Are high heels a health hazard?

Many people consider high-heeled shoes an essential part of a fashionable outfit, particularly for women in a corporate workplace, but could this fashion choice have serious consequences on an individual’s health?

According to a new study published in Ergonomics, regardless of the past experience of the wearer, high heel elevation impacts not only balance, but also functional mobility.

The study referenced a survey conducted by Hotter Shoes (2010) on 3000 women who wear high-heeled shoes, which revealed that 10% of women had to receive medical attention or even be hospitalised because of their shoes, while nearly 50% of women twisted their ankles. The top injuries were broken ankles, twisted knees, infected blisters, bunions and torn tendons.

The survey also showed that above 60% of women were ready to continue wearing high-heeled shoes despite suffering pain and injuries.

The study stated that long-term wearing of high-heeled shoes induces shortening of the gastrocnemius medialis muscle fascicles and increases Achilles tendon stiffness, reducing the active range of motion of the ankle. Experienced wearers were also reported to have much greater increases in knee flexion during the stance phase of high-heeled gait, which may cause knee abnormalities such as osteoarthritis (Csapo et al. 2010).

Study method

To discover the extent of the impact of high-heeled shoes on wearer health, scientists devised a series of tests to assess how different heel heights and levels of wearing experience can affect people. The authors divided the groups into ranges of experience and heel height — four pairs of shoes were used with heel heights of 1 cm (flat), 4 cm (low), 7 cm (medium) and 10 cm (high).

Thirty female participants with mixed levels of experience (10 experienced and 20 inexperienced) tried all shoe types over a range of different tasks designed to quantify an individual’s ability to maintain standing balance in a variety of complex sensory conditions. Also examined was the basic functional mobility that would be required for performing activities of daily living, assessing balance control and fall risks.

Results

The results showed that the heel elevation induces more effort from lower limb muscles (particularly calf muscles) and results in worse functional mobility starting at 7 cm heel height. With the heel height increased to 10 cm, the standing balance becomes even worse.

Experienced wearers did not show significantly better overall performance on standing balance and functional mobility, even though they have larger maximum excursion and better directional control.

The study says these findings can enhance the understanding of biomechanical challenges imposed on the human body while wearing high heels and may help to further establish safety footwear recommendations for improving human balance and fall prevention.

To view the full study, ‘Effects of high heeled shoes wearing experience and heel height on human standing balance and functional mobility’, click here.

Image courtesy of Dave Collier under CC-BY-2.0