d, regular heel wearing can actually change the shape of our feet and prevent them from doing their jobs properly in any kind of shoe. (You know, walking, running, things like that.) The Barbie-like position our feet take on in heels shortens the Achilles tendon, the tissue that connects the calf muscle to the heel bone. This becomes inflamed and irritated, making it increasingly difficult to stretch, making walking in flats or even running shoes increasingly painful over time.

Is It the Style?

All right, I’ve been scared into thinking about my heel choices. If I lay off of the spikes that are extra hard to balance on and opt for thicker heels or even wedges, will I counteract this damage at least a little? Probably not, according to a series of medical studies.

In 1998 a team of Harvard researchers linked heel wearing and a painful, degenerative joint condition called knee osteoarthritis—basically the breakdown of the knee’s cartilage. Surgeons perform about 300,000 knee operations each year because of this condition. The lead professor in the study, Dr. D. Casey Kerrigan, associate professor of physical medicine, and her team found this connection in women who wore very narrow stilettos. In 2001 they went back and took a look at the chunkier heels that are now in fashion (and that I’m clinging to in hopes of them being less harmful) and published their findings in The Lancet. Even though they’re often more comfortable and feel easier to balance on, thicker heels also increase the risk of knee problems: “Wide-heeled shoes give you the perception of more stability when you’re standing, and they feel comfortable, so women wear them all day long,” Kerrigan writes. “They are better for your feet than stiletto heels, but just as bad for your knees.” Both types increase knee pressure by around 25 percent. But my knees feel just fine …

“It takes a long time to feel the effects of knee osteoarthritis,” writes Kerrigan. “And once you do, it’s too late.”

So if we’re talking about knees, low-heeled shoes (meaning less than two inches) are our safest bet. Do wedges offer any benefit?

When it comes to wedges, the rise still matters. As we learned from the Harvard study, our center of gravity is still changing as we’re pushed up onto the balls of our feet, which is bad for the back. We’re also still pushing the foot up from its natural, flat position. A three-inch rise means seven times the body weight of a one-inch heel is pressing down on the front of the foot. That’s a whole lot of stress, heel or wedge.

Easing the Stress

Now that I’m no longer blissfully in denial (but still unwilling to quit the habit), is there anything I can do? For those of us stubborn heel devotees, there are some tricks for easing the pain and at least prolonging the damage a bit:

    * Try not to stand in heels for longer than half an hour and don’t walk in them farther than absolutely necessary. Bringing a pair of commuter shoes can save thousands of hours and pounds of pressure, prolonging the days we can continue wearing them around the office once we get there.

    * Break them in before you wear them out. This is more than wearing them fiv

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