My face met the ground the first time I wore heels. Ok, maybe that was bit of an exaggeration. I didn’t exactly fall but I came pretty close.  I wonder what went wrong. Could it possibly have been the height? No, they were only 3 inches. Despite how “low” I thought the heel was, research has shown, as the heel’s height increases, so does the increased amount of pressure on the forefoot (ball of foot). For example:

1-inch = 22%

2-inches = 57%

3-inches = 76%.

Can you imagine if I wore 6 inch heels?

In a survey of 100 women, 26 said they never wore heels; 74 wore them at some point in their lives. Although it has been shown over a 30 year span, less women are wearing heels today (40%) than in the 1980’s (60%); more younger women (ages 18-25) wear high heels (50%) compared to those in their 50’s and up (35%). I found this survey very interesting. The point is most women wear heels and this practice, although declining in comparison to earlier years, is still ever present.

Recall the old adage: “Form follows function”. This was a principle associated with architecture. It states that the shape of an object should be based on its intended function or purpose. Think of it this way, high heels cause muscles in the leg to become fatigued or function abnormally for long periods of time. One may develop “form” issues in the sense of poor posture, stress on the back of the knees, shortened calf muscles, or even spine problems over time.

highheelLet’s Review Some Anatomy (And How High Heels Affect Them):

  1. Feet: The feet can be considered the base or foundation of the body’s skeleton. For those home builders out there, you may know, if you don’t have a good foundation, that house is subject to unevenness and instability. In the foot, joints become unsteady, arthritic, and painful which can lead to bunions and hammertoes.
  2. Calf muscle: The calf muscle or Gastrocnemius-Achilles tendon unit is one of the strongest muscle-tendons in the body. It helps one during push off and the propulsive phase of gait (walking). It works best when it is elongated and freely glides. Wearing high heels can shorten this muscle-tendon unit over time, which can lead to problems when walking barefoot or in other shoes. You might be enjoying those compliments of how nice your legs look from behind, but they may be costly in the long run.
  3. Knees: Wearing high heels shift the knees forward, thus straining the back of the knees and hamstrings. The knee joint itself may develop arthritis over time.
  4. Hips: As the center of gravity continues to shift forward, the hips become affected and can throw off one’s posture. Many thigh muscles originate from the hips and control how one stands, walks, or runs.
  5. Back: As the knees and hips move forward, the back compensates by hyperextending backwards. Sure this will back your derriere look nice (hence, the cat calls again); however, this may lead to back soreness, spasms, and eventually spinal issues.


Am I saying, “Don’t EVER wear heels”? No. But, I think the best patient is a well-informed patient. Dr. Bridget Moore gave some excellent tips in our last blog (6 Tips to Save Your Feet When Wearing High Heels) for all you brave souls. Would I wear them again? Sure. Knowing what I know now, I think I will stick with a lower heel.

Heather Driessen, DPM

The Foot Institute


I have a confession. Can you keep a secret?? … I am a podiatrist, and I love wearing high heels! Shhh! Most of us know that the age-old consensus regarding long term use of high heels is that they are bad for your feet, right? They can cause and/or exacerbate corns & calluses, ingrown toenails, bunions, hammertoes, metatarsalgia, neuromas, plantar fasciitis, achilles tendonitis, ankle sprains, osteoarthritis, and gait abnormalities. But what are the chances that you are going to leave your podiatrist’s office and never don a pair of heels again? Slim to none. So, for those out there, like me, who enjoy wearing heels; here are a few tips on how to do so with minimal complications.

  1. Moderation: Like your parents told you growing up “everything in moderation” or “moderation is key”. Do not wear high heels more than 3 inches high extended periods of time. Also, make sure that your feet/ankles are stable when wearing them. When wearing high heels to work, I never wear them for more than 4-5 hours at a time. I always take them off during lunch. If I’m running errands during that time, I change into a pair of supportive sneakers.
  2. Variation: Yes, another reason to buy more shoes!! But seriously; Do not wear the same type heel every day. Alternate between your stiletto, chunky, and wedge heels with varying toe boxes. When shopping, look for more open, peep, and round toe shoes. Also, make sure your higher heel shoes have a platform sole- this decreases the steep angulation of the foot, in turn decreasing ball of foot pain (metatarsalgia), as well as ankle and knee pain.
  3. Sizing: Try before you buy, and please don’t be that lady asking for a size 6.5 when you’re really a 9.5! Even though you may think you’ve always been a certain shoe size, doesn’t mean that you are currently that size. Have your feet measured often and always try your shoes on. Moreover, try on shoes in the afternoon/evening to accommodate any swelling that may occur throughout the day. Other factors that can change the size of your feet include adult growth spurts, pregnancy, and weight gain/loss. Finally, all manufactures do not size their shoes the same or have standardized widths. I’m the customer the salesperson keeps their eye on because I’m walking around a lot (and often to the adjacent dept.) in their shoes because, let’s be honest- trying on shoes while seated or standing in place does not cut it!

