Very excited to have a little guest blog from our friends down at PodMed in Double Bay. We treat alot of women with foot & lower limb problems…. when discussing aspects of their rehabilitation the wearing of high heels is often a question that comes up… So we asked the podiatrists…. they are at the end of the day experts when it comes to feet!
I am asked this questioned nearly every day by women who present with all kinds of different foot pain. There is a common misconception out there that high heels are the primary cause of most foot pain and deformity in women. Yes, I can guarantee you that if your foot is squeezed into a high-heeled shoe eight hours a day, at some stage foot pain and deformity will be the end result. High heeled shoes can do a lot of irreparable damage to the feet and ankles. However when used in moderation some of the pitfalls can be avoided. Many of my patients wear high heels on the odd occasion and as long as it’s only for a couple of hours at a time at a party or out to dinner; it’s generally not a problem. Of great concern to us is the number of young teenage girls presenting in our clinic showing early onset deformities as a result of high heel wearing. Parents need to discourage their teenage daughters from wearing high heels at any time. The developing and immature foot structure does not cope at all well with the excessive forces placed on the foot by the high heeled shoes. High heels put the anatomical structures inside your foot into an unnatural position. With each step the toes are squashed inside the shoe. The pointier the shoe and the higher the heel the more pressure placed on the toes. It’s important not to under estimate the damage this can do to the foot in the long term. Habitual long-term high heel wearers routinely present with problems like clawed toes, bunion formation, metatarsalgia and nerve damage. Foot structure will have some bearing on how resilient the foot structure is to the adverse effects of high heels but as I like to say, footwear is designed to protect your feet, not to hurt you. If your high heels are hurting you, take them off because they have already been on too long. ‘If the pain persists…..see your Podiatrist’. High heeled shoes shift an unnaturally large amount of force onto the forefoot with every step. The natural heel to toe transition is altered and the force moves too quickly from heel to the forefoot where the high loading remains for the duration of the steps. It is the increase in time that the foot is overloaded with every step that does as much damage as the pressure itself.
The postural position high heels places the body has historically and is still considered aesthetically appealing to the human eye. In the leg, the calf muscles protrude more in high heels giving the impression the legs are strong and slender. At the knee, it is bent when the heel is lifted up. Usually with a 3 inch heel, the pelvis is tilted forward 10-15 degrees which leads to a “sexy” curvature in the spine. This makes the buttocks protrude 25% and also lifts the bust (see picture below). That is how a sexy and wavy body posture is obtained and explains why 3-inches high heel is apparently more popular and loved by most women. However, it is also due to these minor postural adjustments that can have negative effects on the body after a long period of time.
Heel height: Wearing a shoe with a lower heel can certainly help. By lowering the heel you can take some of the pressure of the foot structure but you can also help reduce the negative postural effects on knees, hips and low back. Lowering the heel can also reduce the stiffness in Achilles tendon’s and calf muscles that habitual high heel wearers suffer. If the Achilles and calf muscles shorten too much then wearing flat shoes or walking barefoot becomes almost impossible.
Insoles: Insoles or customised orthotics can prove to be a wonderful way to manage foot pain on a daily basis. However, it is best to discuss what type of insoles or orthotic might be right for you with your local Podiatrist.
Wearing well-fitted shoes: When a shoe fits very well it will generally be comfortable for eight hours or one hour. It is important to select the right type of shoes for right occasion. You wouldn’t wear your high-heeled shoes for exercising i.e. a long walk, a run or to the gym. Nor would you choose to wear your exercising footwear or comfortable casual shoesout to dinner or to a cocktail party (unless you had to). Alternating between flats and heels can sometimes prove difficult (see ‘wearing a lower heel’). However, providing that the difference in the heel height between the flats in the heels it’s not too extreme, alternating between the two is a fantastic way to go. Try to make sure that the flats still have some small amount of heel raise in them. Most foot types appreciate a small amount of heel raise in their flats and this makes the transition from high-heeled shoes into to flattish shoes much easier.
Also it is best to buy high heels in the afternoon when your feet are at their largest. Therefore when your legs and feet expand, the shoe size is correct and the toes aren’t cramped.
Stretching: Most of us have been wearing shoes with some form of heel raise in them from a very young age and this somewhat shortens the Achilles tendon’s and calf muscles. For this reason, stretching is very important. Stretching is even more important for long-term high heel wearers because their Achilles tendon’s and calf muscles can become extremely short and tight. To walk normally and without having to make unnecessary compensations is not only important to have a good range of motion in your calf muscles but also in the other important muscles of the leg, thigh and hip. High-heeled wearers typically have very tight planter flexers in the bottom of the foot, short calf muscles, tight hamstrings, quadriceps, ITB’s, hip flexors, gluteals and over time the body over compensates and muscle imbalances and postural issues often arise.
Thanks to Sarah Bongioletti from Pod Med Podiatry Centre for her words of wisdom.
Check out their website HERE