I suspect that might be a significant part of the problem - wearing shoes that are too small for reasons of vanity. The height of the heel might be less of an issue than the "squash factor" affecting the toes. ;)
Maybe they need to bind their feet like the chinese! ;o)
It's a little of both. The heel height throws your back, pelvis, and legs out of alignment, and also forces your toes frontward and mashes them into the toe box or off the end (if sandals. I need shoes about 1/2 size bigger for every 1 1/2" of heel, so 3" heel shoes need to be 1 size bigger for me.
Considering that I'm already 5'10", with feet to match, I'm a little scary wearing 3" heels :lol: .
Most of the time I wear flats, but will wear heels if I'm dressing up, like for weddings. But if I start dancing, the shoes come OFF.
LQ