Many women's shoes not made for walking

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But in the centuries since our ancestors first wrapped their feet in woven grasses and animal skins to protect them from rough surfaces, function has clashed with fashion in the design of our shoes. The crocodile-hide loafers and cowboy boots that cross paths with dress oxfords on today's city streets are often chosen for what they say about their wearer rather than for comfort.

Among women's shoes, fashion has truly trumped function. As the summer months approach, colorful sandals, flip-flops, wedges, high heels and ballet flats dot the sidewalks. One of trendiest shoes this season is YSL's platform "Tribute" -- with a tottering 5 1/2-inch heel.

Often painstakingly selected to complete outfits, shoes like these put stress not just on feet, but on ankles, knees and backs, contributing to the approximately $3.5 billion spent annually in the United States for women's foot surgeries, which cause them to lose 15 million work days yearly.

Experts warn against what one group of foot doctors calls "cruel shoes," Shoes with "pointed toes, shoes with thin soles, and shoes with high spike heels" are of the cruel variety, according to the Web site of the American Orthopaedic Foot & Ankle Society, because they can "cause crowding of the toes and increased pressure," which can result in hammertoes and bunions.

When humans walked barefoot, "societies seemingly had a low incidence of foot deformities and pain," according to a 1994 essay published in the Journal of the Southern Orthopaedic Association. The first shoes were made in the shape of the foot and were sandals.

Today, despite mounting evidence of the damage ill-fitting shoes can cause, women squeeze their toes to fit into oh-so-popular pointed-toe shoes, and they readily break the American Academy of Orthopaedic Surgeons' rule of thumb: no more than three hours in three-inch heels. Wearing heels causes your foot to slide forward, "redistributing your weight, creating unnatural pressure points and throwing your body's natural alignment out of whack," according to the Mayo Clinic. High heels have "been linked to overworked or injured leg muscles, osteoarthritis of the knee and low back pain," continues Mayo.

For those women who want fashion plus function, so-called comfort-brand shoes claim to offer the best of both worlds. Among them: Naturalizer, Ecco, Aerosole, Cole Hahn and Taryn Rose, created by a former orthopedic surgeon who brought her first line of luxury shoes to the market in 1998.

Foot doctors often recommend these lines to patients. "Comfort shoes tend to have a rounded toe box, more cushioning (and) more arch support," said Theresa Fahy, a podiatrist with offices in Virginia. T

But when it comes to properly fitting shoes, women often find fewer options than men. As a result, women are at greater risk for shoe-related health problems than men and account for about 90 percent of surgeries performed for the most common foot ailments.

That risk can include bunions, stress fractures, joint pain in the ball of the foot, Morton's neuroma, "pump bumps" (enlargement of the bony area on the back of heel), corns and calluses, hammertoe, toenail problems and tight heel cords (shortening or tightening the Achilles tendon).

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