CORNS/CALLUSES: Corns (occurring on the top of the feet or toes) and calluses (occurring on the bottom of the foot) are areas of thickened skin that develop as a result of repeated friction or excess pressure. They develop to protect the area from further irritation but they can become painful if they get too thick. Excess pressure at the balls of the feet is common in high-heel wearers. Toes can also be crushed and forced into an unnatural shape as a result of wearing high heels. This can result in long-term joint damage such as clawing of the toes, which can cause corns to develop on the tops of the disfigured toes. “The tech should assess corns and callus areas, and pay special attention to them with scrubs, foot files, and pumice stones,” recommends Krista Ammirati Archer, DPM, PC. “But never use sharp instruments like Credo blades.”

PAIN/INGROWN TOENAILS: In a survey of 1,000 U.S. adults conducted by The American Podiatric Medical Association, nearly half of all women (49%) wear high heels, even though 71% complain these shoes hurt their feet. Specifically, high heels cause excessive forefoot pain, numbness, and pain in the balls of the feet. “When wearing high heels, body weight is transferred to the ball of the foot, smashing the foot into the toe box of the shoe at one to three times the bodyweight,” says Archer. “Bruised and ingrown toenails are also common from this pressure, and high heel wearers may be more prone to nail fungus from toenail trauma.”

NEUROMAS: Neuromas, also known as pinched nerves, or nerve tumors, are benign nerve tissue growths but can cause pain, tingling, burning, and numbness. They’re often caused by shoes that force the toes to be squeezed together and shoes with heels higher than two inches. “Shoes at this height increase pressure on the forefoot area,” Archer says. “Because high heel wearers walk largely on the balls of their feet instead of the natural heel-toe stride, it can cause nerve compression and resulting numbness.” If your client is suffering from neuromas, suggest that she alternate days of wearing high heels with wearing flats.   

ACHILLES TENDON TIGHTNESS: Wearing high heels daily can cause the strong tendon at the back of the ankle, the Achilles tendon, to shrink. Unfortunately, this not only causes pain but can also increase risk of injury, even while wearing flat shoes. Wearing higher than three-inch heels shifts body weight forward, which strains the back, causes destabilization, and shortens the Achilles tendon, causing pain. Doing yoga — especially Downward Dog pose — and performing lengthening stretches for the backs of the legs (hamstrings), calves, and lower back helps to counter the shortening of the Achilles tendon and relieve pain.

High-Heel Wearer’s Rx

Tips when performing pedicures on high-heel wearers:

> Use a mineral foot soak, such as Epsom salts, that contains magnesium. This mineral is absorbed into the body through the skin and can help ease pain, and build and repair tissue.

> Keep the client’s toenails short to help prevent ingrown toenails.

> Take extra time with the massage. Feet and legs are held in an abnormal position when wearing high heels, and massaging deeply can relieve resulting tension and spasms.

> Use a highly emollient moisturizer. Wearing high heels causes pressure points on the foot that can cause skin breakdown and calluses.

> Be able to assess and notice a potential problem in order to refer the client for medical evaluation.

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