High Heels—Friend or Foe?

High Heels—Friend or Foe?

For many women, high heels are one fashion accessory they can’t live without. While it no doubt adds a striking and elegant element to any outfit, they are considered orthopedically unsound.

When worn excessively and for long periods, it can affect the posture by pushing the centre of mass in the body forward, taking the hips and body out of alignment. In addition, while high heels can make the wearer appear taller and make the legs look longer, it also puts more pressure on the forefoot the higher they are. Since it will force the calf muscles to contract and adjust to the angle of the ankle, it can cause the calf muscles to shorten and tighten. This may improve the contour of the calf but can lead to other issues associated with an over-tight Achilles tendon.

Wearing high heels can also make the wearer more susceptible to the following conditions:

Falls and ankle sprains

Wearing high heels require training and negotiating uneven surfaces or slopes often pose a challenge. Furthermore, many women have loose joints making the ankle the most prone to twisting (inversion) injuries and ligament tears.


The altered posture when walking using high heels can also put excess strain on the inside of the knee as well as the kneecap—common sites of osteoarthritis. Also called degenerative arthritis or degenerative joint disease, osteoarthritis is considered the most common type of arthritis, affecting millions of people the world over.

The conditions occur when the protective cartilage found on the ends of the bones wears down over time and under high-pressure loads. While the condition can develop in any joint in the body, osteoarthritis often affects the joints found in the spine, knees, hips, and hands.


Osteoarthritis often develops gradually and can worsen over time. Telltale indicators of the condition can include:

  • Pain – the joint may hurt during (or after) movement.
  • Stiffness – may be especially noticeable after long periods of inactivity or early in the morning.
  • Grating sensation – may be felt or heard when the affected joint is used.
  • Tenderness – the joint may feel tender when light pressure is applied.
  • Loss of flexibility – individuals affected may not be able to move the joint through its full motion range.
  • Bone spurs – extra bits of bone which can feel like hard lumps may form around the joint affected.


While the process underlying osteoarthritis cannot be reversed, its symptoms can be managed effectively through lifestyle changes, medications, physical therapy, and surgery.


Tight-fitting and pointed-tip shoes can result in a bony protrusion at the joint found at the base of the big toe. It can also force the big toe to angle toward the other toes, causing pain and pushing under the second toe.


Common signs and symptoms of bunions can include:

  • Bulging bump – usually situated on the outside of the base of the big toe.
  • Redness, soreness, and swelling – usually around the big toe joint.
  • Calluses or corns – often occurs when the first and the second toes overlap.
  • Intermittent or persistent pain.


Depending on the severity of the condition, treatment interventions can range from noninvasive options (medications, shoe inserts, splinting, etc.) to bunion surgery.


A toebox that is narrow will push the ends of the smaller toes into a bent position. Over time, the muscles in the second, third, and fourth toes will not be straightened even when there’s no confining shoe. While it is possible for the deformity to already be present at birth, it can also occur as a result of wearing ill-fitting shoes (tight and pointed heels) and arthritis.


Common indicators of hammertoe can include:

  • Toenails that bend downward
  • Calluses or corns on the tip of toes
  • Walking difficulty
  • Inability to wiggle or flex the affected toes
  • Claw-like toes


Treatment intervention for hammertoe will depend on the severity of the condition. Treatment options for hammertoe can include wearing insoles or toe pads and medications to treat the corns and bunions. However, when patients are no longer able to flex the affected toe, surgery might be recommended to restore movement. Surgery is also carried out to remove the injured or deformed bone, reposition and fuse the toe, and realign the tendons.


Wearing high heels can force redistribution of the body’s weight from heel to the toes. Prolonged wearing of high heels may also result in joint pain in the ball of the foot. The second toe is affected most as it is usually the longest one. The condition can also be attributed to activities that involve too much jumping and running.

While generally not considered serious, the condition can sideline patients. Fortunately, homecare treatments like ice and rest can often help resolve symptoms.


Metatarsalgia symptoms can include:

  • Burning, sharp, and aching pain in the ball of the foot.
  • Pain that often worsens when standing, running, walking, and flexing.
  • Shooting pain, tingling in the toes, and numbness.
  • A feeling of having a pebble in the shoe.


Conservative measures like using a metatarsal pad, changing shoes, or resting might be able to relieve some of the symptoms. In rare cases when pain is not relieved using conservative treatment interventions or when the condition has been complicated by other foot conditions (like hammertoe), shortening the metatarsal bone through surgery might become an option.