– Dr. Johanna Youner – New York Times article, Tales of Love and Pain
Dr. Johanna Youner, DPM, FACFAS
Board-Certified Podiatric Surgeon
40 Park Avenue, Suite 5
(37 East 36th Street)
New York, N.Y. 10016
Fax: (212) 889-6150
As a Podiatrist Shops, Tales of Love and Pain
By DIANE COLE
JUNE 23, 2002
”LOOK at that!”
With an accusatory finger, Dr. Johanna Youner, a podiatrist, pointed to the evidence: an X-ray of her right foot squished into the narrow, pointy toe box of her favorite pair of Manolo Blahnik stiletto heels. The next X-ray was equally graphic: with the shoe-heel height, about four inches, putting so much pressure on the ball of her foot, Dr. Youner’s big toe appeared almost dislocated.
Can these feet be saved?
More practically, can these shoes be worn comfortably? The answer to both is yes — but only if you know what you’re doing.
With that in mind, Dr. Johanna Youner, who has a private practice in Manhattan on Park Avenue, and is director of the podiatry clinic at NYU Downtown Hospital, agreed to meet a writer at the designer-shoe salon at Saks Fifth Avenue.
”This is my idea of bliss!” cooed Dr. Youner, a reedy 5 feet 7 inches tall, who wears size 9 or 10 shoes. In fact, that is lesson No. 1: ”Shoe sizes are not standardized,” she said, not even among similar styles marketed by the same designer. So, have your feet measured.
But as Dr. Youner’s eyes alighted wistfully on the Jimmy Choo feather-and-rhinestone-trimmed stiletto-heeled mules in a fairy-tale lilac peau de soie, it seemed that the only appropriate shoe clerk would be Prince Charming. Ditto for the roomier-toed Chanel pumps with long ballet-shoe laces. They gave the illusion of a dancer on point — but their high, narrow four-inch heels, alas, could make your feet feel that way, too.
”These are beautiful, like museum pieces,” Dr. Youner said, a love-struck note in her voice. But returning to reality, she warned: if you do wear stilettos, don’t plan on walking too far.
That is lesson No. 2: the higher the heel, the more pressure is put on the front of the foot — the tippy-toes, which cannot carry full body weight. As a result, walking becomes increasingly less stable, raising the risk of twisted ankles. A study in the medical journal The Lancet also suggests a link between knee arthritis and high heels.
If your outfit still insists on stilettos, there are options.
”There are shoe-repair shops that will shave off about a quarter-inch of the heels and rebalance them so you can walk a little bit,” Dr. Youner said. But, she added: ”I did that with mine, and I was still limping. I looked so good — but my feet hurt so much, I was holding onto my date’s arm.”
To pad those tippy-toes, you can also add some shock absorption with an insole (Spenco is one brand) made of wet-suit material and available at many shoe repair or sporting goods stores. ”If there’s room in a fashion shoe for that, this will make your life better,” Dr. Youner said ”Otherwise, there’s nothing to shield the bones of your feet from the concrete you’re walking on.”
Better yet, go for lower heels. But not so low as to provide minimal support. For example, wearing sleekly gorgeous, but utterly wispy, archless, flatter-than-flat razor-thin-soled sandals may result in plantar fasciitis, an inflammation of the arch.
Happier mediums exist. Jimmy Choo offers an enticing mule with a rhinestone accent strap, with heels only two inches high. Then there’s Prada’s Arabian Nights-inspired gold-and-orange silk mules with kitten heels (short stilettos shaped like hourglasses), also about two inches high.
Several stores offering shoes that are orthopedically sane but still aim for style have Web sites that indicate the possibilities. Some of Dr. Youner’s suggestions were www.eneslow.com
But there are always caveats. ”With mules, your toes have to clench, to work to keep the shoe on,” Dr. Youner said. ”And if you clench enough, you’re going to rub your little toe raw.” Backless shoes — which include sandals, sling-backs, flips-flops and thongs — will increase the chances of your heels drying out, and the skin thickening and cracking, because more friction is required to keep the shoe on. To minimize problems, keep the heels moisturized and exfoliated.
Dr. Youner gave a high approval rating to a low-heeled Badgley Mischka blue-and-beige toile de Jouy print sandal with a sequin-and-flower strap. ”Delightful and wearable,” Dr. Youner said. ”The heel is low enough to walk, but high enough so the arch doesn’t get strained.”
Another advantage to this style is that the sandal’s shape resembles the shape of a foot. The front is full, as opposed to sharp and narrow.
When wearing any sandal, beware of what Dr. Youner dubbed summer sandal foot: scrapes and abrasions conforming to the placement of the sandal straps. ”Asking thin, little straps to keep the body’s weight in the shoe is just asking too much,” she said. With sandal straps, wider is better. And be sure to take Band-Aids to protect feet against thongs that rub between your toes.
Dr. Youner’s mission was to find a pair of smart (as in good-looking and comfortable) business shoes. ”A tie shoe is going to be your best bet — if you can find it in a fashion shoe — because you don’t have to clench and unclench your foot to keep it on,” she said as she glanced at miscellaneous loafers, sandals, slides and pumps.
For more formal shoes, Dr. Youner said, there are styles that fuse good looks with comfort. As she examined a handsome Stuart Weitzman black calf two-inch-high chunky-heeled loafer pump with a roomy toe box, Dr. Youner explained that the back of the shoe (the heel counter) should be rigid and bend only at the forefront. If it twists in the middle, watch out: too much flexibility equals too little support and shock absorption. Having passed these tests, this particular shoe was deemed ready to be tried on.
”This is a crowd pleaser,” she said as she slipped on a pair in 9 1/2 medium, then walked around to check the fit. ”I found a pair of comfortable shoes!”
Buoyed, she decided to try another pair of Stuart Weitzmans, stylish brown-leather buckle loafers with 1 1/2-inch heels that fit like a charm in size 9. The sole was rubber — good for cushioning and preventing slips.
Paying for her purchases, Dr. Youner said, ”Admittedly, these are not cutting edge, but they are comfortable and appropriate” for day-to-day wear.
With a longing backward glance at some gold lamé-and-satin evening shoes, she headed for the escalator. ”I have to be in my scrubs, ready to perform surgery in an hour,” she said. Until then, Dr. Youner would wear the Selby shoes with which she had begun the day. With their steady two-inch heels, they were fashionable enough and made for walking.