When You're a Shoe-In for Foot Problems

NewYork-Presbyterian/Columbia Podiatrist Offers Advice on Preventing Hammertoe and Other Footwear-Related Conditions — Even If You Wear High Heels

Apr 28, 2011


Wearing stiletto heels or other extreme footwear can put you one step away from a host of foot problems such as hammertoe, a painful condition in which the toes are bent in on each other.

Podiatrist Dr. Tzvi Bar-David of NewYork-Presbyterian Hospital/Columbia University Medical Center says common sense applies to taking care of your feet. "To prevent hammertoe, it's not necessary to give up on wearing heels entirely, but women should limit the amount of time they spend wearing them. I recommend wearing comfortable shoes for your commute or when you're on your way to a party. Change into your heels when you get there."

When asked for some general guidelines on footwear, Dr. Bar-David suggests picking a shoe with a soft, spacious toe box and good arch support. A uniform lift and wide heel is better than a narrow, spiked lift. "Don't force yourself into a bad shoe," says Dr. Bar-David. "When buying new shoes, try them on for 10 to 15 minutes. Even better, see if you can wear them home and return them later if they aren't a good fit."

If hammertoe develops, it's important to see your doctor. While the condition can be treated using pads and gel protectors, surgery is sometimes necessary. The contemporary approach involves placing tiny metal implants inside the affected toes to realign the bones. Recovery is fairly quick: Patients can lace-up in comfortable shoes in as soon as two weeks. These implants improve on the older, wire-based approach, which took longer to heal and had a higher infection risk, explains Dr. Bar-David.

In rare cases, hammertoe can be a sign of muscle, nerve or joint damage from a congenital deformity or conditions such as osteoarthritis, rheumatoid arthritis, stroke or diabetes. "In particular, people with diabetes have to be extra careful with hammertoe because the condition can cause infections and other problems," says Dr. Bar-David.

Other common shoe-related conditions include bunions, a bump around the joint at the base of the big toe, and plantar fasciitis, irritation and swelling of the thick tissue on the bottom of the foot. These can be treated with custom insoles, or in severe cases, with surgery.

"While it's easy to forget about our feet, we should never treat them badly," says Dr. Bar-David.

NewYork-Presbyterian Hospital/Columbia University Medical Center

NewYork-Presbyterian Hospital/Columbia University Medical Center, located in New York City, is one of the leading academic medical centers in the world, comprising the teaching hospital NewYork-Presbyterian and its academic partner, Columbia University College of Physicians and Surgeons. NewYork-Presbyterian/Columbia provides state-of-the-art inpatient, ambulatory and preventive care in all areas of medicine, and is committed to excellence in patient care, research, education and community service. NewYork-Presbyterian Hospital also comprises NewYork-Presbyterian Hospital/Weill Cornell Medical Center, NewYork-Presbyterian/Morgan Stanley Children's Hospital, NewYork-Presbyterian Hospital/Westchester Division and NewYork-Presbyterian/The Allen Hospital. NewYork-Presbyterian is the #1 hospital in the New York metropolitan area and is consistently ranked among the best academic medical institutions in the nation, according to U.S.News & World Report.

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