By Curves

At what height do high heels start to cause significant foot and ankle pain and even damage, inhibiting your stride and even your desire to work out? The answer, says A. Holly Johnson, M.D., a self-described “occasional” high-heel wearer and foot and ankle specialist at Massachusetts General Hospital in Boston, depends on the answerer. “Some women simply cannot tolerate 1-inch heels, and there’s a subset of women who actually feel better in 1-inch heels. It really depends on the person. My rule of thumb: If it hurts, it’s too high.
Crave a little height without the hurt? Here’s Dr. Johnson’s Rx:

Pick platforms.
“The number one complaint high-heel wearers have is pain in the balls of their feet, because when you’re wearing stilettos, that’s where all the weight of your body falls—on your forefeet and metatarsal heads,” says Dr. Johnson. “When you wear platforms, you’re still getting height, but you’re allowing more of your foot to bear the volume of your body.” Less pain, still a height gain.

Choose a platform stiletto.
If Carrie Bradshaw is your style icon and stilettos are a non-negotiable must, pick a stiletto with a forefoot platform. “The heel may be 4 inches,” says Dr. Johnson, “but the forefoot platform reduces the height you’re requiring of your feet to 3 inches. And that represents an improvement!”

Go for peep toes.
“Open-toe shoes have more room in the forefoot,” says Dr. Johnson. “If you’re prone to hammer toes or bunions, narrow toe boxes are not your friend.”

Size up.
“Most women wear shoes that are too small by at least a half a size,” says Dr. Johnson. “So next time you buy a high heel, upsize by at least a half-size or even a whole size, then place a little pad in the forefoot so that your foot doesn’t reach the end of the shoe. What you’re doing is making the toe box effectively wider—and the experience of wearing the shoes far less painful.”