(Photo: Bryan Whitney/Getty Images)

What kind of damage are we talking about?
Just for the record, there’s nothing wrong with wearing a high heel. The problem is where you wear it, when you wear it, and what you’re doing when you wear it. If someone’s going to take a twenty-block walk in stilettos, they’re crazy. The heel puts a tremendous amount of force on the front of the foot, and the foot’s not built for that. It can cause metatarsal problems, exacerbation of bunions, and neuromas. Dancing’s also a killer. I once coined a fracture called the “Gloria Gaynor fracture”—she’s a patient of mine.

So if we stay away from stilettos we’ll be fine?
Not exactly. Flats can be just as bad. They put a lot of stress on the Achilles tendon and the plantar fascia in the heel. If you have any ankle injuries, a flat shoe can actually exacerbate your problem.

It sounds like we should just go barefoot.
Actually, I think a one-inch heel is perfect. It really doesn’t distort the relationship between the front of the foot and the back of the foot.

Suppose we can’t give up our three-inchers’—what’s your best piece of advice?
Don’t go shoe shopping in the morning. Go in the late afternoon or early evening. You want a shoe to accommodate the foot at its most swollen moment. Also, don’t try to fit a size-8 foot into a size-6 shoe. People think they can “break in” a shoe. There’s no such thing. Either it fits or it doesn’t.

Related:

• Archive: “The Everything Guide”
• Articles by Sarah Bernard
• Table of Contents: Feb 12, 2007 issue of New York | Subscribe!