When walking in my neighborhood mall, I saw a lady walking in very sexy high heels. The stilettos, without the lady in them, were real eye candy. But the lady's walk left me wondering how much time she'd take to break her ankles. And the lady was not bothered at all about the stiletto - badly twisting to one side.
This prompted me to write this post and maybe I'll write a detailed one on the topic sometime later.
Do hold your stiletto in your hand and try to twist is mildly to each side. If it twists easily, you have a problem in hand [actually, in feet ;) ]. When you walk in such a shoe, you roll to a side [mostly the outside]. This stretches ligaments at the ankle too much, paining and even tearing them. It leads to ankle sprain, osteoarthritis if the problem is allowed to persist.
There could be two reasons for this:

Two, foot related: the shank fixing can weaken or the heel can wear out on one side if you have some gait related problem. The answer is in wearing customized shoes [if the walk is too wavy] and repairing heels as soon as they show signs of wear.
Whatever the reason, don't walk in high heels if the heel does not stand straight on the ground.
For my other shoe related tips, please visit this section.
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