Looking Good and Feeling Terrible:
The High-Heeled Dilemma
by Paul Chek

Have you ever noticed that your feet, back and/or neck hurt after wearing high-heeled shoes to work, but no on the weekend while in flats?

Yes-it’s true – there is a connection.  The body is beautifully designed with a fully functional, durable, shock absorbing foot.  Because the foot is the body’s only contact with the ground when standing it represents the body’s base of support.  Wearing high-heeled shoes alters the base angle in proportion to the height of the heel (Figure 1).

 

Figure 1

If the body were rigid a two-inch heel would displace it 22.5 degrees forward, while the four inch heel would displace it 45 degrees forward.  Because the head and eyes must always remain level for reasons of posture and balance, this forward displacement must be compensated for by all joints above the foot.  This is demonstrated in Figure 2 A-D.

As the body’s base is inclined, there must be a compensation in all weight-bearing joints above the ankle (Figure 2).

 

Figure 2

Common postural deviations in attempt to compensate for high-heeled shoes are seen in A, B, and D.  Good posture is shown in diagram C.  To appreciate the magnitude of postural compensation created by high-heeled shoes, compare the other diagrams to  “normal” as seen in diagram C.

As the body alters its natural alignment in compensation for high-heeled shoes, the joints must deviate from a neutral position, disturbing the skeleton’s ability to bear the body’s weight against the force of gravity.  The three most common deviations from normal posture are exaggerating the bend in the knees with increased lumbar and mid-back curvatures and a forward head (Figure 2-A), a flat how back and a forward head with increased mid-back curvatures (Figure 2-B), and hyper-extended knees with exaggerated spinal curvatures.  Good posture is seen in figure 2-c.

The gravitational force that is normally supported by the skeleton is now supported by the muscles.  This is a common source of tension headaches, low-back pain and a variety of other musculoskeletal complaints.  The increased tension produced in the muscles that are compensating for faulty postural alignment creates compression in the joints they cross, encouraging degenerative joint disease with time.  This finding will be most common in the big toe, knee, hips, and spine.

The poor feet are distorted and compressed by the small and pointed toe boxes found on most high-heeled shoes because there is such an angle to the weight of the body and the force of gravity.  This is a common source of bunions in females and can cause ingrown toe nails.

The finest gymnast or ballet dancer will loose her grace of movement upon donning a pair of pumps.  After all, if you were at the Del Mar race track, would you put money on a horse that wore high-heels?  If you have been wearing high-heeled shoes to work for a year or more and suffer from chronic musculoskeletal aches and pains, a program of specific stretches and exercises to correct your posture may be the antidote your body needs.






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