I was sitting in a podiatry clinic in Leeds two winters ago. One sock off, foot resting on a foam wedge and waiting for a diagnosis. “Look at this” said Mr Adeyemi. Straight talking Londoner who’s clearly had this exact conversation four hundred times. He picked up my foot, flipped it over like he was checking for a barcode and I steadied myself. Come on then, I thought. Say it.
Tell me it’s the heels. Tell me it’s the thirty- one pairs currently living in my hallway cupboard blocking the door like a shoe rack Tetris abomination. Tell me I did this to myself with a decade of four inch stilettos drunk evenings and I’ll take it on the chin. Men have nicer calves than me for less.
He didn’t say that. He said “some of this is your mother’s feet, love”, paused for the impact to register before following it up with “the shoes haven’t helped”.
That pissed me off more than a blunt yes would have. I wanted to vilify something. I wanted the shoes to be the villain in my story so I could stuff every pair of pointed ones I own into a fire and feel better about my swollen joint. Instead I got a shrug laundered through medical terminology and took myself on a genuinely mortifying journey through podiatry journals and forums where women argue about hallux valgus with more vigour than actual humans reserve for footballer weddings.
The bunion blame game isn’t as simple as Instagram makes out
You know what no one warns you about before googling foot disorders at 11pm with your foot propped up on a bag of frozen peas? Bunions are genetic. Like actually, it’s really pretty conclusive if you look at the research. Structural shape of the foot, angle of your first metatarsal, how your ligaments are constructed, it’s all passed down from your parents like a crooked nose or a widow’s peak. One study in the Journal of Foot and Ankle Research found that heritability estimate for bunions “ranged from moderate to high…approximately 90 per cent in some family studies” which honestly doesn’t sound like a whole lot til you compare that to any Instagram post using the phrase “toxic pointed toe shoes”. My mum has bunions. Her mother had bunions. Grandma got a photo taken of her feet recently so I can’t link to one for you but trust me when I say there was never a doubt that I’d end up joining that ladies club before I owned a heel higher than a basic school shoe. Preventable? Yes. Absolved of all blame? No way Jose, heels.
Which doesn’t absolve heels entirely though and this is where I think things get shoehorned into either “heels are the cause of bunions, end of story” or “heel verdict NOT GUILLTY, ITS ALL IN THE GENES” when the truth – and the actual information helpful to people who care about this kind of thing – sits in that frustrating middle ground that no one wants to click on. Wearing heels doesn’t conjure your bunion out of thin air. Most podiatrists I’ve since spoken to agree that what heels do is exacerbate and speed up a structural weakness that was always likely to develop given time. Narrow shoes with a pointed toe box squeeze your big toe inwards. A heel height of about two inches or more forces your centre of gravity forward onto the ball of your foot/toes and if your first metatarsal joint was already going to fold like a cheap suit under pressure, marching around in shoes that ask it to do more than it’s designed to is kinda asking for trouble. Heels won’t give you bunions that need surgery if you were never going to get them. But if you were going to, at some point, yeah, maybe heels are what take you from a mild bump that never really bothered you to the severe deformity that has you sobbing into shoe foam at 35.
What my own feet, and my mother’s, actually told me
For years I held an opinion on the heel/bunion question that I’m only admitting now because enough time has passed that it’ll reek less of arrogance and more of “god what was I thinking”. Whenever heels came up and bunions happened to be in the same sentence I would bang on about how my nan had spent her life wearing flat shoes and had far worse feet than me, which is a nutritious dietary intake of irrelevant bollocks. I said this to someone’s mum at a hen do once. Honestly, Saskia if you’re reading this, apologies for being a complete tit in Whitby. I had the cocksure air of someone who’d done literally no research but loved being proven right. Full stop. Because I picked one little anecdote about my own family and tried to use it to discredit years of podiatrists recommending women steer clear of the more damaging shoe shapes.
What I’d ignored was that although genetics load the gun, heels very well and truly scream-firefight at your feet if you let them. My nan wore flat shoes every day for seventy years. They never once had to deal with pointers or skyscraper heels, because that’s not what ladies wore in her working class neighbourhood when she was growing up. My fucking heels started bothering me in my mid-thirties. Because I wore a particular type of damaging shoe so often and for so many years, my feet hadn’t had the chance to slowly adjust to slowly worsening alignment like my mum’s and my nan’s had. Same genetic starting line, completely different paths from there. Mr Adeyemi laughed when I told him the hen do story. “That’s the thing, love. You’re both right and also neither of you are, that’s foot blogging for you.”. *
*I am not and have not been foot blogged by Mr Adeyemi.
