I don’t recommend women wear high heels for long periods of time. Wearing heels shifts your weight to the balls of your feet, which puts pressure on your feet. This also creates a balance problem: It forces your knees and hips forward, hurting your back and legs.

Wearing these shoes can cause hyperextension, ankle sprains, mid-foot fractures, benign nerve tumor, pinched nerves, bunions and hammertoes.Reason enough to save those Manolo Blahnik’s for only the occasional soiree.

But now I am seeing a reverse trend. Ballet flats.

Ballet shoes have been becoming very popular in recent years and are seen as a stylish alternative to high heels. However, podiatric physicians worldwide warn that ballet flats should not be viewed as an alternative to high heels because they come with their own set of health concerns.

There is such a thing as too flat. Shoes that are too flat don’t provide adequate arch support, cushioning or shock absorption, which those with collapsed arches or flat feet need.

Also, ballet flats usually are too narrow in the toe box. Another problem is they have a very thin sole which creates a higher risk of being pierced by a foreign object, like a nail. The only good thing about a ballet shoe is that, with being flexible, it causes the muscles to work harder,making them stronger. But that is about it.

Ballet shoes lead to tendonitis, strains, inflammation, stress fractures, corns/calluses, collapsed arches and plantar fasciitis.

In recent years, though, I have been starting to take note of an increase in the incidence of ingrown toenail cases among patients who wear ballet shoes.

Ballet flats have a narrow toe box and can be seen as the cause of ingrown toenails. They put a lot of pressure on the nail, causing it to bend and become ingrown. Ingrown toenails, also known as onychocryptosis, is usually caused by trimming toenails too short, particularly on the sides of the big toes or having unusually curved toenails.

However, they may also be caused by shoe pressure from shoes that are too tight or short, injury, fungus infection, or poor foot structure. Ingrown toenails occur when the corners or sides of the toenail dig into the skin, often causing infection.

A common ailment, ingrown toenails can be painful. Ingrown toenails start out hard, swollen, and tender. Left untreated, they may become sore, red, and infected, and the skin may start to grow over the ingrown toenail.

In most cases, treating ingrown toenails is simple: soak the foot in warm,soapy water several times each day. Avoid wearing tight shoes or socks. Antibiotics are sometimes prescribed if an infection is present.

However, when the toenail becomes painful and non-responsive to these treatments, you should consult your podiatrist. There is a minor procedure your podiatrist can do to lift the toenail which will separate it from the overlying skin and help the nail grow above the skin edge.

In severe cases, if an acute infection occurs, surgical removal of part of the ingrown toenail may be needed. Known as a partial nail plate avulsion, the procedure involves injecting the toe with an anesthetic and cutting out the ingrown part of the toenail. In more severe cases, the entire nail may need to be removed. In either case, it is best to see your podiatrist because left untreated, ingrown toenails can lead to a serious skin or bone infection that may result in amputation of the toe.

Ingrown toenails can easily be prevented by wearing properly fitting shoes that are not tight around the toes and protect the feet. As a precaution, remember to trim your toenails straight across and keep them at a moderate length that is not too short or too long. If you would like to discuss your footwear with a podiatrist or would like more information about ingrown toenails, please call your podiatrist.