The Lows of High Heels: Are they really bad for your health?

Read Michael’s latest article for the East Anglian Game & Country Fair newsletter…

Michael I’Anson, Practice Director, Creative Chiropractic

Michael J. I’Anson M.Sc (Chiro), D.C. Practice Director

It is frightening to think that the festive season is almost upon us and although the nights are drawing in and the days are getting shorter, the after-work parties are soon to begin meaning party frocks and high heels! At Creative Chiropractic we have been looking at the effects on women who wear high heels and the subsequent possibility of developing or exacerbating a low back problem. The British Chiropractic Association also published an article on the same subject.  As a Chiropractor, and as many of my colleagues would also vouch, there are certain questions we are regularly asked by our patients, one being, “can the wearing of high heels exacerbate my existing low back problem or can they cause other issues?”

Creative Chiropractic, heels, high heels, posture, chiropractor, The Lows of High Heels: Are they really bad for your health?Research suggests that 59% of women wear high-heeled shoes for between one to eight hours per day. It may not be surprising then that shoes with an increased heel height have been linked to low back pain. With the feet and ankles in an altered position, it is not unexpected that wearing high heeled shoes can change foot-loading patterns, cause an alteration in back muscle activation, effect pelvic tilt and result in a different walking pattern. High heels also raise the centre of mass of the body, thus, altering postural stability which can lead to changes in muscle timing and activity resulting in discomfort and fatigue.

Studies have revealed that there is an increase in electromyography (EMG) recording (a technique for evaluating and recording the electrical activity produced by muscles) of the deep low back muscles with increasing heel heights. More specifically, in younger women (20-25 years) both low (4cms) and high (10cms) heeled shoes resulted in significant differences in low back muscle EMG activity. In middle aged women (45-55 years) it was only high heels that resulted in this significant difference.

Creative Chiropractic, heels, high heels, posture, chiropractor, The Lows of High Heels: Are they really bad for your health?

This x-ray image showing a foot in a 10cm high heel shoe. It is easy to appreciate how much force is being put through the ball of the foot (shown in RED). Pains in the sole of the foot, ankle and calf are common and fractures to the toes are not uncommon.

The conclusion of this research indicates that wearing a stiletto-type heel significantly increases low back muscle EMG during walking in all individuals. The clinical consequence includes increased muscle fatigue, creating swelling and/or limited movement, promoting fibrosis (the formation of excess fibrous tissue affecting the normal architecture of the muscle) in the associated muscles and altering joint loading. Collectively, these findings suggest that permanent wearing of heeled footwear could contribute to muscle overuse and repetitive strain injuries. All these factors could be both consequences and potential causes of low back pain. Other research has looked to see if wearing high heels affects any other areas of the body. An American study suggests that the patellofemoral joint (the joint between the thigh bone and the knee cap) can also come under increased loading stress when wearing high-heeled shoes leading to knee-cap pain. Some Brazilian research questioned whether walking in high-heeled shoes could contribute to common causes of venous complaints such as pain, fatigue, and heavy-feeling legs. It was found that walking in high heels reduced the muscle pump function of the legs (where the leg muscles contracting on to the veins to push blood back up to the heart). The continuous use of high heels tends to provoke venous hypertension in the lower limbs and may represent a causal factor of venous disease such as leg ulcers, swelling, skin pigmentation changes and eczema. Another American study looked at heel heights of just 3.8cms and the changes in knee loading stress (called, torque), which is thought to be relevant to the development and/or progression of knee osteoarthritis. The results showed a significant increase in knee torques and the researches conclusion was to advise women not to wear high-heeled shoes for prolonged periods of time.

In no way do we want to appear like party-poopers and when it comes to our Christmas party, our ladies will party as good as the rest but I will leave you with the question, “Are high heels bad for your health”? Well, I will let you decide!

Look after your backs and enjoy your festive parties,


For more information or to have your feet assessed, call Creative Chiropractic on (01263) 715522 and ask for a ‘free pain & posture assessment’. Alternatively, a voucher can be downloaded by clicking here.

The Lows of High Heels: Are they really bad for your health?

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