Women are more likely than men to complain that their feet hurt, and to blame it on their footwear, according to a survey by the American Podiatric Medical Association. To avoid painful feet from high heels some women alternate their high heels with flats but this transition can also leave the legs and feet in agony. Higher heels uses different muscles to lower heeled footwear and overuse or repetitive stress may result in damage to supportive structures like tendons and ligaments. Plantar fasciitis is one of the most common foot pain complaints and damage to the Achilles tendon at the back of the ankle may also arise. According to experts both high heels or flats can on their own be a source of foot pain and problems. A survey found women wearing "high-risk" shoes that lacked sound structure and support, including high heels, sandals and slippers, were more likely to complain of foot pain later in life.