As a podiatrist, up to 40% of my day involves treating ladies of high heel wearing age, some of who have made a conscious decision to buck the trend and choose comfort over fashion, and many who haven’t.
The human foot was once described by Leonardo Da Vinci as “a masterpiece of engineering and a work of art”, and this is evidenced by our ability to walk, run, jump, and play. However, it doesn’t take much to upset the fine balance between precision function and disaster. High heels, by their nature shift the body’s anatomy into foreign territory, causing marked postural and alignment strain. If horses could talk they would tell you that walking on your toes (equine) has its drawbacks, and we’ve only got two feet to manage with!
By elevating the heel bone (calcaneus) there is an immediate change in the distribution of weight under the feet from the heel to the forefoot – the percentage of which is directly proportional to the height of the heel. With regular use, the calf muscles in the lower leg can permanently shorten, leaving you unable to comfortably wear flat shoes and further increasing pressure under the ball of the foot.
Habitual high heel wearers will invariably, at some point, suffer heel pain and disability because of this alteration in the way our body adapts to the ground and distributes weight.
Common complaints can include calluses, corns and blisters right through to permanent deformities including bunions, hammer toes and acquired flat feet. This list does not include increased incidences of fractures of the ankle and metatarsals (forefoot), arthritis, pinched nerves, tendonitis and other soft tissue injuries and inflammation.
Foot alignment or lack thereof, has the potential to affect the posture and position of all the joints in the lower limb and also the pelvis and the back. Many studies have found that increasing heel height increases anterior pelvic tilt and subsequent increased curvature of the lower spine (lumbar lordosis). Again, with repetitive use this can generate chronic lower back pain and increase intervertebral disc compression as well as deteriorate core stability strength.
Before you lose faith and trust in all things fashionable, here’s some tips on how to minimise risk while wearing your heels:
• Like most things in life, moderation is the key. Avoid wearing heels when walking to and from work (joggers are the safest bet), and kick off the pumps in the office and replace with flats.
• Pick shoes that suit the activity for the day – flats or shoes with only a slight heel pitch are best for standing and walking, whereas heels may be suitable during a seated meeting or dinner date.
• Keep the heel height sensible – really anything over 5cm is hazardous and should be for only special occasions.
• Stilettos (Italian for dagger) could not be named more aptly – really a dangerous shoe for ankle sprains and fractures. Try broader heels with more stability and tread on the ground.
• Stretch your calf muscles regularly to improve fl exibility and reduce the likelihood of muscle contraction.
• Seek immediate assistance from a podiatrist should you experience pain, swelling or a change in shape of any part of your foot. People suffering from diabetes, reduced circulation or with a history of foot problems should check with their podiatrist before changing footwear styles.