The altered forces at the knee caused by walking in high heels, may predispose to degenerative changes in the knee joint. most of the lower foot, but not covering the ankles. they make the wearer appear taller. outsoles made of natural rubber or a synthetic imitation. insoles are often added for comfort or health reasons (to control the shape, moisture, or smell of the shoe). The outsole may comprise a single piece, or may comprise separate pieces of different materials. Each manufacturer has developed its own proprietary lasts for producing boots, which are considered trade secrets and are highly guarded. Athletic shoe soles may be made of rubber. Such damage can be prevented by heel protectors, also called covers, guards, or taps, which fit over the "stiletto" tips to keep them from direct, marring contact with delicate surfaces, such as linoleum (rotogravure) or urethane-varnished.

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