Do you like wearing high heels?

I do, particularly when I am dancing tango. Did you know that wearing heels affects your posture, balance and efficiency of your muscles to perform optimally?

I’m not here to tell you to stop wearing high heels, but it is worth considering the impact that they might have on your body and start considering how to reverse that impact.

Here is the deal, when you wear high heels, it can change our plumb line (how we align our body against gravity); this affects how we are carrying weight through our joints, and how much work our muscles need to do to hold us up in standing. Heels very much affect how our body will propel us through space.

Studies have shown our quads (thighs) and our hip muscles can become more active1 when walking in heels. If high heels are worn often, there can be an adaptive shortening in your calves, which reduces your muscle’s ability to contract even though the demand is higher! Pain in the ball of the foot is a common complaint for people who wear high heels, and why shouldn’t it be? The increase in pressure to the ball of the foot has been documented to increase up to 40%, or in other words, pressure shifts from 29.50% when barefoot, to 70.50% in 7 cm high heeled shoes. This shift in pressure alone can result in a range of issues from bunions to metatarsal pain or neuromas to name a few.

Knee pain is another common complaint, this makes sense too, considering the angle at your ankle, every step you take is as if you are going downhill. This increases the demand on your quadriceps as well as the forces going through your knees.

Interestingly, many clinicians believe and see anecdotally there is an increase in the arch in the lower back in static postures when wearing heels, which they associate with low back pain. Many studies, however, have shown that compensation for the ankle position is a shift of the torso, which decreases the curve in the lower back and pelvis, which is the opposite. The low back pain associated with heels may have more to do with motion, back muscle activity is increased in high heeled shoes due to increased forces from the ground, changes in center of mass and base of support, all which can lead to fatigue and overuse. The over activation of these muscles also increases compressive forces to the spine. There is some evidence that there is an increase in pelvic range of motion in a younger population, when walking in heels as well. Compensations in posture can be made all the way up to the position of the head, leading to overuse of the cervical neck muscles. Overtime the body adapts to whatever stimulus it is exposed to, so eventually wearing heels, could affect your body’s optimal functioning from head to toe, even when you are barefoot.

So; the question is, what should I do?