your feet are a little more swollen and request that the shoe salesperson measure your feet to get the official size that your should be wearing. If you fall between two sizes, I would go for the slightly larger size as going smaller can cause problems with blisters, calluses, hammertoes, bunions, ingrown toenails, ect. The most important thing is to judge it on how it feels (assuming you have no problems with nerve damage or numb feet).

In my own case, I love the Jambo shoes but I can't wear them because I fall between two sizes. One is too small and hurts and the other is flopping off my foot! Dansko, however, always is a perfect fit for me personally so I always know I'm safe ordering a Dansko shoe. If you fall between two sizes, it doesn't mean it's not a good shoe but maybe it's not a good shoe for you.

I checked out the Aquatalia and they are gorgeous! Thank you for introducing me to a brand that I hadn't heard of! They look like they may be good but I can't tell until I physically can check them. My experience has been that there is no way to tell the quality of a shoe until you can flex and bend them. Shoes that look sturdy can be flimsy while shoes that look flimsy can be sturdy. You have to pick them up and check them - the less flexibility and bending - the better. With Aquatalia, the question is: is the forefoot sole thick and rigid enough? If you order the shoe and the forefoot area is really flimsy, they probably aren't so good. If, however, you order the shoe and the forefoot sole is thick and rigid, it is probably excellent. Sorry I can't give you a more specific answer! I'll keep my eyes out for the shoe so I can check them in person.

As far is if the toe box is large enough - it depends on your foot. They did look a little tapered to me but if you have a narrow forefoot, it shouldn't be a problem. If you have a wide forefoot and have a history of forefoot problems like bunions and hammertoes - they may not be wide enough.

I hope that was helpful!
Thanks for reading and let me know how you do with them...

Anonymous said...

Thanks Dr. McCarthy! This is very helpful! I'm going to follow your suggestions. I find Aquatalia appealing because they are (suppose to be) weatherproof. Nordstrom carries them. Thanks again!!!

Doctor of Podiatry Discusses and Recommends Shoes. said...

Your welcome!
I would love to hear your feedback on Aquatalia...

Julio Loose said...

Most foot injuries are indeed caused by ill-fitting and inappropriate shoe selection. For people who prefer to wear high heels, shoes with a platform under the toe box will decrease the overall stress on the foot. If you are purchasing a lower-heeled shoe, make sure that the heel is secure and that there is ample room in the toe box. The most important thing to do to avoid any injury caused by your footwear is to always wear proper footwear wherever you go.

Jeny said...

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