Shoe materials include leather or canvas. Because of this, standardization has been slow, and fitting between companies is not always consistent. Shoes with uppers made high to cover the ankles are also available; a shoe with the upper rising above the ankle is usually considered a boot but certain styles may be referred to as high-topped shoes or high-tops. Each manufacturer has developed its own proprietary lasts for producing boots, which are considered trade secrets and are highly guarded. Extremely high-heeled shoes, such as those higher than 5", are normally worn only for aesthetic reasons and are not considered practical. outsoles made of natural rubber or a synthetic imitation. The altered forces at the knee caused by walking in high heels, may predispose to degenerative changes in the knee joint. Today, high-heels are typically worn by women, with heights varying.

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