The highs and lows of heel health.
LAST week office temp Nicola Thorp sparked a media storm by revealing her new employers sent her home - because she was wearing flat pumps and not shoes with at least a two-inch heel.
Setting aside the sexism in the workplace debate that followed, the story also highlighted some related health issues for any woman who does choose heels on a daily basis.
While the likes of Victoria Beckham are obviously huge heels fans, does forcing our feet into stillettos condemn us to a future of bunions and backache? And are flats actually any better in the long run?
Why high heels hurt
They can transform an outfit and make your legs look longer and slimmer, but high heels can also have a less than positive impact on your feet and back.
"The main reason for this is because they force your foot forward, altering the angle of your body so your weight isn't evenly distributed over the spine. This triggers pain from your knees all the way up to your lower back," explains Carnation Footcare podiatrist Michael Ratcliffe.
"And the higher the heels, the greater the impact on the front part of the foot, potentially leading to blisters, corns and, in the long-term, bunions."
Indeed, one study found that walking in 31/2-inch heels causes excess bone-on-bone movement in the knees, which researchers believe this could explain why women have a higher incidence of osteoarthritis in the knees than men.
Another study, published this year, suggested that high heels may actually alter the muscles around the ankle joint, leading to instability and balance problems. The Korean researchers behind this study concluded that by pushing our centre of gravity forwards and upwards, high heels force us to constantly change posture just to keep balanced, leading to an increased risk of ankle injuries.
"In addition, because you're almost on tiptoe, wearing heels tightens the calf muscles and stiffens the Achilles tendon," adds Ratcliffe, "which can lead to lasting leg ache - and make walking in flatter shoes very uncomfortable."
However, one small Italian study conducted by urologist Dr Maria Cerruto concluded that a pair of moderately highheeled shoes might strengthen your pelvic floor, leading to unexpected benefits. "They directly work the muscles which are linked to an orgasm," she stated.
So what is the best way to keep our feet and backs happy, but still look good?
Don't fall for flats
While the downside of heels is well documented, what many people don't realise is that too much time in flats can actually do almost as much damage to our feet.
"This is because popular shoes such as ballet pumps and flip-flops offer little arch support, allowing your foot to slide around, and this lack of stability can also increase pressure on the lower back and result in heel pain and pressure sores on the toes," explains Michael Ratcliffe. "This style of shoe also forces wearers to grip their toes throughout each step, which can alter the walking gait and lead to cramp and muscle fatigue."
Avoid sharp points
"Unsurprisingly, the constriction of the foot front and toes in pointy-toe shoes can cause major issues for your feet," says Michael. "The most common issue being 'hammer toes', in which your middle toes become painfully deformed and permanently bent forwards."
Any adult shoes, high or flat, that are not wide enough are also closely associated with the formation of bunions - those painful and unsightly bony swellings at the base of the big toe, which Mrs Beckham has famously suffered from thanks to her love of pointytoed heels.
Plump for a midi heel
According to foot experts, the ideal female shoe shape has a contoured foot base to support the foot arch and a small heel (2-4cm) to absorb heel impact.
And the good news is you don't have to swap style for comfort, as this summer's most fashionable shoes feature a mid-height block heel.
This is a shape that's ideal says Michael Ratcliffe: "The lower, chunky heel offers a wider, weight bearing surface area for your heel, which, in turn, allows body weight to be more evenly distributed over the whole of the foot when walking. This means less pressure over any one area and a reduced risk of ankle sprains."
So step to it and get yourself a pair.
FIVE WAYS TO GET SHOE SAVVY
1 Swap from high to low Alternating between mid-heels and flats on different days will lessen your chance of experiencing foot problems.
2 Measure up "The main cause of harm to women's feet is wearing shoes that are too small for them," says podiatrist Michael Ratcliffe, "so check your sizing." And bear in mind your feet can change shape over the years, especially after having a baby, so it's worth getting re-measured if you're not sure of your correct size.
3 Strap in Choose shoes with a strap or laces across the middle of the foot - these act like a seatbelt in a car for extra support.
4 Cushion the blow Keep super-high heels for occasional wear and try not to walk on them for more than a few hours at a time. Cushioned inserts can help lessen the strain on the balls of your feet for nights out. Try Carnation's Tip Toes (www.firstaidfast.co.uk, PS4.75)
5 Stretch them out After wearing heels, stretch out your calves before you go to bed to prevent tightening muscle problems. Simply drop your heel off the edge of a step until you feel a gentle pull in your calves - repeat the exercise on both sides.
CHOICE Block heel (below) is better for you than ballet pumps