Our feet endure strain from walking, standing, running, and for women who can't do without heels - all these activities sometimes in killer heels.

But the joints, muscles and ligaments in our flexible feet endure wear and tear beyond what we can imagine, particularly in women who have a soft spot for heels.

Imagine this - About 75 per cent of our our body weight is shifted to the ball of the foot when we don three-inch heels, compared to about 20 per cent when we pound the pavement on one-inch heels. As a result, women who are constantly in heels are especially prone to forefoot problems and shortened calf muscle.

Some of the more commonly encountered foot problems include:

Morton's Neuroma

When the balls of the feet are overloaded with extra weight and squeezed into a shoe with a narrow narrow toe boxes, the tissue around the many nerves that run between the bones in the forefoot get thickened and damaged. This is most common between the third and fourth toes joints, which means you end up with pain, numbness and often an electric shock-like feeling to these toes.

Bunions

Those ugly protruding bones that you may see on the side of some women's feet, just below their big toes are bunions. This is when the big toe is pushed against the lessor toes causing the base of the 1^st toe joint to protrude outwards (Picture 1).

Habitually squeezing your feet into an ill-fitted toe box that is narrower than the widest point of your foot will cause it to gradually take on the same shape of the shoe.

And now that the bones are misaligned, the cartilage protecting your big toe wears down much faster causing arthritic changes in the joint. The joint can become red and inflamed. The increased width of the forefoot also makes it hard to find shoes that fit comfortably.

Picture 1: Bunion seen in the right foot

Achilles Tendonitis

Wearing high-heeled shoes too freqeuntly and for long periods also make our calf muscles overwork, contract and shorten. While you will experience aching calf muscles at the end of the day, a longer term problem is that.the shortened calf muscles become overstretched when the foot is not in high heels. The tendon fibres in feet may then tear causing inflammation and pain in the back of the heel.

In addition to the above problems, high heels also alter the body posture, pushing the hips forwards and making it necessary to arch the spine backwards to maintain in an upright position. This causes lower back pain and anterior knee pain.

Practical tips

Asking a woman to give up her heels may be next to impossible. So the next best thing to do is to wear them for as short an amount of time as possible.

Keep a pair of comfortable one-inch heels at the office and wear these instead for moving around, while changing into your high-heeled court shoes only when necessary.

If you find yourself unable to do that, pick shoes that have broad heels for stability and toe boxes that are almost as wide as your feet. Look out for shoes that are made of leather as this natural material will stretch slightly to accommodate your foot.

Otherwise, consult your podiatrist who can prescribe a range of padding and insoles, so you can wear your high-heeled shoes more comfortably.

This article is contributed by Ms Malia Ho is a Podiatrist at The Foot Practice at 10, Sinaran Drive, Novena Medical Centre, #08-08, Singapore 307506. Appointments for consultation can be made at Tel: 6737 1000.