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High-Heeled Shoes: Platform to Pain

Shoes have evolved from once being a protective element for the feet to an iconic symbol for sophistication, sexuality, and elegance. No other footwear exemplifies the symbolism unlike high-heeled shoes. High-Heels, Pumps, or Stilettos are beyond a means of protection for feet and are not humbly worn but rather expressed with passion, adored, and have become a staple within the female culture. From the beauty depicted in magazines to the glamour percepted through television and hit films - high-heels have become an indispensable component in most female's closets. However, the glamour may not be all it is raised up to be. As many women will already willingly admit, high-heeled shoes are rarely worn as a means for foot comfort – but how bad can they really be?

Is the glamour worth the pain?

At some point you have either personally felt pain, complained of discomfort, or, have dealt with a friend or family member who has experienced some negative side effect from wearing high-heeled shoes. Is the pain worth the look? Most do not realize wearing these 4-inch "Glamour Platforms" is causing unnoticed injury to ones body.

NPI Unveils Critical Research

With the heel raised in relation to the toe there is an increased force on the forefoot that predisposes many foot ailments. With a wide variety of heel heights, ranging from ½" up to 4", the larger the heel the larger the increase of force placed upon the forefoot. In one study they examined the effects of high-heeled shoes as opposed to barefoot walking while measuring joint torques. Kerrigan found high-heeled shoes to significantly impair normal ankle functioning. This may not come as a surprise due to the falls commonly associated with wearing high-heels. However, the impairment does not stop at the foot, but also, compromises the knee and the hip in order to compensate for the unstable ankle. The study results concluded a 23% increase in varus torque of the knee(1). In other words, the ligaments of the knee are enduring extreme amounts of compression in order to stabilize the ankle and to prevent you from falling. The findings of this study support evidence of osteoarthritis being twice as likely in women compared to men.

If knee issues are not enough to limit your love for heels maybe your lower back might change that decision. Another study examined the biomechanical effects of wearing high-heels in different heel heights. The study concluded lumbar flexion decreases significantly as heel height increases(2). Therefore, the body's center of gravity is displaced and an unstable posture results. Put differently, as heel height increases, center of gravity is altered causing the upper body to become top heavy and unstable. The shift causes an exaggerated lumbar lordotic curve ultimately increasing compressive forces to the lower back. The alerted angle requires compensation through increasing the activity of muscles that stabilize the spine - primarily the erector spinae. To many, having muscles activated through wearing heels may seem as a positive but the activation is a result of poor posture and ultimately will result in future lower back complications. The compensation may become apparent if low back pain and fatigue are part of your life if you fashion high-heels regularly.

If a predisposition to knee osteoarthritis(1) and lower back pain(2) are not convincing evidence to limit high heels other studies recorded wearing heels resulted in an shortened Achilles tendon(3), increased oxygen consumption(4), decreased stride length(5), & altered gait pattern(6), walking speed(7), and mobility(7). With the strong evidence weighing negatively in the favor of wearing high-heeled shoes, a serious consideration should be emphasized before selecting a fashion statement over a healthy body.





  1. Kerrigan, D. Casey, Mary K. Todd, and Patrick O. Riley. "Knee Osteoarthritis and High-heeled Shoes." The Lancet 351.9113 (1998): 1399-401. Print.
  2. Lee, Chang-Min, Eun-Hee Jeong, and Andris Freivalds. "Biomechanical Effects of Wearing High-heeled Shoes." International Journal of Industrial Ergonomics 28.6 (2001): 321-26. Print.
  3. Scholl, W., 1931. The Human Foot: Anatomy, Physiology, Mechanics, Deformities and Treatment. Charles C. Thomas, Springfield, IL.
  4. Mathews, D.K., Wooten, E.P., 1963. Analysis of oxygen consumption of women while walking in different styles of shoes. Archives of Physical Medicine and Rehabilitation 99, 569–571.
  5. Adrian, M.J., Karpovitch, P.V., 1965. Foot instability during walking in shoes with high heels. Research Quarterly 37, 168–175.
  6. Gastwirth, B.W., O'Brien, T.D., Nelson, R.M., Manger, D.C., Kindig, S.A., 1991. An electrodynographic study of foot function in shoes of varying heel heights. Journal of the American Pediatric Medical Association 81, 463–472.
  7. Murray, P.M., Kory, R.C., Sepic, S.B., 1970. Walking patterns of normal women. Archives of Physical Medicine and Rehabilitation 51, 637.
  8. "History of High Heels | Random History." Random History and Word Origins for the Curious Mind. Web. 01 Aug. 2011. <http://www.randomhistory.com/1-50/036heels.html>.
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