How many pairs of high heels do you have in your closet? Two pairs or twenty? You might love the way high heels make your legs look and the fact that they add a few inches to your height. For a night out on the town, a pair of high heels is a must if you’re wearing something dressy. But, what about day to day wear? You might enjoy the way you look in heels at the office, but we now know that wearing them too often can cause orthopedic issues, including back pain. There’s even evidence that over-wearing heels may contribute to other health issues, even osteoarthritis. Are you increasing your risk of osteoarthritis when you slip on a pair of high heels?
Osteoarthritis and High Heels: Is There a Link?
Osteoarthritis is a form of degenerative arthritis where the cartilage that covers skeletal bones becomes thinner and less capable of preventing friction between the bones when they move. Osteoarthritis is common, especially after the age of 50, and is two-fold more common in women as opposed to men. While a number of factors contribute to the higher incidence in women, experts have questioned whether the heel wearing habits of women may play a role in the osteoarthritis epidemic.
How so? Studies show that wearing heels alters gait biomechanics and the higher the heel is, the greater the impact. This study also looked at the impact added weight in combination with wearing heels has on gait. One of the biggest risk factors for knee osteoarthritis is being overweight or obese. The heavier you are, the more weight and added stress it places on the knee joints. The force on your knees when you walk is proportional to your body weight. According to Harvard Publishing, this force is roughly equivalent to 1.5 times your body weight. So, more weight equals more force and stress on the knees. When you walk on an incline, the force increases to 2 to 3 times your body weight and when you go upstairs, it increases even more, to 4 to 5 times your body weight. That’s substantial!
What impact does wearing high heels have on all of this? According to the study, wearing high heels (3.5 inches or higher) compounds the negative impact on gait and leads to further changes in gait biomechanics, especially in people who are overweight or obese. The researchers believe these factors may contribute to the development of osteoarthritis.
While giving the high heels a break won’t guarantee you won’t develop osteoarthritis, wearing heels is linked with other orthopedic issues as well. One concern is that high heels throw the body out of alignment. Wearing them pushes your chest and lower back forward and places extra pressure on your knees and the balls of your feet. Throwing your back forward increases the risk of spinal problems as well as low back pain. But, it’s not just your back that can be affected. Wearing high heels can indirectly contribute to neck and shoulder pain as throw your entire posterior chain out of alignment. Wearing them on occasion probably won’t have a major impact, unless you injure yourself while wearing them, but all bets are off if you wear them frequently.
And it’s not just your back, neck, and shoulders that bear the brunt of wearing high heels. As any podiatrist will tell you, your feet and toes suffer too. In fact, high heels keep podiatrists in business! When you wear heels, especially those with narrow toes, your risk of developing bunions, blisters, corns, calluses, hammertoes, and generalized foot pain goes up. Plus, some people buy high heels that are too small and that compounds the problem.
Wearing Heels Safely
Ideally, we shouldn’t force our tootsies into high heels but that’s not always practical. If you won’t give up your heel-wearing habit, consider lowering the height. Heels that are 2.5 inches are easier on your feet than ones that are 4 inches in height and can still look fashionable. Look for ones without an extremely narrow toe box to avoid cramming your toes together and make sure you’re selecting the right size.
Get your feet measured by a professional and don’t assume you know your size. Your feet change with age. Check your shoe size at the end of the day when your feet are their largest. Foot size increases a bit as the day goes on, especially in the summer, due to fluid retention and the effects of gravity. Always walk around the store in shoes for a bit before purchasing them. Also, make sure you can get your money back if you get them home and they’re uncomfortable.
Ideally, a shoe would have a wide toe box and a narrow heel, says Eugene (“Pepper”) Toomey, a Seattle orthopedic surgeon. But few shoes that are cosmetically attractive will make sense for a woman with any real foot problem. Shoes with a wide toe box and narrow heel are undeniably ugly, he adds. He recommends chunky heels and platforms over stilettos with a high, thin heel. Platforms and wedges spread the impact out over a larger base and provide more cushioning when you walk. Also, don’t forget that people are more casual these days and are wearing more flat and low-heeled shoes. You don’t necessarily need a pair of high heels to look fashionable, even at the office.
Once you get home from work and one the weekends, give your feet a break from heels. Put on a pair of comfortable flat shoes and give your feet a much-deserved respite.
The Bottom Line
Yes, wearing heels alters gait biomechanics in a way that may increase the risk of osteoarthritis, especially if you’re carrying around excess weight. So, give the high heels a break and save them for special occasions.
Journal of Orthopaedic Research. Volume 33, Issue 3. March 2015. Pages 405–411.
Harvard Health Publishing. “Why weight matters when it comes to joint pain”
American Osteopathic Association. “The Real Harm in High Heels”
Podiatry Today. “When Patients Insist On Wearing High Heels”
Forbes.com. “How to Find Comfortable Shoes That Don’t Compromise Style”