High heels have been made from all kinds of materials throughout history. In the early years, leather and cowhide was preferred. As civilizations progressed, silk and patent leather were introduced, while cork and wood were utilized as cheap resources in times of war. After the World Wars and the increase in production of steel, the actual heel was a piece of steel wrapped in some kind of material. This has enabled designers to make heels taller and skinnier without them snapping. The soles below the ball of the foot of Ballroom shoes can also be made of materials like smooth leather, suede, or plastic. 
A 2001 survey conducted by researchers from Pennsylvania State University using 200 women found that 58% of women complained of lower back pain when wearing heels and 55% of women said they felt the worst overall back pain when wearing the highest heel. The researchers explained that as heel height increases, the body is forced to take on an unnatural posture to maintain its center of gravity. This changed position places more pressure and tension on the lower lumbar spine which explains why the women complained of severe back pain at a higher heel length.
Wearing high-heeled shoes is strongly associated with injury, including injury requiring hospital care. There is evidence that high-heel-wearers fall more often, especially with heels >2.5cm high, even if they were not wearing high heels at the time of the fall. Wearing high heels is also associated with musculoskeletal pain, specifically pain in the paraspinal muscles (muscles running up the back along the spine) and specifically with heel pain and plantar calluses (only women tested).
Altra is known for its Foot Pod design, mapping out the foot and balancing weight and pressure on tendons and bones. This technology married with the comfort and responsiveness of the Altra Intuition 4.5 is what sets it a notch above the rest. The Intuition 4.5 has a 0mm drop, allowing for your body to align properly while feeling the road under your feet. It's a great shoe for a long run, the kind that clear your head.
In a 2012 study, researchers examined the risk long time high heel wearers would have in regards to calf Muscle fascicle length and strain. The control group consisted of women who wore heels for less than ten hours weekly and the experimental group consisted of women who wore heels for a minimum of forty hours weekly for at least two years. The experimental group was told to walk down a walkway barefoot and in heels while the control group walked down barefoot as cameras recorded their movements to calculate muscle fascicle lengths. The data showed that wearing heels shortened the length of the medial gastrocnemius (MG) muscle fascicles in the calf significantly as well as increasing stiffness in the Achilles Tendon. The experimental group also demonstrated a larger amount of strain on the muscle fascicles while walking in heels because of the flexed position the foot is forced into. The researchers were able to estimate that when wearing heels, the estimated fascicle strains were approximately three times higher and the fascicle strain rate was approximately six times higher. Additionally, they were able to conclude that the long term usage of high heels can increase the risk of injuries such as strain along with discomfort and muscle fatigue.
This is a common complaint that can be easily remedied. First, look for running shoes for women that have uppers that are as seamless as possible. This keeps skin irritation down be not having seams that can rub on your feet as you run. Secondly, if you know you ankle area is a trouble spot, look for additional cushioning in that region to help keep your feet comfortable. Finally, runner’s best friend: Leukotape. Place on problem spots before they cause discomfort, it stays put through the entire run and won’t unstick because of sweat or rain.
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We chose all the shoes in this roundup based on feedback from the women on our test team, as well as test results from our RW Shoe Lab. We also researched the market, surveyed user reviews, spoke with product managers and designers to find the best of the best. Every shoe was evaluated over the course of hundreds of miles, with attention given to overall performance, comfort, ride, longevity, value, and yes, even style—because who doesn’t want to feel like they look good, even alone on a trail? Here are our favorite running shoes for women this year.
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