The love affair between women and shoes is well documented in popular culture. From Imelda Marcos to Carrie Bradshaw, style-conscious women feel completed by their shoes beyond the simple satisfaction of co-ordinating an outfit. The right shoes will flatter a woman, making her look taller, slimmer and sexier than she would be in her stockinged feet. But although a shoe's flattery will bring you confidence, its love for you is not unconditional. It comes at a high price. Many a woman's chic Manolos hide a battleground of scars, bunions and misshapen toes. Il faut souffrir pour être belle, they used to say, but fashion has moved on. Style and healthy living are no longer mutually exclusive - the fashionable are clad in designer yoga wear, the trendy tipple is mineral water. So, why allow your feet to be subjected to the tyranny of beauty?
In the pursuit of perfect health from the ankle down, two eminent podiatrists have looked closely at some examples of this season's footwear trends. Although the shoes may be pretty, the effects can be very ugly. Kimby Osborne is the in-house expert for Carnation, a company making corn plasters and other treatments for feet that suffer habitual abuse. She has worked in footcare for 20 years and writes an advice column on www.laterlife.com. Dr Tariq Khan is consultant podiatrist at Great Ormond Street Hospital for Children, and consultant and deputy director of the Marigold Clinic of Homeopathic Podiatry at the Royal London Homeopathic Hospital.
It is worth remembering, however, that a shoe that makes one woman limp might be fine for another. Dr Kevin Hill, a representative of the Society of Chiropodists and Podiatrists, explains: "Because feet vary so much between individuals, you need to try shoes on. Some people will be more comfortable with a higher heel; others with a lower one. If you want to know what type of shoe is best for you, consult a podiatrist with an interest in biomechanics."
You might think that something so flat and pliable would get top marks. But this type of shoe can cause problems. "Very flat shoes put a strain on the back of the legs and ankles," Osborne says. "The heel is very low, giving negligible support to the foot." Dr Khan agrees: "They put strain on all parts of the feet, causing problems such as plantar fasciitis (inflammation of the plantar fascia, or tissue supporting the arch of the foot), bunions, corns and calluses, as they pull on the soles of the feet."
Plantar fasciitis causes a sharp pain in the base of the heel, and in severe cases can require surgery. However, there are advantages to the ballet shoe, too. The rounded toe gives the toes plenty of room, which helps to avoid blisters or corns in this area. Wearing an insert to cushion the foot and cradle the heel will help to take the strain off your soles.
Health rating: 4/10
For summer dressing, they're shoe heaven. For the feet, they're shoe hell, say our experts. "This shoe gives negligible support," Osborne says, "and the narrowness of the straps can cut into the toes and feet causing blisters and corns."
But that's not the only problem. "Many people could find that the extreme flatness of the shoe puts a strain on the back," she says, and Dr Khan warns: "They also give rise to cracked and sore heels as the "slapping" motion on the heels when walking causes friction and pressure."
Health rating: 4/10
Round-toed high heels
Some of this season's styles demand a ladylike shoe, with a round toe and a high heel. Osborne concedes that round toes are better than the pointed ones that have dominated fashions of late, which can result in bunions and hammer-toe. However, she warns that "the low front may rub the feet causing blisters and corns", and is careful to emphasise that any shoe with heels higher than two inches throws the weight forward on to the front of the foot, and can cause a newly identified and uncomfortable condition called Morton's neuroma, which feels like having a stone in your shoe all the time.
And that's just your feet. It's the posture problems that concern Dr Khan: "This type of shoe gives rise to an under-use of the tendoachilles, with shortening and tightness, which in turn leads to cramp in the legs, and lower- back pain."
Health rating: 3/10
"What makes strappy shoes sexy and glamorous is also what makes them so uncomfortable," says Osborne. "The straps at the front tend to be too narrow and cause the widest part of the foot, just behind the toes, to be squeezed into the shoe above the strap." As if this wasn't bad enough, the height of the heel throws the weight on to the front of the foot, which is a recipe for calluses or corns. "You should also take care with ankle straps - if they are too tight, they can restrict the ankle joint," Osborne adds.
"Heels above two inches can cause excessive pressure on the balls of the feet leading to shortening of the tendoachilles," says Dr Khan. "This causes the calf muscle to shrink and lose elasticity. The overload of the forefoot gives rise to bunions as there is instability in the walking cycle. In addition, the soles of such shoes are usually thin, so callus formation on the ball of the foot also leads to inflammation and pressure on the digital nerves."
To alleviate the pressure on the front of the feet, you can buy gel pads that slip under the toes, reducing the inevitable pain that comes from tottering around on high heels all night long.
Health rating: 1/10
These are everywhere this spring. Just how comfortable they are will depend on the style, with wedges that enclose the foot being better than sandal-type wedges such as those shown here. But overall, Osborne is not a fan: "The wedge-style heel makes the shoe's sole totally inflexible, which means that the foot arch can't be used for stability when walking or standing. This causes the toes to curl up and grip the insole in an attempt to keep the foot stable and the shoe on. The height of the heel also puts a lot of pressure on the ball of the foot, causing tenderness and hard skin to build up."
But it's not all bad, according to Dr Khan, who is prepared to defend the chunkier kind of wedge heels. "Generally, wedge heels are better than narrow heels as they give better stability and contact with the ground during walking. This gives strength to the ankle, which is lost on narrow heels, as they allow the ankle to give way and cause ankle sprains."
Health rating: 5/10
Low-heeled pointed boots
The really flat ones are the worst of the lot, according to Osborne: "Very low shoes give negligible support to the foot." As with other low shoes, the flatness could cause back pain. But even if your boots have a reasonable heel, the point is likely to cause problems, says Osborne: "It can rub the toes causing blisters and corns, and may put pressure on the joint at the base of the big toe, leading to bunions."
Dr Khan agrees: "The narrow front has a jarring effect on the toes, which leads to hammer and clawed toes, and then corns and calluses."
Health rating: 5/10
For more information: www.feetforlife.org