We all know the pain of high heels after a long day or the soreness of walking several miles in flats. But what are our shoes actually doing to our feet -- and which shoes are the ones we really should be wearing? We talked to Dr. Jacqueline Sutera, a doctor of podiatric medicine and surgery in New York City, and Dr. Neal Blitz, Chief of Foot Surgery/Associate Chairman of Orthopedics at Bronx-Lebanon Hospital and the creator of the Bunionplasty, to break down the dangers of all our favorite shoes.
Wearing heels shifts your weight to the balls of your feet, which puts pressure on your foot. This also creates a balance problem: It forces your knees and hips forward, hurting your back and legs. Wearing these shoes can cause: hyperextension, ankle sprains, midfoot fractures, neuromas (benign nerve tumors), pinched nerves, bunions and hammertoes.
Wedges also have heels, which puts pressure on your foot and juts your body forward. But the heels tend to have more cushion, plus they often have platforms which protect the ball of your foot and reduce the incline. This helps with balancing. Wearing these shoes can cause: Hyperextension, ankle sprains, midfoot fractures, neuromas (benign nerve tumors), pinched nerves, bunions and hammertoes.
Depending on the heel height, these can cause similar issues to stilettos. Keeping heels to two inches or below is best -- as Dr. Blitz explains, "There's a rule of thumb: 25% of your body weight gets increased for every inch that you go, in terms of your body weight on the front of the foot." But in booties, the material around the ankle helps hold the foot steady, putting you at less risk for injuries. "When you incorporate the ankle into the shoe, you add stability," Dr. Blitz says. Wearing these shoes can cause: hyperextension, bunions and hammertoes.
If the heels are high, you’re going to have the same issues as with stilettos -- hyperextension of the back, pressure on the balls of your feet and lack of balance. But the casing around the leg creates more awareness of the leg in general, says Dr Blitz, which can help with stability. Wearing these shoes can cause: hyperextension, midfoot fractures, neuromas (benign nerve tumors), pinched nerves, bunions and hammertoes.
"There is such a thing as too flat," says Dr. Sutera. Shoes that are too flat don't provide adequate arch support, cushioning or shock absorption, which those with flat feet need. However, as Dr. Blitz notes, flats are flexible and cause the muscles to work harder, making them stronger -- that's a good thing. Another problem: There's a higher risk of the sole being pierced by a foreign object. Wearing these shoes can cause: inflammation, tendonitis, heel pain, strains, stress fractures and external injuries (e.g. stepping on a nail).
These sneakers have a thicker sole than flats, so they do provide shock absorption and cushioning. For those who do need extra cushioning or arch support, Converse-style sneakers allow you to add extra support internally (e.g. Dr. Scholl's). They're also very flexible -- the soft canvas exterior can be more comfortable for those suffering from bunions and hammertoes. The material also protects your foot from the environment. Wearing these shoes can cause: inflammation, tendonitis, heel pain, strains and stress fractures.
"Too much cushion is not the best thing, either," says Dr. Blitz, "When you have a lot of cushion, you're not getting the foot-brain feedback" that allows you to sense the ground. These shoes are ideal for forward motion, i.e. running, walking, jogging (not hiking, dancing, cycling, etc). Wearing these shoes can cause: chronic stress injuries, particularly to the heel.
"Most flip-flops are too flat, too thin and too open," says Dr. Sutera. This exposes the foot to the environment and doesn't provide arch support or cushioning. The thong that sits between your toes is also dangerous as it forces your toe muscles to over-grip. Plus, when your big toe hangs off the flip-flop, which Dr. Blitz calls "muffin toe," you increase your risk for toe fractures. Wearing these shoes can cause: inflammation, tendonitis, heel pain, strains, fractures and external injuries (e.g. stepping on a nail).
Rain can cause a moist environment, plus rainboots tend to be made of Latex or other thick, non-breathable materials. "You sort of walk more like a Stormtrooper, so you just might get more fatigue from walking in them," says Dr. Blitz. The top of the boot can also rub uncomfortably against your calf. Wearing these shoes can cause: mold, fungus, bacteria, wart viruses and blisters.
Infographic by Alissa Scheller for the Huffington Post.
Sure, it may make you feel more confident during a game of beach volleyball, but a bikini wax can also pose some health risks. In 2009, the state of New Jersey almost went as far as to <a href="http://www.womenshealthmag.com/health/bikini-waxing-dangers" target="_hplink">ban the fuller Brazilian bikini wax</a> entirely after two women ended up in the hospital. Similar to eyebrow waxing, there's a possibility of burning the skin, Krant warns. And you also run a risk of bacterial, viral and fungal infection. "Once the hair is ripped out, the skin is actually damaged for a while until it heals," she explains. "Anything can get in there." That risk is upped for Brazilian waxes, as the skin area in the back, in particular, is near a lot of bacteria. Different states have different licensing procedures for waxing, so check yours out ahead of time to make sure the salon complies (also ask if your waxer has received special training in the Brazilian technique, if applicable). And keep an eye out for fishy procedures -- like double dipping, or placing a wax stick back into the communal bowl after it has already touched your skin (imagine getting a brow wax after someone else's bikini wax). Ingrown hairs are more likely to develop on the bikini area than the eyebrows -- cleanse gently at home after your wax and speak to your doctor if ingrowns show any sign of infection.