I want to be blunt about heels, bunions and the internet. There’s a lot of brow-furrowing about heels not being feminist from women who spent their whole life wearing them, and equally as many people giving them a pass that lets them migrate unchecked into women’s wardrobe without question. My nan was predisposed to bunions so they shouldn’t bother ladies in the present, doesn’t give ANY shoes a free pass to destroy feet. They’re a tool, like anything else. If you’re going to use a hammer, you do so with knowledge that you could poke your eye out if you’re reckless. Wear heels in extremely pointed, very narrow shapes and you’re playing rng with how quickly your naturally good feet decide to rebel against you. I’m saying that not to shame anyone out of enjoying shoes they love. I’m saying it because I sat in that same podiatry clinic wondering if I needed surgery and I wanted someone to look me in the eye beforehand and say these three words, quite plainly: “You messed up your feet.”
The heels that were actually the problem, and the ones that probably weren’t
Once I stopped getting offended on behalf of almond toed heels everywhere I actually looked at my own shoe rotation and cringed at the pattern I saw. It wasn’t necessarily height, it was height and a tightly pointed toe box combined. Worn repeatedly, for long periods of time and usually – but not always – on hard floors. I have a pair of block heeled boots I lived in throughout one winter, about three inches high but roomy as fuck across the toes. Never had an issue once. Pointy heeled mules from a brand I’ll discreetly not mention were hands down two of the best shoes I owned. Looked amazing. Killed my feet after ninety minutes of wear. Hell maybe twelve. My toes had enough room to touch under regular shoes, let alone that thin of a toe box. Point is I wore the boots nearly daily throughout winter. The mules….twice? Three times? Were they really enough to do lasting damage? Ask me now, seven weeks after that appointment and I’d put money on them wrecking my feet more than the boots did in a year of regular wear.
My friend Odalys is an orthopaedic physio who has little time for any kind of fashion bullshit, and summed the whole problem up to me over a coffee that went cold from me staring at it so hard she said it: “they squeeze your toe together, Emma. Heels don’t make your toeunion worse on their own, but the more heels you wear, the more they shift your weight forward and squat your toe in that damn narrow shoe.” She’s since become my go-to for shoe advice when I’m slipping up my old habits and googling again, and that sentence has stuck with me because when you think about, two heels that are the same height can be drastically different in terms of how soft they are on your feet. A kitten heel with a horribly pointed toe can wreck you while a four inch heel with a decent rounded almond or square toe and enough room across the forefoot will probably be fine. Not what you wanna hear when you’re scrolling Instagram for easy answers but boy is it the truth.
So now what? Do I hate heels? No. Am I suddenly like one of those yoga mat wearing hipsters who’s given up on all things fancy? Also no. Mother fucking no. The difference now is I care way more about which heels I’m wearing than I used to. I swear to god this is the least exciting part of my feet journey but it’s made all the difference. I avoid tightly pointed toes because they pinch when I try them on and they’ll only get worse by the time I get home. I pay way more attention to how long I’m wearing things for, because lord knows I spend enough time on my feet at my actual job. My mother still gives me literally zero credit for worrying about this and scoffs every time I mention heels and surgery in the same sentence. Every. Single. Time. Said to me recently “well you should’ve listened to me when you were younger and wore flat shoes like a normal person.” Yep, plain as day my mum taught me to believe flats were better for your feet, only instilled such a fear of wider shoes that I welded my body into a point for a decade straight afterwards.
If you’ve stuck with me this far, thank you. Here’s the takeaway. Don’t ask me if heels cause bunions because I’ll sigh, roll my eyes and tell you to ask again. Squirt your QUESTION about heels into this sentence instead: “can wearing THE wrong heels speed up the development of a bunion if you were already genetically more likely to get one?” Now we’re cooking with fire, friends.
Here’s your answer: probably? If you wear very narrow pointed heels a lot, and by lot I mean multiple times a week for several years, there’s a chance you’re going to have a problem down the line. Does that mean every pair of pointed heels will send you towards surgery at 40? Nope. But it also doesn’t give you carte blanche to go forth and pound the gravel like it’s nothing. You heard me. And Mr Adeyemi. Hear your mothers.
