As chiropractors who analyze and treat the feet on a daily basis, we get exposed to tons of people so it is very easy to observe the types and styles of shoes they are wearing.

We know that patients feel their best and get better results from their chiropractic care when their bodies are properly supported through custom stabilization. However, many popular women’s shoe styles don’t comfortably accommodate custom orthotics due to their tight-fitting, low-profile designs. For the purposes of this discussion, I want to hit on a topic that can be a sore spot, especially for female patients. This has to do with wearing “high heels”.

For some chiropractors, this subject is taboo and women should never wear high heels, period! But being more realistic about it, high heels are a fact of life for many women. So it’s important to be able to talk about and support your female patients in their choice to wear heels with custom flexible orthotics meant specifically for those shoes. The newly re-designed 5th Avenue Collection is made just for them.

In today’s world, heels are still seen as a symbol of professionalism, style and fashion. We will have patients who wear heels on a fairly regular basis. So what is the big deal? Let’s start with the anatomical differences between the feet of men and women.

Anatomical Foot Variations Between the Sexes:

Women and men differ in many ways and the feet are no exception. Look at the picture below and see how the physical shape of a woman and a man’s feet differ.

Women have a more streamlined foot that is triangle shaped vs. the man’s square-shaped foot. In another picture, we can observe how women have a more curved medial foot area with a higher medial arch and a shallower big toe than men.

From a clinical standpoint, the anatomy dictates that women tend to have more forefoot issues than men. Bunions, hammer toes, calluses, neuromas, and metatarsalgia are more common in women. We see these types of ailments aided by shoes women wear that are tight-fitting, with narrow toe boxes. 

In an average woman’s flat shoe, the foot bears weight 50% on the ball and 50% on the heel. We know overpronating feet throw these percentages off, but for the sake of understanding, let’s stick with the 50/50 weight distribution. When the foot goes into a high heel, the biomechanics change. 

The Perils of High Heels:

Foot Levelers went back to the drawing board to reimagine their popular 5th Avenue Custom Orthotic Collection with new features for enhanced fit, comfort and support.

The thinner, narrower design provides a better fit in a broader assortment of women’s shoes, including narrower ones with smaller toe boxes. They provide patients with maximum support and comfort for a wide range of shoe styles. The 5th Avenue One Inch supports all three of the arches and is ideal for dress flats and heels up to 1″. The 5th Avenue Two Inch supports two of the arches (no lateral), is thinner and more narrow and designed to be worn in shoes with heels between 1″-2″.

For best results, it’s recommended that patients get both custom orthotic styles in the 5th Avenue Collection and match each to the various shoes in their wardrobe, based on heel height. It is important to note that a patient should not get a pair of the 5th Avenue Two Inch and wear them in ALL of their other shoes. The 5th Avenue Two Inch style does not have support for all three arches as they are made specifically to support the foot at the angle of a 1″-2″ heel. There won’t be enough support provided by that particular orthotic if it’s worn in a flat shoe. Most women have a wide variety of shoes in their wardrobes, so having both orthotic styles in the collection helps them stay continuously supported in all their footwear.

What’s the difference between the Foot Levelers Dress Luxury Custom Orthotic and the NEW 5th Avenue Collection?

The Dress Luxury has been my “Go To” orthotic for women’s and men’s dress shoes since it was first introduced as the “Profile” orthotic many years ago. It’s been a staple for me and my patients. I have always felt the Dress Luxury had great 3-arch support, was comfortable for everyone, and fit nicely into dress shoes and heels up to 1″.

Now that the new 5th Avenue Collection has debuted, I have been able to immediately begin prescribing them. This line is more tailored for women’s feet which makes it easy to add to my repertoire. The 5th Ave custom orthotics are more narrow and they have a new “rounded cut” at the end. Additionally, the new microfoam bottom has appeared to soften the feel that early female testers have complimented.

The Dress Luxury Traditional Dress length product has more of a “flared cut”. It’s wider than the 5th Avenue as well so it is not as narrow. It is always suggested that you have samples of different orthotics in your office. You especially want to have samples of your most popularly prescribed orthotics so your patients can touch them and feel how well-made they are. You likely already have a sample of a Dress Luxury custom orthotic. So now just make sure you request both of the redesigned 5th Avenue custom orthotics. You can see all the differences we just described above when you are looking at these 3 orthotics side by side.

In conclusion

Overall, the redesign of the 5th Avenue Collection gives chiropractors another two solid additions to an already quality-proven line of 3-arch, flexible, custom orthotics. Having a specially designed, quality-made, comfortable option for flats and heels up to 1″ and one for shoes with 1″-2″ heels will allow our patients to have the very best support for all of the shoes in their wardrobe.

Dr. Kevin M. Wong, DC is a graduate of the University of California, Davis, and a 1996 Summa Cum Laude graduate of Palmer College of Chiropractic West. He has been in practice for over 25 years and is the owner of Orinda Chiropractic & Laser Center in Orinda, CA.

As a member of Foot Levelers Speakers Bureau since 2004, Dr. Wong travels the country speaking on extremity and spinal adjusting. See upcoming events with Dr. Wong and other Foot Levelers speakers at Check out his monthly blogs with proven practice tips to help you achieve optimal patient outcomes.