Stilettos: High Heel Hell for your health?

We at Creative Chiro have been looking at the impact high heel shoes may be having on people and the way they could possibly be exacerbating or even causing problems in spinal health…

As our Chiropractor Michael would vouch, there are certain questions we are regularly asked by our patients, one being “Can the wearing of high heels aggravate my existing lower back complaint and can they cause other problems?”.

The British Chiropractic Association has published various articles on this subject and the latest data indicates that 59% of people wear high-heeled shoes for between one to eight hours a day. It may not be surprising then that shoes with an increased heel height have been linked to a higher incidence of low back complaints.

With the feet and ankles in an elevated position, high-heeled shoes can dramatically change the balance of foot-loading, causing an alteration in back muscle activation. This affects pelvic tilt and can result in a different walking pattern.

High heels also raise the centre of mass of the body and this affects postural stability which can lead to changes in muscle timing and activity resulting in discomfort and fatigue. Other consequences can include swelling and/or limited movement, promoting fibrosis (the formation of excess fibrous tissue) which affects the normal architecture of the muscles and alters joint loading thereby increasing the risk of repetitive low back strain injuries.

In flat shoes the load is spread evenly along the foot…

…look at the difference in high heels!

Studies have also revealed that there is an increase in the electrical activity produced by skeletal muscles of the deep low back with increased heel heights. This indicates the muscles are under increased strain. More specifically, in younger people (20-25 years) both low (4cms) and high (10cms) heeled shoes resulted in significant differences in low back muscle activity. Interestingly, in older people (45-55 years) it was only high heels that resulted in this significant difference.

Other research has looked to see if wearing high heels affects any other areas of the body. An American study suggests that the patellofemoral joint (the joint between the thigh bone and the knee cap) can also come under increased stress when wearing high-heeled shoes creating patellofemoral pain and a Brazilian study questioned whether walking in high-heeled shoes could contribute to common causes of complaints such as pain, fatigue, and heavy-feeling legs.

It was also found that walking in high heels reduced the muscle pump function of the legs (where the leg muscles contract on to the veins to push blood back up to the heart). The continuous use of high heels tends to provoke venous hypertension in the lower limbs and may represent a causal factor of venous disease such as leg ulcers, swelling, changes in skin pigmentation and eczema.

Another American study using heel heights of just 3.8cms, looked at the changes in knee loading stress, called ‘torque’, which is thought to be relevant to the development and/or progression of knee osteoarthritis. The results showed a significant increase in knee torque and the conclusions advised people not to wear high heel shoes.

At Creative Chiro, we look beyond the symptoms of pain and focus on the causal factors of why the body has moved away from a state of ‘equilibrium’ resulting in discomfort, dysfunction and distress. So, with the question being, “Are stiletto’s ‘high heel hell’ for your health? Well, I will let you decide! Take care of your spines - Michael