Sunday, January 31, 2016

High Heels Anyone?

Picture by Vestman from Flickr
What you wear on your feet can affect how your body moves. Just watch your little kids. When they walk or run in their bare feet, they tend to land near the front of the feet. Put them in well supported shoes and straight away they start to land on their heels.

High heeled shoes affect the shape and functioning of our feet . Walking in heels can also change the natural position of the foot-ankle complex, and this may lead to problems going up the lower limb to your spine.

It has been demonstrated that the feet and ankles of women who wear heels over a long period of time are different from those who wear flats (Cronin, 2014). Hence a group of researchers wanted to track the progression of changes in women who spent time wearing high heels.

The researchers recruited a group of young university women training to be airline attendants who were required to wear high heels for their training since they needed to wear them if hired by the airline company. With each passing year, the women will have one extra year of heel wearing, making it easy to track changes.

Girls from each year from freshmen to seniors were selected and their ankle strength (on computerized exercise machines) and proprioception (joint position sense) tested on a wobble board.

Results showed that the sophomores and juniors had greater strength than the freshmen (who were mostly new to wearing heels) in muscles around the inside and outside of the ankle.

This difference suggest that wearing high heels may at first lead to adaptation and increased strength as the ankles respond to stresses placed on it by the high heels,

The senior women (who had been wearing high heels the longest) showed weakening of the same muscles compared with even the freshmen. In fact, muscles at the front and back of the ankles were weaker and proprioception was much worse.

All of the sophomores and above women subjects had worse balance than the freshmen even as some of their muscles were getting stronger.

This may be due to the ratio of strength between the muscles on the sides of the ankles and those of front and back become increasingly unbalanced over the years. This leads to ankle instability and balance problems and eventually a decrease in strength in the muscles that had been stronger for a while.

Despite the findings, the researchers do not suggest women deliberately avoid wearing high heels, but suggests strengthening their ankle whenever possible by doing simple heel lifts (in bare feet rise onto your toes repeatedly) and heel drops (stand on the edge of a stair and slowly lower your heel over the edge).

Whilst sitting, the researchers also suggests taking off your heels since the heels can alter the resting length of tendons and muscles around the ankle which can destabilize the joint and increase injury risk.

Remember the scene in the movie Jurassic World where the heroine had the Tyrannosaurus Rex released from its paddock and lures it into battle with the Indominus where she ran in her high heels? I had this scene in my mind as I read the articles.

Well, if you ever attempt to run from a fast moving deadly animal, high heels are perhaps the worst choice of foot wear possible.

You have been duly advised. Heel wearers beware as strength imbalances around the ankle are known to increase risk in the hamstrings or upper leg and the lower back as well.


Cronin NJ (2014). The Effects Of High Heeled Shoes On Female Gait: A Review. J Electromyo Kinesiol. 24(2): 258-263. DOI:10.1016/j.jelekin.2014.01.004.

Kim MH, Choi YT et al (2015). Reducing The Frequency Of Wearing High-heeled Shoes And Increasing Ankle Strength Can Prevent Ankle Injury In Women. Int J Clin Pract. 69(8): 909-910. DPI: 10-1111/jcp.12684.

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