High heels shown to be high risk

They may look fantastic, but evidence shows that wearing high heels is bad for your health.

A survey by the American Podiatric Medical Association (APMA) found that high heels were the most common cause of foot pain among women by a long way. Callouses, blisters, bunions, and ingrown toenails are all common among high heel wearers, and the higher the heel the more problems it causes. Wearing heels increases the wearer’s risk of sprains, strains and osteoarthritis of the knee.

Much of the associated foot pain is related to contorting the feet into a steep plantarflexed position. Too long spent in this position leads to shortened calf muscle fibres and a toughening of the Achilles tendon. This reduces the ankle’s range of motion, contributing to the risk of injury.

A study published in the Journal of Orthopaedic Research suggested that the altered gait caused by walking in heels was likely to contribute to an increased risk of knee osteoarthritis in women, particularly when combined with increased body weight. The study’s authors suggested that heels could be at least partly to blame for the higher incidence of osteoarthritis in women than men.

Tips to improve leg health include reducing heel height and length of time spent wearing heels. The APMA recommend a maximum heel height of two inches. For those wearing heels for any length of time, occasionally sitting and moving the knees through a full range of motion may help. Another suggestion is to stand against a wall or with one foot on a step and stretching the feet for a few minutes every day.

But these could be difficult health messages to get across. The average women who owns high heels has nine pairs, and when those in the APMA survey were asked what they do when shoes hurt their feet, 38% responded that they would “wear them anyway if I like them”.

Going to another extreme and wearing flip-flops may not be much better for foot health, according to research by Auburn University. This found that the altered gait induced by flip-flops can cause problems and pain from the foot up into the hips and lower back.

Flip-flop wearers were found to take shorter steps and their heels hit the ground with less vertical force than wearing athletic shoes. They did not bring their toes up as much during the leg’s swing phase, resulting in a larger ankle angle and shorter stride length, possibly because they tended to grip the flip-flops with their toes.

Last updated
The Pharmaceutical Journal, PJ, 27 June/4 July 2015, Vol 294, No 7868/9;294(7868):DOI:10.1211/PJ.2015.20068530

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