Shocking Facts About High Heels

“They went into my closets looking for skeletons, but thank God, all they found were shoes, beautiful shoes,” a smiling Mrs. Imelda Marcos said, wearing a pair of locally made high-heeled silver shoes. 

These were the words of Mrs. Marcos (You know her, right? If not, where have you been…) in a documentary I once watched.  Wherever shoes are discussed among Pinoys, the name Imelda is sure to follow.  But surely she is not alone in her obsession for stilettos.

If dogs are man’s best friend, then high-heeled shoes and women are bosom buddies. Unfortunately, like dogs, when heels are not treated properly, they are bound to bite back.  Not much is publicized about the risks of wearing high-heeled shoes, but the problem is real and backed by scientific evidence.  

I think women, my wife included, have an inkling that wearing heels everyday is not good for their health.  But I also realize that it is next-to-impossible to persuade them to abandon their Jimmy Choos and Louboutins. (I just learned these terms from my wife a while ago). It might be easier to teach my dog how to talk.

Christian Louboutin colorful rivets pumps

Why do women wear high-heeled shoes?

From the female perspective, heels, pumps, platforms and stilettos have gone far beyond the function of shoes.  No longer just a tool to make them taller, through the modern ages, high heels have become the ULTIMATE fashion accessory, a female anting-anting (amulet), and status symbol all rolled into one.

      Do you know that heels force the lower spine to arch backwards to maintain balance? This changes a woman's posture, pushing the buttocks back and the chest forward, exaggerating their giftedness, if they are gifted.  No wonder women claim they look and feel sexier with their heels on, and look more desirable and appealing to men.  Others claim that heels give them the confidence boost they need for work and other important activities.

What are the Risks of Wearing High-heeled Shoes Frequently?

Whatever their reasons may be, they do not discount the fact that there are harmful effects of wearing high-heeled shoes frequently. I recently got to discuss this when I was interviewed for a GMA news TV show “On Call”.  The following video was my actual interview. Pardon the quality as it looks like a pirated Quiapo DVD, but the sound quality, I think, is good enough.

To recap, the risks posed by high heels include falls, ankle injury, bunions, foot deformities, ball of the foot pain, blisters, and calluses.

   Several studies also document increased pressure through the knee, and an increased incidence of knee osteoarthritis. Some ortho colleagues postulate that this may be one of the reasons why knee osteoarthritis is more frequent in women than men.

      As I already mentioned, the use of high-heeled shoes shifts your weight forward to compensate, which may lead to low back pain.

     One study examined the effect of heels on the Achilles tendon (the tendon at the back of your ankle).  It found that long-term use of high-heeled shoes induces shortening of the calf muscle and increases Achilles tendon stiffness. Over time, the motion of the ankles are limited and the feet become accustomed to its downward pointing position.  The shortening of the muscles and Achilles tendon stiffness are the reasons why some women report more pain in flat shoes and find themselves losing their balance when not in heels.

     Note that a tight Achilles tendon can also cause plantar fasciitis, an inflammatory condition at the bottom part of the foot, which is very painful and can become chronic if not properly treated.  

What can be done to prevent or minimize the risks of wearing high heels?

 In order to avoid long-term complications of heel wear, I would suggest to women, to limit heel-wear to 2-3 hours at a time, limit heel height to 2 inches or less, and/ or wear heels only for special occasions. Make sure they are well-fitted and don’t wear them every single day.  Heels with soft material in the arch and around the heel tend to provide more support.

     For women who must wear heels for work, then I suggest you wear flat, comfortable walking shoes for driving or commuting.  Daily stretching of the calf muscles and Achilles tendon will delay or prevent shortening and stiffening, and all its painful complications.

     At the end of the day, soaking your feet in warm water and light foot massage may help relax the foot muscles and tendons.

Take home message

It is obvious that my wife will continue to buy and wear high-heeled shoes, even against the advice of her handsome and most trusted medical professional (that’s me, who else?).  The desire to look fashionable, sexy and confident will continue to drive women to wear high-heeled shoes, despite significant foot and lower extremity problems it may cause.  A survey conducted by the American Podiatric Medical Association found that 42% of women they polled said that they would wear a shoe they liked even if it gave them discomfort.  

      But think of it this way, if your car tires are out of alignment, you can only drive so many miles before you increase your risk of blowing a tire.  The same is true for your body, especially your feet.  Without the proper body positioning and alignment, a part of you is bound to give in, and its usually your feet.

More foot care in future posts…………..