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The High Heel Dilemma

High heels hurt.  A recent scientific article about High Heels found in Arthritis Care & Research discusses this very issue.  (http://www.sciencedaily.com/releases/2009/09/090929004214.htm.) The article came to the conclusion that women wearing high heels had a high correlation of eventually developing heel pain.  Now I am not a big fan of correlative studies.  A correlation means that people which did such-and-such eventually ended up having so-and-so.  Example:  It was found that 100% of people who brushed their teeth eventually ended up dying.  Hmmm . . . thus the need to be very careful reading correlative studies.

Surprising or not there is very little scientific literature about high heels hurting.  Perhaps researchers thought people chose shoe gear by common sense and comfort (lol . . . hilarious right?).

Janice (names have been changed to protect the . . . health information (google HIPPA) is in her mid 30′s and sells real estate.  She came into the office indicating the balls of her feet were becoming progressively painful and said that she spent most of her time showing houses in her high heels.  To get the weight off the balls of her feet she would take the heels off and had been walking around her house barefoot.  Her heels then started to hurt.  The heels hurt worse when first getting out of bed in the morning.  After the first few steps her pain would go down a little but felt much better when she got back into her high heels.  She had a constant cycle of pain occurring to first the front and then the heel parts of her feet.  After making sure she wasn’t wearing the featured heels in the pictures below we had a good discussion about what was happening:

  1. By forcing your entire weight onto the front of the foot soreness and subsequent pain occur.
  2. By continually having the achilles tendon in a contracted position when you take off that heel there is not sufficient motion across the ankle joint.   So instead of walking in a normal heel-to-toe gait you walk more toe-to-heel.  This essentially slams the heel into the ground with each step.  Ouchy.

Janice wanted surgery to fix the pain in her feet.  I agreed she did not have enough motion across her ankle joint.  We also agreed, however, that stretching her achilles tendon and wearing a middle ground heel (1-1.5 inches) to get her gradually back down to normal achilles length should be a precursor to any surgery.

I have found women will put up with a lot of pain before finally relinquishing their heels completely or even partially.  Thankfully most don’t use the ones pictured below.