PhotoWomen who wear high heeled shoes for long periods of time may be compromising their health. That's more or less been a consensus view for years, but researchers from the University of North Carolina (UNC) Charlotte adds more evidence.

Tricia Turner, associate professor of kinesiology and athletic training coordinator in the College of Health and Human Services, says the harm doesn't show up right away. In fact, high heel wearers may get some initial benefits, according to a new study by Korean scholars.

“Initially when wearing heels the muscles that surround the ankles have to continuously contract to keep you upright and walking,” she said. “Over time you need less muscle contraction as the lower leg muscles adapt to the changes in footwear. Once that occurs less muscle contraction occurs.”

But with prolonged use Turner says there is muscle shortening in the back of the leg and muscle lengthening in the front of the leg. These changes in muscle length can alter muscle strength, and not for the better.

Reviewed results on flight attendants

As a means to test the hypothesis, the UNC Charlotte report looked at ankle strength and balance in women training to be flight attendants, collecting data for each class year. Turner said high heels can cause problems because they force the foot into a naturally unstable position.

“In sneakers or flat shoes, the foot is positioned in neutral where the bones of the ankle are under the bones of the lower leg, creating a more stable joint and a decreased likelihood of injury,” she said. “High-heeled shoes also change the normal walking or gait cycle, with the ultimate result being a less fluent gait cycle.”

The result can be damage to both ligaments and nerves in the ankles. It's not uncommon for pain to occur in the legs and back.

Prone to falls

The American Osteopathic Association has found that women who wear heels are also more prone to falls. Its research has found 10% of women wear high heels at least 3 days a week and a third have fallen while wearing them.

Dr. Natalie A. Nevins, an osteopathic physician from Hollywood, Calif., warns that too much time in heels can lead to permanent health problems.

"Extended wear of high heels and continually bending your toes into an unnatural position can cause a range of ailments, from ingrown toenails to irreversible damage to leg tendons,” she said. "High heels have also been linked to overworked or injured leg muscles, osteoarthritis of the knee, plantar fasciitis, and low back pain."


Nevins isn't suggesting women have to give up heels. She does, however, offer these six tips for improved comfort and avoiding injury:

1. Choose sensible heels. Select shoes with low heels - an inch and a half or less - and a wide heel base; a slightly thicker heel will spread the load more evenly. Narrow, stiletto-type heels provide little support and three inch or higher heels may shorten the Achilles tendon.

2. Wear soft insoles to reduce the impact on your knees.

3. Make sure your shoes are the right size so the foot doesn't slide forward, putting even more pressure on the toes.

4. Don't wear heels when you know you'll be doing a lot of walking or standing.

5. When you do wear heels, don't wear them all day.

6. Take time every day to stretch your calf muscles and feet.  

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