  4. Stretching: There are stretching exercises for every part of your body, including your feet. Perform range of motion and stretching exercises at your desk, in your office, or even in the bathroom. They can include wall stretches to prevent over contraction of your Achilles tendon, drawing the alphabet using your big toe like a pencil or index finger, and wiggling/extending your toes. Bottom line – move them!

  5. Orthotics/Padding: Orthotics or shoe inserts are devices designed to align your foot/ankle, offload certain areas and help relieve pain. They consist in prefabricated (OTC and in-office) and custom orthotic (made specifically for your foot) devices. If you typically wear orthotics in other shoes, have your podiatrist prescribe you custom dress orthotics for heels and dress shoes. If your heels aren’t very well padded, a variety of shoe cushions (gel, felt, foam) can be purchased without a prescription.
  6. Categorizing: Decide which shoes can be worn for various time frames. Personally, I have my heels organized
    in the top of my closets (yes- that’s plural) by increasing time and/or heel height. There’s the 0-2 hr section, 2-4 hr section, 4-6 hr section, etc. Choose your heels based on your comfort level in them and the amount of activity you will be performing that day.

I hope these tips enable you to be smart about wearing high heels, and don’t let this be you!

Bridget Moore, DPM

The Foot Institute, LLC

Running for “The Big Guy”

In the green shorts standing at 6ft tall and weighing in at 270lbs.  He has completed several half marathons, a plethora of 10k’s and 5k’s.  He is free of foot pain, knee pain, hip pain, or back pain.  He is “The Big Guy.”

th (3)

Big Guys can run too.  If you recently decided to train for a 5k, 10k, or half marathon, you probably downloaded a training app to get you race ready.   Here lies the problem; you are not an 8-minute miler.  These training apps suggest that you add 1-2 minutes to your 5k pace in order to run farther distances.   For example, if you run a 12:30 mile adding a minute or t wo yields you WALKING!  NOT GOOD!  So how does the “Big Guy” get race ready and remain pain-free?  There are several simple but effective methods:

  1. Get properly fitting shoes: the best shoes are those that are designed for your particular foot type and provide additional shock absorption to reduce the stress of your weight on your joints.  You can find these at a Run Specialty Store (i.e Foot Solutions, The Foot Store, Fleet Feet)
  2. Get custom molded orthotics (arch supports): these are shoe inserts that will help to control the biomechanics of your feet while running and/or walking. They also assist with reducing shock on your joints.  Your local podiatrist or pedorthist can evaluate and recommend arch supports for you.
  3. Get warm: the difference between a corvette and a mack truck is how fast they get from zero to 60. The “Big Guy” is a mack truck therefore it takes him longer to get from zero to 60.  Starting too fast can result in injury, fatigue, or complete failure.  Add 5 to 10 minutes to your workout in order to properly warm up your muscles, joints, and tendons.
  4. Get mentally tough: one of the biggest hurdles the “Big Guy” has to cross is the thought that he is NOT able to run. Mental blocks or self doubt is the kryptonite to your inner Superman.  Don’t be concerned with the time; focus on the distance.  Start one mile at a time an increase by a quarter of a mile every two weeks if you are running at least 3 times per week.
  1. Get in FORM: getting informed about running styles and running form is essential to longevity in running. The “Big Guy” more likely will have a shorter stride length and be more of a heel to midfoot striker.  Knowing this will help you learn how to relax or increase your speed while running.  The best way to learn this is to simply RUN physically and mentally.  Pay attention to your body from your feet to your shoulders while you run.

Ready, Set, Go, Big Guy, Go!

Kevin Ray, DPM

The Foot Institute, LLC clip-art-of-fat-man-running

If you all are like me and enjoy occasionally people watching as you sit in a public place as a park, I’m sure you have observed a person in the process of what they perceive to be running. Often times in the novice runner early attempts at running may come out looking more like a floppy, uncoordinated, non-rhythmic, painful ordeal instead of the well timed gazelle like movements of a seasoned runner. Apart from proper training a lot of this is due to lack of core muscular tone and endurance. The core muscles include the  pelvic floor muscles, transversus abdominis, multifidus , internal and external obliquesrectus abdominiserector spinae (sacrospinalis) especially the longissimus thoracis, diaphragm, latissimus dorsigluteus maximus, trapezius, and the hip flexors.

