Although high heels originated as male footwear around 1500, since the late 1700s, men's shoes have had primarily low heels. 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 spending at least a third of the time on their feet in contour-supportive "flat" shoes (such as exercise sandals), or well-cushioned "sneaker-type" shoes, saving high heels for special occasions. Despite its close association with US culture, the cowboy boot is originally Mexican and traditionally part of the outfit of the Mexican vaquero (cowboy). In England, the balmoral is known as the Oxford. The word "Oxford" is used by American clothing companies to market shoes that are not Oxfords, such as rubber-sole bluchers. One accessory used with cowboy boots is a spur, which is sometimes.

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