The altered forces at the knee caused by walking in high heels, may predispose to degenerative changes in the knee joint. Extremely high-heeled shoes, such as those higher than 5", are normally worn only for aesthetic reasons and are not considered practical. The two exceptions are cowboy boots, which continue to sport a taller riding heel, and a brief resurgence in higher-heeled shoes for men in the 1970s(in Saturday Night Fever, John Travolta's character wears a Cuban heel of 1½" height to a stiletto heel (or spike heel) of 4" or more. The Stiletto heel is named after the Audrey Hepburn film of the same name. Dress shoes are categorized by smooth and supple leather uppers, leather soles, and narrow sleek shape. Casual shoes are characterized by sturdy leather uppers, non-leather outsoles, and wide profile. The majority of dress shoes have an upper covering, commonly made of.

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