These muscle groups are often ignored mainly because you probably never knew they existed, but developing these muscles can greatly improve your running form and ease of running. These muscle groups are collectively the center of all human locomotion. These muscles support the spinal column and pelvis keeping everything in proper alignment during motion. This will help you to avoid injury during athletic activihairety and an added benefit of looking cooler and not look so much like a floppy air dancer that are outside of used car dealerships. As a college athlete running for speed and explosiveness I began noticing my athletic performance increasing in leaps and bounds when I began dedicating significant time to core strength training with my strength and conditioning coach. I was able to see that my running movements were more efficient, quicker, and I was able to cover more ground in a stride with less energy expenditure.

In terms of strengthening of these core muscles exercises can be separated into two types static vs dynamic. I believe a combination of the two types of exercises are essential. A simple example of a static core exercise would be planks or wall sits. These exercises can be done with body weight alone or extra weight can be added by use of a weight vest for added difficulty. An example of a dynamic core exercise would be a crunches or leg raises. These exercises require the muscles go through and lengthening/contraction often against gravity or external weight as resistance.

Finally flexibility is the second component toward the goal of better running. Strength training alone will build stronger and larger muscle groups but will also lead to loss of flexibility and muscles tendon unit length.  If this is not address as part of training process then this too will contribute to injury and inefficient running.  The more flexible you are the better joint range of motion which equates to in long more efficient strides which cover more ground with less energy. Yoga is an excellent means of gaining flexibility over a period of time.

Overall becoming a better runner is a balance of these two disciplines strength and flexibility. So lace up your sneakers and get to training. Below you will find links to core building exercises. Good luck and happy trails

By: Aaron Haire, DPM

The Foot Institute, LLC

For further reading, click on these links:

I love running. Some people run to exercise, but I exercise to continue running. My knees can no longer take 7 days of running, so I mix it up with spin classes, Kettlebell classes, and cardio sculpting. However, they are all a distant second to running.

I grew up in Boston. My parents were frugal Bostonians. Any sport that required more equipment than a pair of sneakers was not in the budget. So, I joined my middle school cross country team, coached by the woodshop instructor. Much to everyone’s surprise I was actually good. Yes, I was a cross country geek and the cross country team was full of the school misfits. We had a girl on the team that literally wore a winter vest and jeans running regardless of the weather conditions.  Running wasn’t a cool sport, but we had fun.

I remember the cool September afternoons running with my team mates, and the excitement of the meets. There is nothing like the exhilaration of seeing your opponent in the far distance, and slowly catching up to them and sprinting to the end to win.running2

If you have never run in a 5K , they are a lot of fun. As an adult, you don’t usually have people cheering you on in life. Occasionally you may get a good job at work, but running a 5K you have the support of not only the fans but your fellow runners.  Enter a 5k and your competitive spirit takes over.  Sadly enough, I have even sprinted to the end to beat a 12 year old kid. Ok, I am not proud of that moment, but regardless of age everyone likes to win.

The Foot Institute will be hosting their second annual 5K run on May 20th. Start training and let your competitive spirit take over.

Maureen Quinlan, DPM

The Foot Institute, LLC


Welcome to our Blog

This blog was created as a way for our medical professionals to stay connected and communicate with the communities we serve.  Our team of foot experts are committed to educating and providing valuable information on foot health, as well as other medical and health news.  Feel free to join in as we welcome your questions and comments.

Our Team of Contributors and their Bio:

Renee Altman, DPM

Hello my name is Dr. Renee Hutto-Altman. I’m podiatrist at The Foot Institute Cayce and Columbia locations. I am a native of the Cayce-West Columbia area where I attended Airport High School. My Bachelor of Science degree was completed at the College of Charleston in Charleston, South Carolina. I received my Doctor of Podiatric Medicine degree from the Ohio College of Podiatric Medicine, now affiliated with Kent State University, followed by residency training at the VAMC in Huntington, West Virginia. Professionally, I enjoy primary podiatric medicine, diabetic wound care, and pediatrics. Personally, my main interest lies in being a mother of three and a wife, reading, cooking, and enjoying God’s creations, specifically the beach!!

James Cawthorne, DPM

Hello my name is Dr. James Cawthorne. I’m a podiatrist at The Foot Institute North Charleston location. I am a native of Pennsylvania and now reside on James Island. I attained my undergraduate degree from Westminster College and my medical degree from Ohio College of Podiatric Medicine. I completed my surgical training in foot surgery at McNamara Hospital in Detroit, Michigan. I have a special interest in diabetic foot care and foot surgery. In my spare time I enjoy flying drones and spending time with my beautiful granddaughter Zoe.