That full, achy feeling from an ear wax blockage may be annoying -- and salons have a solution for it. Ear candles are 10-inch-long, hollow <a href="http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm201108.htm" target="_hplink">cones that</a> are burned in the ear to supposedly remove wax, impurities and toxins while improving hearing. But experts warn the procedure is dangerous -- the FDA has even issued a safety warning cautioning that the procedure <a href="http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm201108.htm" target="_hplink">can cause serious health problems</a>, including burns, perforations in the ear drum and blockages in the ear canal. "The ear is a sensitive organ," says Gordon Siegel, M.D., associate professor of clinical otolaryngology head and neck surgery at Northwestern University's Feinberg School of Medicine. "I don't think that I would trust any sensitive organ to a salon." Siegel has seen patients with serious perforations from candling, which he compares to sticking a vacuum cleaner in your ear -- and while many holes will heal on their own, others can require surgery and even cause long-term hearing loss. Instead, he recommends that patients try one of the many over-the-counter wax removal products, most of which soften the wax and then use a syringe to irrigate the ear. If you have symptoms in your ear, though, and don't have a history of wax -- or if you can't remove it on your own -- it's best to see a physician. To prevent build-up in the first place, you can use a few drops a week of a half peroxide/half water mix in the ear, or periodically let water run in and out of your ears in the shower, Siegel says. Cleaning the ears with a <a href="http://www.nlm.nih.gov/medlineplus/ency/article/000979.htm" target="_hplink">Q Tip</a> can actually push wax further into the ear causing additional blockages -- not to mention that it could cause a serious perforation.
You may have a little more trouble relaxing into that massage chair with a magazine after this one -- an unsanitary pedicure could lead a viral infection (such as warts), bacterial infections from ingrown toenails and agressive filing, or a fungal infection of the skin and nails, among other serious health problems, says Jackie Sutera, a New York City podiatrist. Since some salons have better sanitizing practices than others, she recommends that you always bring your own tools (her favorites are <a href="http://www.tweezerman.com/store/catalog/feet/" target="_hplink">Tweezerman</a>), including cuticle nippers, toe clippers, a nail file, nail clippers and, most importantly, a foot file. "That's one of the dirtiest things in that whole salon," she says. "There's a misconception that because they put it in a blue solution or because they put it in a thing that looks like a toaster oven, it's clean -- but it might not be." Sutera recommends hitting the spa earlier in the day, when things tend to be a bit cleaner and sanitary -- before dozens of feet have soaked in the same bath on the same day and before technicians have a possibility of getting tired. And she would skip the "Wednesday Special" (that too-good-to-be true package deal for a mani/pedi combo), as it drives a lot of business and, correspondingly, could up your germ exposure. Also, don't give into the temptation to soak your feet too long. "It's a cesspool in there," Sutera says of the foot bath. "Don't sit there and soak in that water forever." As far as those foot razors that promise to shave your callouses down for sandal-ready feet -- skip it. "It's really dangerous," Sutera explains. Going at the heels too hard can reveal deep layers of skin that should never be exposed, leading to permanent damage or even scarring. Instead, just keep a pumice stone in your shower to keep up with the daily maintenance yourself. Don't shave your legs for at least 24 hours before the appointment, suggests Jessica Krant, Founder of <a href="http://www.jessicakrantmd.com/" target="_hplink">Art of Dermatology</a> in New York City -- freshly shaved skin can be more prone to infection, especially when a technician is massaging up your thighs. Post-pedi, slip your toes into your own flip flops -- and for extra safety, clean your own feet when you get back home, Sutera says.
"Aside from the obvious -- ending up with the wrong shape, there are plenty of things to look out for when waxing your brows," Krant says. In the long run, repeated waxing can do permanent damage to the hair follicles so that, over time, the hairs stop growing, she explains. And in the short term, other risks include "burns from wax that is too hot, skin peeled off from waxing that is too vigorous and infections after waxing when bacteria may get into microscopically traumatized skin," she says. If you're using a retinoid cream (for acne or wrinkles) on any area of your face, the skin will be more fragile and, ultimately, more easily ripped or burned. You'll need to stop medications for at least a week prior -- and check with your doctor first. Make sure that your technician is a licensed aesthetician with a current license, and try to stick with a cream-based wax if possible to avoid ripping off skin, says licensed aesthetician Scott-Vincent Borba, founder and creator of <a href="http://www.borba.com/" target="_hplink">BORBA</a> and author of <a href="http://www.amazon.com/Skintervention-Personalized-Solution-Healthier-Flawless-Looking/dp/product-description/0757315526" target="_hplink">"Skintervention: The Personalized Solution for Healthier, Younger, and Flawless-Looking Skin."</a> If that's not possible, he suggests asking the waxer to first cleanse the skin with witch hazel, then add two layers of finely ground corn powder (common in salons). At the end, finish with an antibacterial cortisone mixture over the area.
