Blame it on the women of Sex & the City, and Hollywood it girls like Gwyneth Paltrow.

Never before have high heels been more ensconced in popular culture — there’s even a best-selling book by a U.K. fashion stylist called How to Walk in High Heels — and never have they been so treacherously high. For most women, a high heel is defined as higher than two inches, but the über-heights we’ve seen on red carpets of late seem to be flouting that definition.

Case in point: Following Paltrow’s appearance in a much-noticed pair of six-inch Alexander McQueen shoes at a London film premiere this past spring, British shoe shops experienced a 35 per cent “spike” in sales of extreme heels.

But sometimes, it’s our feet that pay the price when we wear high heels. According to Stephen Hartman, a chiropodist and the chief executive officer of the Canadian Federation of Podiatric Medicine, heels that are two inches or higher propel the body forward, turning the simple act of walking into an awkward chore. They also point the foot downward, reducing its ability to flex and absorb shock. This leaves areas like the knees and hip joints to pick up the slack, which can aggravate and sometimes even cause arthritis.

And the problems get worse over time. Says Hartman, “Left untreated, short-term issues such as corns, callouses and ingrown toenails can lead to long-term problems such as hammertoes, bunions and ‘pump bumps’ (a bony bump at the back of your heel, caused by shoes rubbing the bone). They can also lead to issues with knee, hip and back pain, and osteoarthritis.” And high-heel wearers may experience pain even when they wear flats. According to Hartman, women who wear heels for many consecutive years can develop a physiologically shorter Achilles tendon that results in the inability of the heel to fully touch the ground.

All that said, are we suggesting you pack up your favourite heels? Not so fast: Any woman who has experienced that terrific feeling of glamour while wearing a great pair of high heels will attest that there’s no substitute for these beauties.

And the benefits are also tangible: They give shape to your calf muscles and elongate the look of legs to make you appear longer and leaner.

Wearing high heels may even improve your pelvic floor muscles: Researchers at Italy’s University of Verona studied 66 women under age 50 who wore shoes with an almost three-inch heel. The study found this placed their pelvic muscles in an optimum position to contract and strengthen.

Hartman recommends looking for heels with proper lift, shock absorbers and arch support, and says firmly: “A two-inch heel is okay in moderation, for one day a week or a special event.”

Fashion meets comfort

• Nike Air teamed up with Cole Haan, an American shoe and accessories company, to develop high heels that utilize Nike Zoom airbag pockets, which cushion the sole and ball of the foot, alleviating the pain you may feel wearing heels. High heels with this technology average three to four inches.

• Insolia inserts, developed by New Hampshire podiatrist Howard Dananberg in 1997, are designed to lift the arch of the foot and shift body weight so it is evenly distributed between the heel and toes. The idea is to improve body alignment and reduce leg and lower back pain.

• All Day Heels, the fashionable line from Canadian footwear retailer and designer Ron White, provide arch support, have built-in cushioning materials, and also include rubber compounds in the sole or heel cushion. Heel height ranges between one and four inches.

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