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Just can’t get enough new high heel shoes this spring? You should remember to measure your feet and look for shoes that will not lead you to pain, suffering and even surgery. For millions of women, high heels are a staple of their everyday wardrobe. They make women appear taller, and many feel thinner and sexier when wearing them.

But according to San Diego’s Alvarado Hospital foot and ankle specialist, Dr. Eric Horton, stylish heels are rooted in instability and delicacy, the healthy foot’s sworn enemies. The list of deformities resulting from high heels reads like an encyclopedia of anatomical horrors. Yet despite the threat of bunions, hammertoes, neuromas and other conditions, there’s something about the high heel women just can’t kick.

According to Dr. Horton, an orthopedic surgeon, nearly half of all women who wear heels experience pain or more severe medical conditions. "If women are resolute in wearing high heels, there are a few recommendations that they should consider,” said Dr. Horton,

He collaborated with Dr. Sheryl Strich, president of the American Association of Women Podiatrists, to compile the tips below:

  • Give those digits some room. Pointy or tight toe boxes cause bunions by forcing the joints to misalign, which will only worsen with continual wear and require surgery to reverse if they become debilitating.
  • Remeasure your foot. Because of gravity, our feet are slowly spreading outward. Ask a salesperson at a shoe store or department store to help you determine your new shoe size.
  • Avoid heels over 2 inches, which put too much pressure on the ball of the foot and cause additional toe squeeze. They also throw off your posture.
  • Buy shoes slightly larger than your size, as feet tend to swell during the day.
  • Look for flexible soles. Synthetic materials such as plastic don’t allow for a balanced dispersal of forces on the foot.
  • Strapped heels should have enough to keep your foot snug. Minimal straps allow the foot to slip around and can cause nasty cuts. Breathable material is important; sweat-induced friction causes sores.
  • Try to only wear heels for a maximum of four hours.