By Dr. David Noonan

Have you ever come into be adjusted and have me comment on your shoes?  Many of you are saying, “Yeah, does the doc have a shoe fetish or what?!”  Well, there certain things I notice about many of you; your t-shirts, your new haircut/color, your fingernail polish, and of course your shoes to name a few.  And most of the time I take the liberty of commenting on them because let’s face it…you’re face down and pretty much at my mercy.  

So ladies, no doubt you’ve heard a comment or two on your high heels.  Guys probably not so much, although it’s not unheard of (I dressed in drag for a photo shoot a million years ago…ever see a guy with 20″ arms in 5″ pumps?)

So what about high heels?  Most of you that wear them know that they aren’t the best thing for you, but… you’re not about to give them up for anything!  Right?  Well that is certainly your choice and I have to admit, I like the way you all look in your high heels.  But alas, my job is not about fashion, it’s about function.  So let me be the one to break down the “Function Faux Pas” of high heels.

Wearing high heels creates faulty biomechanics and unnecessary stress on your ankles, knees, pelvis, and potentially throughout your entire spine. This is because your body, from feet to head, is one long chain of articulating bones, where the happy functioning of each joint depends on the happy functioning of every other joint. If the joints of your feet don’t work properly because of the strain of wearing high heels, other areas of your body are forced to compensate and suffer extra wear and tear.  

Each of your feet is made up of 26 major bones, 33 joints, 107 ligaments, and 19 muscles and tendons (yes I got an ‘A’ in anatomy).  Your feet are designed to provide you with balance and strength as you walk or run over many different types of terrain.

Did you know your two feet strike the ground an average of 1,800 times over the course of walking one mile?  The average person walks around 5 miles per day, translating to 8,000 to 10,000 steps per day.  When you walk, your feet bear the force of one and one-half times your body weight. When you run, this force increases to three to four times your body weight.

With so much demand on your feet just to get through an average day, you can realize how important it is to wear comfortable shoes. Even with super comfy running shoes on, your feet have tremendous strain on them throughout the day. Can you imagine the burden they face when your entire weight and more is crushing down on the base of your toes rather than being evenly distributed to all 26 bones of each foot?  This can cause repetitive stress and micro trauma. 

Compression injuries are common in high heel wearers. A neuroma can result from compression of a nerve or a bursa between two bones in the top of your foot, called metatarsals. This result is inflammation and fibrosis and can diminish both nerve and blood flow, resulting in a burning sensation that extends into the toes.  Do you know that a three-inch heel was found to create seven times more stress on the forefoot than a one-inch heel?  Think about what a couple more inches will do.

The same compression can cause a hallux valgus and bunion formation. In this condition, one or more of the foot’s three arches has collapsed or lost integrity, which changes weight transfer in the forefoot.

High heels cause muscles in the calf to shorten over time, limiting normal ankle and knee motion, which creates excessive pull on the tendons and ligaments of the sole of the foot.  This can cause knee pain, and plantar fasciitis, a painful condition of the foot that may require treatment.

On to the pelvis we go.  High heels cause the pelvis to tilt anteriorly (forward) causing the spine to flex.  Yes, it causes you to stick your back side out farther and that looks great but, this puts pressure on the facet joints of the lumbar spine and can cause lower back pain.  Of course the upper body must compensate by trying to pull the body upright by extending (leaning backwards) putting stress on the upper back and neck muscles.  In some cases, this can even put pressure on nerves that can result in chronic headaches.

Whew!  Still not gonna give up those Jimmy Choo’s, eh?  Well, I’m a teacher…not a preacher so here are a couple things you can think about when wearing these torture devices…um, I mean beautiful new shoes.

1. Strive to never wear high heels. (oh, sorry we already covered that one)

2. When you go shopping for shoes, do it in the afternoon or evening, as feet tend to get a little bigger throughout the day because of fluid accumulation. You want your shoes to be able to comfortably house your feet when they are at their biggest.

3. Measure your feet each time you buy shoes. And be sure to measure them while you are standing. Feet tend to flatten out as we age and may change sizes.

4. Try shoes on both of your feet, as one foot may be larger than the other.

5. If you’re not already there, strive to be lean and mean for your body type. Being overweight means extra stress for your feet, not to mention the joints of your legs and spine.

6. Eat whole, unprocessed foods that will keep your blood vessels and circulation strong, as the health of the tissues in your feet are largely dependent on how efficiently they receive nutrients and have waste products shuttled away. The two worst foods for your circulation are hydrogenated oils and sugar. Try to stay away from them completely.  One thing you can add is an Omega 3 Fatty Acids source.

7.  If you can, bring a pair of flat shoes with you and wear them when the high heels are not a must, ie…walking around the office 

8.  Stretch your calf muscles regularly.  Also, massage your feet regularly and get them adjusted along with your spine!  This may help delay the inevitable onset of pain and degeneration.

Good luck with your good looks!