When only high heels will do, heed the following advice from Dr. Jay Goldstein, a Portland podiatrist:

• The lower the heel, the better. 'Anything over an inch-and-a-half can cause problems,' Goldstein says. 'The higher you go, the more weight you're putting on the ball of your foot, which can lead to permanent injury.'

• Change out of high heels and into flats as soon as possible.

• Alternate heel heights often. Wearing flats stretches calf muscles and Achilles tendons that are shortened by wearing high heels. Goldstein tells of an elderly patient who must wear heels to walk even the shortest distance, because years of wearing them have dramatically shortened her Achilles tendons.

• Be aware that like sun damage or tooth decay, the risks of wearing high heels are cumulative. 'Even if you don't feel pain at the time, you can be causing long-term damage,' Goldstein says.

Ñ Jill Spitznass

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