August 2014

High heels, bad for feet and body?
A love-hate relationship

Queen of high heels, Sarah Jessica Parker, 48, whose Sex and the City character Carrie Bradshaw made high heels the must-have fashion accessory, has been forced to give them up. The actress revealed: “I went to a foot doctor and he said, ‘Your foot does things it should not be able to do. That bone there…You have created that bone. It doesn’t belong there.’” Then there is fashion designer Victoria Beckham, 39, who recently confessed she needs surgery on bunions caused by wearing towering shoes years and years. Those celebrities are definitely not the only ones. A fifth of all women feel the burn from tottering on high heels already after 10 minutes and to be even more precise: on average, killer heels really start to hurt after one hour and six minutes. So why then are women still wearing these unfeasible things? I went to talk with podiatrist Liz Haro and she informed me about everything regarding wearing heels and the risks of it.

By: Simone Batelaan
Projects Abroad Volunteer
Den Haag, The Netherlands

The madness of High Heels
Photo: Ximena Noya

First, to make you understand all the complicated medical terms and explanations in this article a little better, here is some basic information about our feet. Your foot is composed of 26 bones; these bones are spread out over three parts in your foot: forefoot, midfoot and hindfoot. When we are walking on shoes that contain a two centimeter platform, 50 percent of all body weight lands on your hindfoot and the other 50 on your forefoot. When you are walking on shoes that contain a four centimeter heel, 43 percent lands on your hindfoot and the remaining 57 percent on your forefoot. All recent researches point out that these heels, up to four, four and a half centimeters at most, do not cause much damage, but when we refer to four and a half centimeters or more it is different: wearing heels from six centimeters long, 25 percent of the bodyweight lands on your hindfoot and 75 percent on your forefoot. Yet ladies these days often wear heels six centimeters or more, where only 10 percent of your body weight lands on your hind foot and all the rest, 90 percent, lands on your forefoot, we have a problem. The bones of the forefoot are much more fragile than the bones of the hind foot since the hind foot can support the strong bones from the ankle joint in contrast to the forefoot.

I was naturally curious to what the most common injuries are for wearing high heels as the cause. Dr. Haro explained to me that all the little pains, minor aches, and small injuries start in the foot itself. A common injury is “hallux valgus” (abnormal position of the big toe).

Wearing shoes that are too narrow and pointy, ensuring that the toes press together is usually seen as one of the main causes of the emergence of hallux valgus. The result is an abnormal foot pattern; the pressure on the foot joint, combined with poor footwear, can lead to instability in the joint.

Women feel and look more elegant when they wear heels.
Photo: Ximena Noya

Another common injury is called “Morton’s neuroma:” a trapped nerve between two metatarsals. It starts as a random common pain in the foot and in this stage many women do not know there is an injury arising in their foot. The symptoms in the early stages are mainly characterized by acute periods of pain in the forefoot, radiating to the toes. As Dr. Haro says, ““People say, ‘The bottom of my foot hurts when I walk.’ They should say, ‘The bottom of my foot hurts when I walk in these pointy toe high heel shoes.’”

In the long run, nerve thickening (neuromas) can become so thick that it is impossible to wear shoes without pain, which is chronic. What to do? For chronic complaints, it is medically possible to get a corticosteroid injection or a surgery in which the nerve or the thickening gets removed. However, most doctors prefer, when the nerve thickening is not yet too thick, to treat it with a podiatric insole and / or a toe orthotic device.

Not only can your foot get in danger, also your calf and back may suffer the brunt. What happens with your calf is that with wearing heels, your calf stands constantly in a shortened and tightened position. Muscles that stand prolonged in a shortened situation adapt to this and thus get shorter. Then, when you walk on flat shoes again, there will arise a rack on these shortened calf muscles which can cause injuries to the calf, to the Achilles tendon (tendon of the calf), and naturally cause plenty lot of pain. As for your back: when you are wearing heels, your position becomes much more forward then normally and, worst case scenario, high heels disturb the natural line of your spine in such a way that its nerves get stuck.

Excessive high heels hurt your back
Photo: Ximena Noya

Finally, chief podiatrist of Dubai Podiatry Centre, Michelle Champlin adds, “We frequently see trauma injuries in our clinic, from sprained ankles to broken wrists and head injuries, not to mention detached toenails from people who have been walking with high heels.”

Yet since I am a fan of high heels, I also definitely want to share what I think are the largest benefits of wearing heels. First of all, heels, and preferably as high as possible, makes your posture much more beautiful. Your calves become longer and slimmer and your back stands suddenly upright. The whole attitude improves.

Aside from the attitude, the manner of walking is more attractive with heels (as long as you can walk on heels, otherwise you are asking for foot problems right away). Women feel more elegant when they wear heels. The footsteps are lighter, the hips move more, it is more careful, more seductive. And of course; the perfect heel of the shoe, the perfect nose, the leather sole, the elegance, the lines and shapes. Therefore, do not hide your finest heels in a closet; put them where you can see them. It will make you happy.

As with many things in life, the answer to the question whether wearing heels is bad is that “it depends” on the circumstances and on the person in question. There is a difference between wearing stiletto heels or block heels, wearing heels from four centimeters or 10 centimeters, wearing them every day of the year or only for special occasions. If you are you going to tinker with these variables, the answer on the question will change.

For the rest, it also depends on the type of foot; not all women are the same. The fact remains that the position of the body, by frequent walking in heels, may undergo changes, and that an unnatural posture may eventually cause problems.

Dr Haro advice is: “Avoid wearing high heels every day, but also make sure your shoes do contain a solid sole that provide firmness. If you do want to wear heels frequently, go for two, three, four centimeter heels at the most. This will not cause long term injuries. What is also very important it to not let children walk on heels! It is very bad for their stunted feet and the rest of their immature body.”

So, be wise and alternate those heels every once in a while for your fancy sneakers or ballerinas. It ensures that bones, muscles, anklets, and the back will stay unimpaired and healthy.

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