"Unfortunately, manicures have many dangers," Krant says. "You can get fungal infections, bacterial infections and permanent nail disfigurement depending on what happens to you there." Stick with salons you're used to, or look online for reviews before trying a new spot -- and, like pedicures, you may want to bring your own set of tools, Krant suggests. When you first enter a salon, evaluate general cleanliness -- dust, hair/nail clippings or dust on any surfaces or floors, <a href="http://www.probeauty.org/docs/nmc/WhatToLookNailSalon.pdf" target="_hplink">according to guidelines</a> from the Professional Beauty Association, the National Cosmetology Association and the Nail Manufacturers Council. These organizations also suggest that you look at where tools are stored and whether they are dusty or dirty before use. Any signs of clients with infected nails, toenails or feet. or products in unlabeled containers, should be a red flag. (See the rest of their guidelines for evaluating the safety of nail technicians and other salon service providers <a href="http://www.probeauty.org/docs/nmc/WhatToLookNailSalon.pdf" target="_hplink">here</a>). Once you're comfortable with a place, it's important not to allow your technician to cut the cuticle away. "The cuticle is actually a very important seal between the outside world and the inside of your body," she says. "If it's cut or detached from the nail, moisture can get in, and that's when a bad infection can start." Instead, have him or her soften and then very gently push down the cuticle with an orange stick -- the same problems can happen from cutting the nails too short, so keep an eye on length. Signs of infection include swollen red cuticles, pain, a white, yellow or black material between your nail-bed and your nail, and a change in the shape of your nail, according to Krant -- if you notice any symptoms, see your doctor immediately.
Would you ever send your hands to a tanning bed alone? Probably not. But preliminary research on the popular gel manicure treatments has found that the UV-A nail lights used throughout the process could possibly contribute to <a href="http://archderm.ama-assn.org/cgi/content/full/145/4/447" target="_hplink">risk factors for skin cancer</a>, according to research published in the <em>Archives of Dermatology</em>. Certain gel procedures may also be counterfeit, some experts warn, causing serious health problems. <a href="http://abcnews.go.com/GMA/ConsumerNews/gel-manicures-harm-nerves-properly/story?id=11029335" target="_hplink">According to a "Good Morning America" article</a> last year, one gel customer warned that a botched gel job may have caused her possible nerve damage. Research the procedure ahead of time to make sure your technician is sticking to the real deal, instead of adapting the steps.
The popular Brazilian blowout promises smooth, shiny locks -- and maybe a dose of formaldehyde. <a href="http://www.huffingtonpost.com/2011/04/13/brazilian-blowout-hazard-alert-osha_n_848741.html" target="_hplink">This past April</a>, the Occupational Safety and Health Administration issued a Hazard Alert for people working with the products because of the dangers associated with exposure to the chemical (although some of the products were even labeled "formaldehyde free"). <a href="http://www.ewg.org/release/government-warns-of-health-risks-from-hair-straighteners" target="_hplink">The Environmental Working Group</a> also warns that the substance could pose serious health risks for workers and customers -- right now, <a href="http://www.fda.gov/Cosmetics/ProductandIngredientSafety/ProductInformation/ucm228898.htm" target="_hplink">Brazilian blowouts are still under consideration</a> by the FDA.
A careless facial performed by an untrained technician can result in serious problems, such as infections or skin that is literally burned off. To stay safe, Borba suggests asking three questions at the salon: 1. Is the person working on your skin certified to be a skin expert? Look at the certificates to make sure he or she is. 2. If the technician is using any electronics or chemical treatments, is he or she used to working with them? Some technicians aren't trained on all of the equipment, especially because it advances so quickly. 3. Is everything sanitary and in a place you can see it? "It should look almost like you're walking into an operation when you are getting a skincare treatment," he says, suggeting that you not allow your eyes to be covered during a treatment to allow you to see that every new tool is coming from a UV sanitizing system. Krant takes that one step further, suggesting that facialists steer clear of any strong chemicals -- only have a medium depth chemical peel if it's prescribed (and supervised by) a dermatologist, she says. And while she thinks gentle extractions are generally OK, Krant suggests avoiding anyone who does it too vigorously, which could damage skin and potentially cause scarring. "If you feel uncomfortable with something that's being done, make sure that you say so and don't proceed with it," she says. For those with extra-sensitive skin, Borba suggests requesting a patch test, trying out the various solutions behind the ears, where your elbow connects or underneath the area where the knee bends, to see if there's any redness, irritation, swelling or hives. When in doubt, do like he does when traveling -- bring your own, preferred products.
Tanning Bed Visits
At the risk of being extremely obvious, a trip to the tanning bed only results in a <em>not</em>-so healthy glow. According to the <a href="http://www.cancer.gov/newscenter/entertainment/tipsheet/tanning-booths" target="_hplink">National Cancer Institute</a>, female tanning bed users are 55 percent more likely to develop malignant melanoma -- those with light skin and a personal or family history with skin cancer are at an even higher risk. Instead, try a self-tanner, either at-home or at the salon.
This story appears in Issue 74 of our weekly iPad magazine, Huffington, available Friday, Nov. 8 in the iTunes App store.