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Heel Pain

High Heels are they as bad as we make them out to be?

Kumar, N. V., Prasanna, C., Sundar, V. S., & Venkatesan, A. (2014). High Heels Footwear Causes Heel Pain and Back Pain: Myth or Reality?. International Journal of Scientific Study, 2(8), 101-104.


This article is a good one! We all like to blame high heels for causing lots of issues but this article looks as the prevalence of heel pain and back pain in those that wear high heels.


The wearers of heels may like what it does to their body: makes them taller and accentuates different aspects of their body but what damage is it doing?


The study contained 100 women and 0 men and ages ranged between 15-55 without any deformity as such- bunions etc. They were made up on mainly students, administration workers and those who undertake home duties.


The results came back with 44% complained of heel pain and 56% complained of back pain over the study period.

These figures are much higher than that of the general population which sits at close to 10% So this goes to show that this is a huge increase compared to the general population.

Those participants who have worn heels for greater than 5 years reported a higher percentage of pain compared to those having worn heels for less than 5 years. There was also a correlation between time spent in heels with pain- the length of time worn each day also increases the rate of heel and back pain. As one might have guessed the higher the heel the greater the rate of pain.


It is suggested the reasoning behind these findings is due to a decrease in efficiency of the muscles involved. The calf muscles and shortened and changes to activation pattern due to the position of the foot, there is an increase workload through the muscles of the hip due of the position of the foot and ankle.


These changes in muscle activation change the load in these muscles involved. This change in load will increase the stress upon these structures and the structures these muscles act upon ( ones and joints).

Other changes associated with high heels include:

· Increased plantar forefoot pressure

· Changes to subtalar joint axis

· Increased instability of the ankle joint

· Lordotic curve changes of the lower back.


We know the body works as a ‘whole’ and changes to one area can affect another. Here is a super interesting exert from the article ‘Increased ankle plantar flexion causes a

kinetic chain of compensation up the lower extremity that

ends with hypertonic psoas muscle, producing a lumbar

hyperlordosis. A hyperlordotic lumbar spine in turn will lead to back pain‘


So the article came up with some interesting points.

· Wearing high heels will increase your chance of experiencing lower back and heel pain- greater than 4 times the general population.

· The longer you have worn high heels for (in years) and the length of time spent in heels each day will also increase your risk of experiencing pain.

The information they gathered was strong in its findings. There is however a few points to note with this study.

1. It was only conducted on 100 women.

2. It was based on a questionnaire not physical or imaging studies to diagnose injury.

3. Was only based on a small aspect of the community.


What does this mean? Should I not wear heels?

This article points out that with prolonged use you are more likely to experience pain and have changes to your body. Wearing heels in the short term for special occasions may result in you experiencing pain or discomfort but if this isn’t done on a regular basis then this should not have any long term complications. Be smart most of the time with footwear choices and stretch and massage those muscles out after wearing the heels to help minimize the damage.

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