high-heels

High time to ditch the heel

Thanks to Physiotherapist Pierre Joubert from A&I Physiotherapy for supplying this article.

For lovers of high heels, it’s a hard habit to break. They make your legs look better, complete an outfit, and make you feel that little bit more confident. But most of us – whether we admit it or not – have left an event with our high heels in our hands at the end of the night. Yes, your favourite pair of stilettos can be uncomfortable when dancing all night, but they may be doing even more damage than the occasional blister.

“For female runners who like to wear high heels, it may decrease your time and endurance due to the alteration in tendon length they may cause”

High heels were initially designed to give women a taller and more slender appearance and make women’s legs look more toned. Some women feel more comfortable and confident in high heels, yet most women agree that high heels are uncomfortable and are not suitable for the workplace. Does that stop most ladies wearing them? Of course not – they remain the footwear of choice despite the likelihood of said heels contributing to the development of various conditions and pain in the lower extremities.

heels-diagram-1

How high heels can change your posture

High heels push the body into a forward weight shift causing a change in posture. The change in posture leads to a misalignment of the spine and it increases the pressure on the forefoot and knee.

The spinal misalignment demonstrated in this picture is the increase of the normal lower back (lumbar spine) curvature, which is commonly known as a ‘lumbar lordosis’. The picture also shows the increase in forefoot pressure when wearing high heels. Forefoot pressure can increase up to 76%.

Why high heels may cause pain

Due to the increased forefoot pressure for an extended period of time, it can lead to other complications such as Morton’s neuroma, Hammertoes, bunions, corns and calluses. The change in posture also increases knee pressure by 26%, which can lead to degeneration of the knee joint and common pathologies such as knee osteoarthritis.

PhysioBlog_img_1664Wearing high heels may also alter the length of the calf muscle and its tendon. This shortening can lead to Achilles tendon injuries and even an Achilles tendon rupture. It’s interesting to note that Kenyan runners are more efficient due to their long Achilles tendons (TA). If your TA length is good, less work needs to be done by the calf muscle because of the elastic recoil properties in your tendons. So, for female runners who like to wear high heels, it may decrease your speed and endurance due to the alteration in tendon length your footwear may cause.

High heels and lower back pain

It’s a very common understanding that high heels can cause lower back pain, but – further to that – it could be detrimental to wear heels if you already have a degenerative back or chronic lower back pain.

This is more probable if you wear high heels on a frequent basis. Elevated heels will cause your lower back to accentuate its lordosis (lumbar spine curve). This will predispose you to increased joint stress and misalignment leading to lower back pain. This increased lordosis, commonly referred to as hyper-lordosis, will narrow the opening between the vertebrae where the nerve root exits thus causing compression of the nerve roots within that opening. It may also cause enough additional disc stress to result in further disc bulging and subsequent sciatica due to nerve root compression.

However, it should be noted that not every woman who wears high heels will develop lower back pain.

Simple tips and high heel alternatives

Listening to your body is always a good call. If pain is increased with high heel use, then you should consider avoiding wearing high heels altogether.

Change your habits by decreasing the time spent in high heels. Wear sensible comfortable sandals during the day and leave the high heels for the evenings.

You can also alternate between heel heights if you have to wear them every day.

When buying heels pay attention to the slope or pitch of the heel as a gradual heel slope has better weight distribution.

Also, stretching your calf muscles can help to lengthen the calf muscle and tendons.

The information provided is general in nature and should not substitute any health or medical advice. Please consult a qualified professional to assist with any specific conditions or queries. The opinions expressed as those of the individual columnists. You know the drill…

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Accident & Injury Physio

Accident & Injury Physio

Accident & Injury Physiotherapy believes in treating both the patient and the injury to ensure fast and complete recovery. The team of experienced physiotherapists and exercise physiologists design treatment programs and solutions for all therapeutic needs, whether it’s severe back pain, a sporting injury or post-operative care. A&I offers a range of health, fitness and treatment services, including musculoskeletal physiotherapy, remedial massage, hydrotherapy, clinical Pilates, exercise physiology, and a GP doctor and sports physician.

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