Do high heels cause bunions?

Almost every day, often several times a day, I am told with great conviction that bunions are caused by wearing high heels. It seems to be a matter-of-fact in popular wisdom that high heels cause bunions. While this may seem like a “logical” and simple answer, it is, unfortunately, completely wrong. High heels do not cause bunions, although they can aggravate the pain and discomfort associated with them, while causing many other issues besides. As in the picture shown above, wearing high heels elevates the heel and places excessive loads/pressure on the forefoot. In addition to this, most high heels stay on your feet by, well, being too small for your feet, squashing your forefoot and toes, and using that pressure to keep the shoe more or less attached to your foot. This can cause or aggravate many foot, ankle and leg related issues, but do not cause bunions.

So, if shoes don’t cause bunions, what does? In simple terms, the way your feet, legs and body move, their structure and function, is the reason why you get bunions. Another popular piece of folk wisdom is that you inherit bunions from your parents, usually your mother. This idea is partly true, but also partly false. You do not inherit bunions in the same way you inherit skin, hair or eye colour. You may inherit a foot, limb or body structure and way of functioning that predisposes you to developing a bunion…but if you do the right things, wearing the right shoes (wearing really flat shoes may well contribute to developing bunions, not high heels), using some medical grade in-shoe orthoses (insoles) to support your feet in the right way, and doing regular therapeutic exercises to target specific muscles in the lower limb, you may never develop bunions at all, despite your mother and grandmothers insistence that you will. Or if you do, they will likely be less severe. Either way, the result may not be as bad as gran predicted.

If you are concerned about whether you or your children may be developing a bunion, or if you or they may have the predisposition to developing one, visiting a podiatrist can be very helpful indeed. You can book a biomechanical/MSK assessment and be given advise and a treatment plan to reduce your risks of developing this and other issues, keeping you on your feet, happy and active, for many years to come.

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