Carrie Bradshaw had cupboards of them in Sex in the City. They can be a girl’s best friend, women love to go shopping for them and try them on.

This month, I look at the shoe that all women seem to love, the high heel. I hear many women tell me that they make them feel more elegant and confident; that they make their legs look longer and sexy; that they lift the buttock and exercise the gluteals (bum); they make you taller; they force your back to arch, pushing the breasts forward and the butt rearward, thus accentuating the female form.

I have heard all the reasons why they like them, but really the side effects of wearing high heels day in and day out are catastrophic! Following are a list of the nasty side effects of wearing heels.

1.  First and foremost, high heels change your posture unnaturally. Yes they lift the buttock and push the breasts forward but the way they do this is by increasing the angle at the lumbosacral region, L5/S1 (low back). Hence increasing the lumbar lordosis, pushes the centre of gravity forward, creating a shearing force at the L5/S1. This increases the forces on this joint, predisposing them to earlier degeneration or otherwise known as osteoarthritis. This arthritis occurs normally in the posterior zygaphosial / facet joints and degenerates the interverterbral disc. Hence high heels can and will take the hips and spine out of alignment and cause pain and chronic hip flexor tightness.

2.  The higher the heel the longer the leg. But as the heel gets higher, so does the pressure on the front of the foot. Over long time periods this can lead to bruising, stress fractures of the toes, hammertoes, metatarsalgia, dropped transverse arches and even bunions. A one inch heel creates an extra 22% load on the forefoot. A two inch heel creates an extra 57%, and a fantastic three inch heel creates an astounding 76% load on that forefoot.

3.  Hammertoes. This is where the toes are held in a continuous curled position, and are pulled back towards the ankle. They form calluses on the bottom of the foot and corns on the top of the toes. Hammertoes are caused by squeezing feet into ill-fitting heels or shoes that are pointed at the toes. Eventually the toes become so misshapen they can’t be straightened with footwear and need to have surgical intervention to try and straighten the toes and release the tight muscles in the front of the lower legs and shins.

4.  Hallux Valgus or bunions. This is where the big toe heads towards the little toe. This can be caused by excessive pronation/rolling in of the foot but also from high heels. Wearing high heels causes most of your body weight to be pushed forward onto the ball of your foot, increasing the forces into this joint and degenerating the joint.

5.  Metatarslagia is normally due to the same causes as mentioned above. This is pain under the balls of the feet, normally due to carrying around the weight of your body on your toes all day long.

6.  Chronic tightness in the calves. Yes the high heel elongates the calf, but have the calf in this unnaturally contraction when you are walking over a long time will cause them to be permanently shorten and tighten, leading to pain in the foot, or knee, hip or low back.

7.  Achilles tendonitis. Chronic shortening of the calves will increase the load on the Achilles tendon as it attaches to your heel. This increased shortening will mean that when you don’t have a high heel on, the tendon will be overstretched and inflamed, and become a condition known as tendonitis.

8.  The dreaded Pump Bump. This is also known as Haglund’s deformity and is an enlargement of the bony lump on the back of the heel. It is commonly caused by straps and the rigid backs of pump-style shoes (hence its name), rubbing and irritating the heel.

9.  Ankle injuries. I am sure you have or least have known someone that has injured their ankle whilst walking or even dancing in heels. High heels affect your balance and increase your chances of falling – particular if you are older or overweight (or even a few too many lemonades). Injuries can include sprained or even broken ankles.

10. The knee. Whilst teetering on that high heel or stiletto, the knee is trying to stabilise you. The proprioceptors are firing in overdrive. As your weight is shifted forward, you put more pressure on the inside of the knee. One study found that there was 26 percent greater pressure in this area compared to flat shoes. This leads to early degeneration of the joint, leading to osteoarthritis.

So the question is, ‘are you still going to wear those stiletto shoes?’ You might say it doesn’t matter at the moment, I am young and I can enjoy them now without these problems but I see time and time again in clinic. The effect of punishing the body early in life, means you will pay the consequences when older, when all we can do is try to manage the problem instead of correcting it.


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This article is written by Dr. Steven Cannon, Chiropractor – Neurohealth Chiropractic