It could have been a rally. The ladies' shoes section of a big department store, 8:30 a.m. Saturday. A small but committed group of working women with grievous foot problems gathered to hear the words of a female podiatrist, and together with her, raise the banner of women's foot comfort. Instead, the attendees happily ate sweet rolls and strawberries as they listened to the young doctor praise women's dress shoes with deep toe boxes, gripping inner heels, and synthetic soles.

Her further recommendation that they still wear "well-thought-out" shoes -- rounded-toe, flat-soled, laced-up ones -- as much as possible, failed to raise even a low murmur among the harmonious crowd. Apparently, less than well-thought-out footwear was the price these women had tacitly agreed to pay to get ahead in a man's world.

Agreed upon or not, the reality was that while such functional foot gear kept their male colleagues well-grounded and fancy-free, it was apt to keep them behind the wheel of the family station wagon. They undoubtedly would do business with the pump peddlers.

For women in the business world today, the pump is synonymous with professionalism. The seemingly vacuous heel is widely believed to contain mystic powers of hiring and promotion. In a still sexist world, women feel compelled to wear them -- unfortunately, at a high cost to their bodies.

Angie Michael, executive image consultant, emphasizes the significance of high-heeled shoes to working women. "The pump is a business woman's best friend," she says. "It completes {her} professional image." Given the fact that women make roughly 60 cents on a man's dollar, they can't afford to look less than the most professional, Michael cautions.

A Gallup survey done for Dr. Scholl's and the American Podiatric Medical Association underscores the cult of the professional pump. The researchers found that women with a higher socio-economic status were more likely to agree that high heels are associated with "making it" professionally. And of the 25 percent in the survey deemed "heavy wearers" (wearing heels a heroic five hours or more a day) four-fifths were white-collar women.

The adverse effects of high-heeled shoes are well-documented. Melvin Konner reported in an article for the New York Times Magazine that high heels force the upper body forward and the lower torso back. To keep her balance, a woman must pull her shoulders back and arch her lower spine; this compensatory posture, dubbed the S-curve, can cause limping and damage to the lower back and legs.

High heels further upset the body's natural symmetry by shifting most of the weight that normally would fall on the heel to the front of the foot. The excess pressure -- 76 percent more in the case of a moderate -- 3-inch -- heel, causes shock waves to be transmitted through the Achilles tendons and calf muscles and, over time, can lead them to become permanently tightened. Ironically, walking barefooted or in flat shoes then becomes difficult -- a distressing phenomenon that requires women to set out of their beds in the morning in platform slippers.

Foot problems abound among high-heel wearers. Bunions, hammertoes and corns, and downward-sloping, pointed-toe shoes are a match made in hell. Most podiatrists say high heels aggravate rather than cause such problems. However, Konner reported in the case of bunions that the ratio of women to men who suffer from them is estimated to be 40-to-1 -- an aggravating statistic indeed.

To treat these painful misalignments of the big-toe joint, male sufferers simply choose a wider shoe to accommodate the abnormalities. Women, whose dress shoes demand rather than accommodate, often undergo debilitating surgery, keeping them out of all but a wooden shoe for up to eight weeks. The ultimate goal of these Olympian office workers -- to get back into high heels without pain.

The high-heeled norm for business women admits few exceptions. Jane Rogers, a legal secretary in the District, works in an office of 60 women. She says a de facto dress code mandates heels for virtually all female employees, and is especially strict for women going up the professional or managerial ladder. "It's about the same pressure teenagers feel," she admits candidly.

Says Alexandria podiatrist Annu Goel: "It's incredible. At least a 1 1/2-inch heel." Regardless of the health of their feet, women feel compelled to wear heels. "I've had women come in and actually cry saying 'I have to give a presentation (at work),' " says Goel.

For executive women, however, there seems to be greater latitude. "Once you've made partner you can afford to be comfortable," says Rogers. Goel believes women in higher-status positions tend to be more health conscious and less intimidated.

Beyond the office, shoe lines such as Easy Spirit, Rockport, and Naturalizer now offer high heels with shock-absorbing soles. Whether the strong sales posted by these and other manufacturers of the so-called "comfort pump" are a sign of women's increasing ability to chart their own foot destiny is unclear.

For podiatrist Anne Furman also of Alexandria, the comfort boom seems to suggest just the opposite. "Women must feel pressured if they go out and buy three pairs of $80 to $90 "Walking Pumps" -- Rockport's entry in the comfort race.

Meanwhile, women may consider organizing what Furman calls "a woman's comfortable shoe day." If they have to work twice as hard to be half as good, women deserve a well thought-out shoe.

Freelance writer Laura Bean doesn't wear high heels.