Is Wearing High Heels Dangerous?

A new paper published in the Journal of Applied Physiology titled “Long-term use of high heeled shoes alters the neuromechanics of human walking” explores whether women who wear high heels have increased risks of injury (outside of the embarrassment of slipping; we’re talking long-term effects here).

The Australian scientists in this study recruited nine young women who had worn high heels for at least 40 hours a week for a minimum of two years. The scientists also recruited 10 young women who rarely, if ever, wore heels to serve as controls. Both groups of women were equipped with electrodes to track leg-muscle activity, as well as motion-capture reflective markers. Ultrasound probes measured the length of muscle fibers in their legs.

The scientists found that heel wearers moved with shorter, more forceful strides than the control group, their feet perpetually in a flexed, toes-pointed position. Most interestingly, this movement pattern continued even when the women took off their high heels and walked barefoot. As a result, the fibers in their calf muscles had shortened and they put much greater mechanical strain on their calf muscles than the control group did. This is the paper’s abstract:

Human movement requires a constant, finely-tuned interaction between muscular and tendinous tissues, so changes in the properties of either tissue could have important functional consequences. One condition that alters the functional demands placed on lower limb muscle-tendon units is the use of high-heeled shoes (HH), which force the foot into a plantarflexed position. Long-term HH use has been found to shorten medial gastrocnemius muscle fascicles and increase Achilles tendon stiffness, but the consequences of these changes for locomotor muscle-tendon function are unknown. This study examined the effects of habitual HH use on the neuromechanical behaviour of triceps surae muscles during walking. The study population consisted of 9 habitual high heel wearers who had worn shoes with a minimum heel height of 5cm at least 40 hours per week for a minimum of 2 years, and 10 control participants who habitually wore heels for less than 10 hours per week. Participants walked at a self-selected speed over level ground while ground reaction forces, ankle and knee joint kinematics, lower limb muscle activity and gastrocnemius fascicle length data were acquired. In long-term HH wearers, walking in HH resulted in substantial increases in muscle fascicle strains and muscle activation during the stance phase compared to barefoot walking. The results suggest that long-term high heel use may compromise muscle efficiency in walking, and are consistent with reports that HH wearers often experience discomfort and muscle fatigue. Long-term HH use may also increase the risk of strain injuries.

In an interview with The New York Times, one of the scientists of the study mentioned that “We think that the large muscle strains that occur when walking in heels may ultimately increase the likelihood of strain injuries.” The suggestion for women who wear high heels throughout the day (or for prolonged periods of time every working day)? First, rely less on high heels, if at all possible. If not, then remove high heels whenever possible, such as when sitting at the desk.

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