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Health Over Heels

It is universally accepted by women that high heels make them look and feel better.  They stand taller, look slimmer, have nicer looking legs, and a sexier posture. Comfortable shoes are assumed to not look good.  Good looking stylish shoes are assumed to be painful.  Nevertheless, there is a trend for women to look for shoes that are higher and narrower. Designers have obliged taking styles to new heights and narrower widths.

But at what cost? Even the most seasoned tend to walk slower and can be somewhat vulnerable to slips or twists, and resultant injuries.  But most relevant is that most women have pain in their feet.  In the United States, data from the American Academy of Orthopaedic Surgeons (AAOS) reveals that one out of six women have chronic pain in the foot or feet. The biggest reason women in particular limp in to see their doctor? Improper footwear. In fact, nine out of 10 of women’s foot issues can be attributed to too-tight shoes, according to the American Academy of Orthopedic Surgeons (AAOS).


This raises the question: is pain in the foot a result of bad shoes or is that bad shoes result in foot pain?  The truth is that both are correct.  Some of the pain is acute or transient and goes away once the shoe is taken off.  But with time, some conditions develop that result in chronic pain, conditions like;

Development of bunions.

This is a condition where the big toe deviates and points towards the other toes.  There is a painful bump that emerges at the base of the big toe. When advanced, even walking barefooted can become painful.  The condition ultimately may require corrective surgery.  In the United States, bunions occur up to 15 times more frequently in women than men.


In this condition, the middle joint of the toes bends and points downwards.  One of the established causative factors is high heeled narrow shoes.  They crowd the toes in a tight box, causing them to flex.  With frequent use of such shoes, the deformity begins to persist and becomes permanent.

Achilles tendonitis, neuromas, plantar fasciitis, corns, and blisters.

Achilles tendinitis results in pain in the back of the heel, while in plantar fasciitis, it is at the bottom of the foot.  Both conditions are characterized by pain when first rising out of bed in the morning, or after a prolonged period of sitting.  Neuromas in the foot result in a burning pain in between the toes.  It tends to worsen after walking for a distance and can severely limit one’s level of activity. In addition to foot problems, high heels can lead to pain in the ankles, knees, and backs.  It can also weaken the small muscle in the foot creating additional vulnerabilities to injury.

Bad Posture

1-inch heels puts 22% of the body weight on the ball of the foot, versus 3-inch heels which puts 76%! This means the lower part of your body will naturally lean forward more to compensate, which causes the upper body to lean back and overarch your back. The result is bad posture, which then leads to lower back and knee pain.



Moderation is the key.  High heels by themselves do not translate to the above listed problems.  Some women, based on their anatomy and genetics are more predisposed.  Others get it because of excessive use or begin at an early age.

Alternating shoe choice through the day or from one day to the next can be helpful. It is also advisable to wear athletic or walking shoes for commuting to and from work, to give the feet a rest.

Stretching the calf muscles before and after wearing heels is recommended. One example it to sit on a flat surface or mat with the feet straight in front, reach for the toes, and hold the stretch for at least 20 seconds. Repeat three times. This helps to stretch the back of the legs, and eases tightness and discomfort.  Likewise, a series of squats performed barefooted can help to strengthen the small muscles of the foot.

It is best to wear shoes that are exact sizes.  Tight shoes are likely to contribute to the above listed problems.  Conversely, loose shoes can keep slipping and result in blisters.

Young girls are even more vulnerable to foot deformities because they have bone that is still more cartilaginous and moldable.  It is therefore strongly recommended by the orthopaedic community that girls should not wear high heels until they have stopped growing.


The feet are extremely important to one’s level of activity and lifestyle. Poor choices today can lead to severe consequences tomorrow.  So wear high heels in moderation.   They should perform stretching and strengthening exercises of their legs and feet.  It is important to seek a professional evaluation if pain or deformities start to develop.


About Dr. Onyike

Dr. Onyike is an American fellowship-trained and board certified Orthopedic Surgeon practicing at the Center for Advanced Specialty Surgery (CASS. He specializes in joint replacement surgery, sports medicine, fracture care, and has very specialized training and experience treating extremely complex problems of the hip and knee joint, including revision surgeries. You can connect with Dr. Onyike through LinkedIn “Dr. Aham Onyike’, or on Twitter and Instagram @CASSurgery

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