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The question

I love my pretty shoes, but my feet hurt more and more often now that I've hit 35. Should I never wear heels again?

The answer

We all have shoes that look great but leave our feet sore and uncomfortable after wearing them.

Your concern is important: high heels and any improperly fitted shoes can cause real health problems such as deformed toes, heel pain, bunions, ingrown nails and corns. A specific concern with high heels is that with prolonged use, they can lead to a shortening of the Achilles tendon (the tendon that connects the calf muscle to the heel bone).

Over time, the shortening of the tendon can make it hard for the heel to fully touch the ground and can lead to heel pain and difficulty wearing flat shoes.

If your feet hurt, they're telling you something. While you don't need to get rid of all of your heels, change your shoe habits with a few of these tips:

1. Wear the right fit: While this may seem obvious, it can be tricky to find shoes that fit properly. When you're trying on shoes, keep in mind that foot shape and size can change over years so your size 5 years ago may be different today. Also, purchase your shoes later in the day when your size may be larger due to normal swelling and fit your shoes while standing up as your feet lengthen slightly when standing. Don't forget to fit both feet and choose your size based on your larger foot. When shoe stores tell you that the shoe will stretch to fit your foot, use caution as this is not always the case and tight-fitting shoes can lead to discomfort.

2. Higher is not always better: Heels that are higher than 2 inches can interfere with balance and posture which can trigger not only foot and heel pain but also knee, hip and back problems. According to the American Orthopaedic Foot and Ankle Society, women should wear shoes with a height of no more than two and a quarter inches. They also recommend that shoes at these heights should be worn no more than two or three hours each day.

3. Find comfortable heels: There are newer styles of heels that have cushioned soles, which will help with shock absorption and arch support. Also, wedge heels are better than stilletos, as they help to spread out pressure points and give better support to the entire foot.

4. Stretch after wear: After wearing heels, even if for 2-3 hours, gently stretch your Achilles tendon to help decrease the risk of the tendon shortening.

Send family doctor Sheila Wijayasinghe your questions at doctor@globeandmail.com. She will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.

Read more Q&As from Dr. Wijayasinghe.

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The content provided in The Globe and Mail's Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.

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