Heather Driessen, DPM

Hello my name is Dr. Heather Driessen. I’m a podiatrist at The Foot Institute Aiken location. I am a native of Hardeeville, South Carolina. I matriculated parochial schools in Savannah, Georgia and am a graduate of Saint Vincent’s Academy. I completed my undergraduate studies at Spelman College, Atlanta, Georgia with a Bachelor of Sciences Degree in Biology. I received my Doctor of Podiatric Medicine degree from the formerly known Ohio College of Podiatric Medicine, which is now Kent State University College of Podiatric Medicine. I am a proud member of Alpha Kappa Alpha Sorority, Incorporated. I have a special interest in lower extremity wound care, limb salvage, and foot pathology.  Outside of the office, I am involved in various projects within my community and enjoy reading, traveling, and spending time with my family and friends.

Dr. Aaron Haire

Hello my name is Dr. Aaron B. Haire. I’m a podiatrist here at The Foot Institute Hartsville and Florence locations. I’m originally from Orangeburg, SC where I attended college at South Carolina State University. I was a former college football punter/kicker. I was professionally trained at Temple University School of Podiatric Medicine in Philadelphia PA. My surgical training was from MetroWest Medical Center in Framingham, MA. My special professional interest are reconstructive surgery/trauma and biomechanics. My personal interests are motorcycle riding, gun collecting, sports, aviation, and music. My motto is “If you have to sign a waiver, it’s probably worth doing!”

Dr. Bridget Moore

Hello my name is Dr. Bridget Moore. I’m a podiatrist here at  The Foot Institute Northeast Columbia and Orangeburg locations. I am a native of Anderson, SC and the middle child with 2 sisters. I attained my undergraduate degree in Biology at the University of South Carolina (Columbia), and received my podiatric medical degree from Barry University in Miami, FL. My surgical training or residency was completed at the VA Medical Center in Augusta, GA. Outside of the world of podiatry, my interests include shopping, reading, cooking, and spending time with my family and close friends. Any given occasion, you can find me and my sisters laughing and shopping somewhere in SC/NC/GA with iPad in hand simultaneously reading the latest contemporary romance e-book! 

Dr. Maureen Quinlan

Hello my name Dr. Maureen Quinlan. I’m a podiatrist here at The Foot Institute Columbia and Northeast locations. I am a former registered nurse who loved the health care field but was looking for a more one to one connection with the patients. I love podiatry because it offers a diverse range of patients and ailments. Podiatry also allows me to do both surgery and office hours. I received my undergraduate degree from the University of Massachusetts and medical degree from Temple University School of Podiatric Medicine. I completed surgical training in podiatric medicine and foot and ankle surgery at Kennedy Memorial Hospital in New Jersey and Drexel University College of Medicine in Philadelphia. The surgery I enjoy doing the most is bunions and skin and nail biopsies. I am a health enthusiast who loves to work out, so I can sympathize when your feet hurt. In addition to working out, I enjoy spending time with my three children.

Dr. Kevin Ray

Hello my name is Dr. Kevin L. Ray. I am a podiatrist here at the The Foot Institute Orangeburg, Columbia,  Charleston, and Florence locations. I am a native Charlestonian, where I attended Charleston County Public Schools. Academic and athletic success gave me the opportunity to play Division I college football under legendary Coach Willie Jefferies (SC State University). I attended podiatric medical school at New York College of Podiatric Medicine and received surgical training in foot and ankle surgery at University of Pennsylvania and Drexel University College of Medicine. My special interest are reconstructive surgery and diabetic limb salvage. I am an avid sports enthusiast that also enjoy political commentary and politics. My patients enjoy my compassionate but serious bedside manner. My motto is “trust but verify.”

Dr. Walter H. Singleton 

Hello my name is Dr. Singleton. I attained undergraduate degrees from The Citadel and The Medical University of South Carolina in Charleston, S.C. I received my medical degree from The Ohio College of Podiatric Medicine in Cleveland, OH, (Kent State University).  My surgical training was completed at the Veterans Administration Medical Center in Huntington, West Virginia. I am dual board certified by the American Board of Multiple Specialties in Podiatry (ABMSP) in Primary Care and Prevention and Treatment of Diabetic Foot Wounds. I have special interest in pharmacology and neuropathy. My personal goals as a podiatrist are to decrease pain, to keep patients ambulatory as long as possible, and to decrease amputations in the diabetic population. Personal interest include: Family,  Music (early rock & roll), radio (has hosted three programs on various stations and am currently the host of “For Your Health” which covers all aspects of health and medicine) and travel.

Marcia McNeil, C.Ped.

Hello, my name is Marcia McNeil.  I am a pedorthist at The Foot Institute at the Florence, Columbia, Cayce and Charleston locations.  My undergraduate degree is from College of Charleston and I completed my pedorthic training at Temple University.  I am passionate about people and what I do. Biomechanics and gait are my specialities, and I firmly believe “Your feet don’t have to hurt” no matter what age you are.   Aching feet do not have to come with old age!  I excel in orthotics thin enough to fit into ordinary shoes.  I am lucky enough to be in a career where people often see immediate results after a visit with me.  What’s not fun about that?