Here's a fashion tip you won't find in the pages of Vogue: lose the heels. And the pumps, and the sandals. Why? Nearly two-thirds of women who reported heel and ankle pain regularly wore these types of shoes at some point in their life. That's according to a new study from the Boston University School of Public Health and the Institute for Aging Research at Hebrew SeniorLife. Makes you wonder whether The Devil Wears Prada should be retitled Prada Is the Devil You Wear.

"We found an increased risk of hind-foot pain among women who wore shoes, such as high-heels or pumps, that lack support and sound structure," says the study's lead author, Alyssa Dufour of the Institute for Aging Research of Hebrew SeniorLife's Musculoskeletal Research Program.
The findings of the study, reported in the Arthritis Care & Research's October issue, are probably about as surprising as news that mink are killed to make fur coats. But researchers say the study is one of the first to look at the association between shoe wear -- beyond just high heels -- and foot pain. The results seem to reinforce, once again, the one-must-suffer-for-beauty paradigm.

To conduct the study, some 3,300 American men and women were asked to respond to questions involving 11 shoe types. The types were classified as "poor" (high heels, pumps, sandals, and slippers), "average" (hard- or rubber-soled shoes, work boots), and "good" (athletic and casual sneakers).

Researchers say more than 43 million Americans -- nearly 30 percent of women and 20 percent of men -- reported generalized foot pain, a finding in line with other foot-pain studies. But 64 percent of women who reported hind-foot pain had worn "poor" shoes, including high heels and pumps, in the past, suggesting a "significant association." Apparently, the shoe industry has been less sadistic when it comes to men's shoes: researchers found no significant link between foot pain and the types of shoes men wear.

Foot and toe problems are among the top 20 reasons for physician visits among those 65 to 74, the researchers say. Despite the prevalence of the symptoms, health professionals know relatively little about what causes foot pain in older adults. While it's true that women are more likely than men to have foot pain, researchers say they don't know if it's because of a higher prevalence of foot deformities, underlying disease, shoe wear, or other lifestyle choices.

When people walk, the study notes, "a significant biomechanical shock is delivered to the foot each time our heel strikes the ground." Shoes such as sneakers and other athletic footwear that researchers classify as "good" often have soles and other features that soften this shock and protect the foot. Of course, the heel and ankle take the brunt of this shock. Researchers say this may explain why high-heel wearers often report pain in this part of the foot.

"Young women," Dufour says, "should make careful choices regarding their shoe types in order to potentially avoid hind-foot pain later in life."

Among some of the researchers' recommendations, women and men should try on shoes at the end of the day, when their feet are at their longest, and should avoid high heels and shoes with pointed or tapered toes. Researchers also urge people to choose shoes based on comfort rather than fashion. That's not likely to go over well with Anna Wintour.

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