What High Heels Are Really Doing to Your Body

What you need to know about your sky-high heels.

“Multiple guests, some older with medical conditions, were denied access to the anticipated world-premiere screening for wearing rhinestone flats,” reads the Screendaily.com report.

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Why high heels hurt so badJoin the club. No kidding—high heels can be hell. Check out the numbers: Women have approximately four times as many foot issues as men, according to the College of Podiatry—something podiatrists contribute to the wearing of high heels. What’s more, a 2014 survey by The American Podiatric Medical Association (APMA) found that nearly half of all women (49 percent) wear high heels, even though the majority of heel wearers (71 percent) say the shoes hurt their feet.

Cramming your feet into pointy-toed shoes can lead to a laundry list of foot problems: calluses, hammertoes, bunions, plantar fasciitis and neuroma (a tingling, burning or numbness in the foot). Pretty, huh? And the trouble can travel up your legs. A 2012 study in The Journal of Experimental Biology found that over time, heels can tighten and shorten your Achilles tendon, leading to muscle spasms

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What’s more, high heels can throw your body alignment out of whack. “Your feet are the foundation for your entire body, and when you walk in heels, you change your center of balance,” says Emily Splichal, DPM, podiatrist, human movement specialist, and author of Everyday Is Your Runway: A Shoe Lover’s Guide to Healthy Feet & Legs ($16, amazon.com). When you slip into a pair of high heels, Dr. Splichal says, your feet slide forward into the shoe.“The increased weight on the balls of your feet causes your pelvis to tilt forward,” she explains. To compensate, you lean backwards, increasing the arch in your lower back, which puts a strain on your lumbar spine, hips, and knees. The higher the heels, the greater the strain.

Your guide to pain-free heel-wearing

Of course, for a lot of women (for example, those at the mercy of the Cannes Film Festival fashion police), it’s hard to avoid heels altogether. And then there are those who don’t mind suffering for the sake of fashion. So here’s how to keep the shoes while minimizing the damage.

Go lower. “Stick with heels that are 3 inches or less. Anything higher will change the biomechanics of how you walk, compounding the stress you put on your back and hips,” Dr. Splichal says.

Steer clear of the skinny stiletto. “A thick heel can offer stability and support, and help spread the load more evenly,” says Elena Blanco, DPM, of New Jersey’s Hackensack Center for Foot Surgery.

Be aware of your posture. “You should be wearing the heels—the heels shouldn’t be wearing you,” Dr. Splichal says. “Be aware of how your body is positioned and counter the tilt of your pelvis by keeping a neutral stance—shoulders back, chest out, soft knees. And resist the urge to fall on the ball of your foot by distributing weight evenly on the heels and balls of your foot.”

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Try a new slant. Another way to relieve some of the pressure on the ball of your foot and toes, Dr. Blanco says: Consider a style with a gradual incline like platforms or wedges.

Change things up. “Every shoe has different stress points, so tease your heel height throughout the week to give each part of your feet a break,” Dr. Splichal says. “If you wear 3-inch heels one day, switch to a 2-inch heel the next, then try a flat.” Another way to give your feet a break, per Dr. Blanco: “Tuck your heels in your bag and wear flatter, comfier shoes when walking to and from work or to a big event. Then swap the shoes when you arrive at your destination.”

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How to undo the damageYep, heels can affect your feet, hips, and back—but you can prevent pain with a few simple moves:

Work the hips. “The more flexible your hips are, the better you’ll be able to tolerate the stress that heels put on your body,” says Dr. Splichal. “Keep them limber by doing at least five minutes of hip flexor stretches before and after putting on high heels.”

Whip out a golf ball. And roll it under the ball, arch, and heel of your foot for five minutes in the morning and evening. This feel-good move massages feet and keeps them flexible.

Step it up. Stand on a step barefoot, letting your heels extend off the edge. With your weight on the balls of your feet, lower your heels down as far as you can, then rise up on your toes and slowly return to the starting position. Repeat for about 30 reps.

Flex your toes. Sit barefoot in a chair and loop a towel under the toes of your foot. Pull up gently on the ends of the towel, pulling your toes toward your chin. Repeat 10 times on each foot.

Write the alphabet. To strengthen your ankles and improve range of motion, use your big toe to trace each letter of the alphabet in cursive in the air, moving only the foot and ankle.

Make like a monkey. Place about 20 binder clips on the floor. Using your toes, pick up one at a time and drop it into a cup. This will stretch the bottoms of your feet.

This article originally appeared on Health.com.