It was near the end of Sex and the City, after the stars had worn high heels in the snow, at the pool, to the beach, in the rain and, of course, to bed. It was after the one who got pregnant went jogging and we were not allowed to see what she was wearing on her feet, and after the only visible shoes I remember spotting other than high heels had made their appearance (flats worn by an office intern and sneakers worn by two guys throwing rose petals during a photo shoot). That's when I started wondering: What are their feet going to look like in another 10 years, after being crammed down a drainpipe? Because those women look as if they've been stuck in heels since before they could walk, their little bronzed baby spikes forgotten in some horrible box of memories.
As it so happens, SATC coincided with what became the Year of Evil Shoes at the American College of Sports Medicine's recent annual meeting. There, two research studies discussed how different types of footwear — flip-flops and high heels — might adversely influence fitness.
An altered gait
There is a long trail of evidence on the problems caused by high heels, including bunions, deformities such as hammertoe, a shortening of the Achilles tendon and stress fractures. There are several other problems listed on the Mayo Clinic's Web site.
To that list, the sports medicine conference added a new worry, when Louisiana Tech University researchers noted that as people in high heels walk down stairs, the dynamics of their gait shift markedly from how they would descend barefoot or in low-heeled shoes:
Force is transferred away from the heel (which normally carries the weight of the stride but in this case has little to balance on) and toward the toe.
How does that affect the rest of the foot and lower body? Would you want to be in an airplane that was landing nose first?
Flip-flops also came under scrutiny, with research showing that they, too, alter the way people walk: People shorten and slow their stride and scrunch their toes in a way that increases the angle of the ankle as the foot goes through its gait.
Auburn University doctoral student Justin Shroyer said the departure point for his study was the sense that people wearing flip-flops for extended periods — to work, for example — experience lower leg pain. His research does not show what might cause that, but he said, "Anything that deviates from normal and you do it for a prolonged period of time, it may cause problems."
Like being barefoot
Since the invention in the late 1950s of what came to be known as the Earth Shoe, a number of footwear designs have come along claiming to mimic the state of nature: walking barefoot.
The Earth Shoe did it with a "negative heel" that gave wearers a slightly backward tilt and, according to the company's claims, made wearers burn more calories and engage more muscle in standing and walking.
More recently, Masai Barefoot Technology and Chung Shi have made similar claims for footwear that uses rounded soles to create a slight imbalance and force a different sort of stride that, reportedly, tones muscles, eases pressure on joints and improves balance.
Studies of the Masai products show that they do increase muscle activation.
"It definitely helps the feet if there are certain weaknesses," Stephen Paulseth, a physical therapist in Los Angeles and head of the American Physical Therapy Association's foot and ankle group, said of the Masais and similar shoes.