In April 13th 2015 Daily Mail there was yet another article discussing the findings of new research proving high heels can lead to arthritis and worn out knees. Is this really new? No, women have known the perils of wearing high heels for years, as many of my patients will testify to me, “I used to wear high heels, but sadly now I can’t”.
Yes heels can increase stress in joints and lead to increased wear and tear, but as a podiatrist I don’t act as the shoe police. There is so much research and information out there to tell women high heels can be damaging, that I feel I would be insulting a patient’s intelligence if I pointed out the harm heels can cause to hips, knees and feet, let alone the scratches and dents on wooden floors. If a female feigns not to know the potential harm heels can cause, it is because she doesn’t want to know, a kind of denial because she loves wearing her femme fatale footwear. They do elongate the legs, thrust the hips forward and make women look and feel sexier, although I often feel there should be deportment classes in teaching women how walk properly in them. It is a skill to get your centre of gravity balanced as to not fall over, or look like Tony Curtis in drag, in ‘Some Like it Hot’.
High heels come in beautiful colours and designs, and are simply gorgeous works of art, which being a woman I am drawn to. I feel every female should have the choice to wear them for those special occasions if they so choose. I sadly cannot wear them due to a long standing knee condition, which I must point out has nothing to do with decadent heel wearing. I get twinges of jealousy for those who can, a big admission for a ‘sensible ’podiatrist.
The ‘sensible’ podiatrist does though have a duty of care to educate and advise when not to wear high heels, which I do when there is a direct link to presenting clinical pathologies. High heels definitely are a predisposing factor to getting bunions, but sadly if there is a genetic link even wearing flat shoes cannot be a guarantee for prevention. High heels if worn constantly can shorten the tendo-achilles, but interestingly one of the main treatments for tendo-achilles pain is to advise the wearing of a heel. I am advising patients to stop wearing flat shoes like ballerina slippers, converses in preference of at least an inch to 2 inch heel. A high arched foot type is more suited towards a heel.
There are obviously heels and heels. A 6 inch stiletto can put more stress through a knee than a 4 inch. A 2 inch heel increases forefoot pressure by about 50% with every step, whilst a 6 inch heel is about 80%! Wearing a wedge type heel can help to spread the weight bearing stresses and is more stable. Wedge type heels can act like supportive and controlling orthotic insoles. Orthotics incidentally are only really functional in shoes with a maximum heel height of 2 inches, as the main weight is on the forefoot increasing deforming stresses. Women are often very disappointed when I point out that orthotic insoles have reduced effectiveness in high heels; “Surely there must be something I can wear?……..all my shoes have heels”. These ladies present me with a challenge, they often are not at the point of giving up on their beloved heels, anything lower equates to ‘frumpy’.
Women don’t want to give up their high heels until they have to, when push comes to shove, when the ‘pain’ becomes too much to mask with painkillers or pads. It is a psychological tipping point that has to be personally reached. I will not force the decision, just point out that “the heels are not helping”. I have ladies in their seventies who are loathed to look at Hotter shoes as an alternative. Half the battle is simply getting them to try on ‘something more sensible’. No ‘new ’research in the world will convert a heel wearer until they want to.
Tips for High Heel Wearers:
- Try to alternate your heel height
- Try to minimise heel wearing times
- Go for a more sturdy heel or a wedge
- With new heels roughen up the sole first before wearing to prevent slipping
- Take smaller steps making sure to place heel down first and glide
- A little wiggle actually helps and looks sexy
- Place a small cushioning pad into the ball of the shoe; helps to stabilise the forefoot
- Regularly stretch out calf muscles to keep them elongated
- Do simple toe exercises like picking up buttons to keep them strong
- Keep skin moisturised and supple
- Don’t choose strappy high heeled sandals which allow toes to claw over the front edge
Finally please take off the sole labels, not a classy look to leave on!
