Heel protectors are widely used in ballroom dancing, as such dances are often held on wooden flooring. Today, high-heels are typically worn by women, with heights varying from a Cuban heel of 1½" height to a stiletto heel (or spike heel) of 4" or more. Early boots were plain leather, but as custom boots were made, cowboys asked for decorative stitching, cutouts in the high tops (early on, often Texas stars), and different materials. Some designs of dress shoes can be worn by either gender. The altered forces at the knee caused by walking in high heels, may predispose to degenerative changes in the knee joint. Some shoe manufacturers now market heels with significantly larger sizes to accommodate men. Also, the Fall 2006 Dior Homme line by Hedi Slimane features 3.5 inch heels for men. A shoe is an item.

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