Dancers and actors focus on the angle between the ball of the foot and the heel when selecting performance footwear. The more acute the angle the shoe creates, the greater the discomfort. So says Dr. Sajid A. Surve, who sees patients experiencing pain or injuries from high heel use on a weekly basis.

Surve notes that a five-inch heel with a two-inch platform will cause less pain than a four inch heel and no platform.“Our bodies aren’t built to bear weight on the ball of the foot,” Surve explains. “They’re designed for weight to be dispersed from the ball through the arch and heel. A comfortable heel has a more gradual slope down to the ball of the foot so that weight is more evenly distributed.”

To prevent pain and discomfort when wearing heels, try these tips:

– No squeezing! A narrow, pointy shoe is the worst choice for comfort and can cause bunions.
– Stay away from stilettos. A thicker heel spreads your weight more evenly and decreases the risk of ankle injuries.
– Arch support is critical for servers, nurses and others who stand at work. Avoid flats and heels whenever possible.
– If you mostly sit at a desk, the sky’s the limit. Just take your heels off and stretch out your feet a few times a day.
– If you wear high heels for a significant portion of your day, perform calf stretches regularly to counteract the long-term effects of the shoes.

Surve is the co-director of the Texas Center for Performing Arts Health and an associate professor at the University of North Texas Health Science Center, Texas College of Osteopathic Medicine.