For much of history, footwear has been used as a protective covering to shield feet from environmental hazards. Shoes, such as they were, fit the shape of the feet they surrounded—which was roughly triangular, starting from the heel and getting wider all the way to the toes. Within the last millennium however, we have seen footwear take on several new roles for humanity, with fashion becoming a primary function.

Prominent amongst the newly embodied ideals is the sleek forefoot, created by tapered toe-boxes. Now, the ends of our toes are unnaturally squeezed into a reverse triangular configuration, making the foot a diamond shape, with the ball of the foot the widest and the toes tapering to a point. A brief look at history reveals that none of the proponents of pointed shoes had a health benefit in mind when they introduced their particular variety of pointed shoe.

Instead, use of pointed shoes can frequently be correlated with either status or subjugation. Many early examples of pointed shoes were worn by the ruling class, serving as a status symbol and a reminder to the working class that, due to the elites’ privileged state, it was unnecessary for them to have healthy feet—since they had no need to perform manual labor. In keeping with most of human history, the non-ruling class attempted to emulate the lifestyle and fashion of the elite, prompting the consequent passage of laws that prohibited such mimicry and set limits on length based on one’s social status.

In truth, shoes focusing on performative fashion rather than practical function are more widespread than many realize. For example, cowboys are portrayed as using pointy shoes. Many assume this is for some practical reason, but it is more likely that the pointed nature of cowboy boots was a detail added as part of the attempt to create a cowboy ‘style’—few original cowboy boots had this feature.

In 10th-century China, women’s feet were bound and distorted for fashion. This allowed them to fit into pointed Lotus shoes, but recent works reveal that the purposeful fracturing of the bones and tight bandaging to arrest the development of growth was not done to create a dainty aesthetically pleasing foot, but to develop sexually-attractive muscles that allowed them to walk with such feet, and even create a surrogate sexual organ out of the feet of these women. For whatever reason, it had nothing to do with allowing them to walk and run naturally. Women’s footwear fashion has continued, almost without exception, to be more about attractiveness than effectiveness ever since.

In the 12th century, Crusaders picked up the pointy-toed style from models they found in the Middle East. The 14th century saw the rise of the Poulaine or Crackow and other narrow-toed styles. From there, the extravagance of the fashion only increased, with a shoe length hierarchy emerging—the longer the toe, the more important the personage. Knight sabatons, made of iron plates, followed the fashion during the 14th century.

The Winklepicker and its variants were inspired by classic medieval design. They rose to popularity in 1950s Britain. The Beatles wore varieties of the style, and their subsequent popularity drives home the connection between the style choices of the wealthy or influential and mass market imitation.

We have continued to include pointed toes in almost all of the footwear that is available in the industrialized world. Even most brands of running shoes—probably the brand you are wearing right now!

Take off your shoes and look at your feet. If you are like the majority today, you will see that the balls of your feet are the widest part of your feet. If this is now “normal,” what is the big deal?

The big deal is that your feet might look normal but they are not shaped naturally. That might have a lot to do with the running injuries you have had, have now, and may encounter in the future. Your feet cannot be healthy if your toes are squeezed into toe boxes that are narrower than the balls of your feet—this is a foot posture of fashion and not healthy running function. It reduces stability and the ability to cultivate an arch.

Considering how many runners are injured in any given year, it might surprise you to learn that the fact that your feet do not resemble natural human feet is not given priority attention by most sports medicine providers—including many podiatrists. Instead, other possibilities are explored and many treatments rendered, all the while ignoring that you are running in shoes that are deforming your toes and negatively altering your entire support system.

Running shoes are starting to get better, but many still put fashion over function when it comes to toes. Avoid pointed toed running shoes (and all tapered shoes), and spread your toes as often as possible. Your feet and body will perform better.

Dr. Ray McClanahan is a running addict and natural sports podiatrist. A law student and barefoot runner, Zeus Smith works as clinic supervisor at Northwest Foot and Ankle with Dr. McClanahan.