While dismounting, the slick sole allows the boot to easily come free of the stirrup. High-heels have seen significant controversy in the medical field lately, with many podiatrists seeing patients whose severe foot problems have been caused almost exclusively by high-heel wear. The outsole is the layer in direct contact with the ground. The tall leather shaft of the boot helped to hold it in place in the absence of lacing. One accessory used with cowboy boots is a spur, which is sometimes attached to the heel of each boot for the purpose of goading the horse while riding. most of the lower foot, but not covering the ankles. If it is not possible to avoid high heels altogether, some doctors suggest that the wearer wear high-heels no more often than twelve hours a day, and that they are.

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