The altered forces at the knee caused by walking in high heels, may predispose to degenerative changes in the knee joint. 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. The stiletto of certain kinds of high-heels can damage some types of floors. 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 in the opening sequence). they change the angle of the foot exposed to air. One accessory used with cowboy boots is a spur, which is sometimes attached to the heel of each.

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