Although the original designer of the stiletto heel is still the subject of debate, most credit Andre Perugia with the development of the high, slim heel sometime after the turn of the 20th century. The technology required to make a sturdy, slim heel was attributed to designer Roger Vivier, who popularized stiletto heels in the 1950s.
Beautiful, But Painful
The impact that shoes have on our gait has become a popular, and controversial, subject in recent years. The popularity of barefoot running, for example, has sprouted from the (unproven) belief that wearing modern, well-cushioned running shoes decreases foot strength and proprioception -- the sense of how the body is positioned in space -- and may contribute to running-related injuries.
According to the Spine Health Institute, 72 percent of women report wearing heels “all the time.” Those of us who fall into this category are painfully familiar with the damage that even (or especially) our daintiest heels can do to our feet. Among them:
● Calluses and corns can develop because of pressure on the skin. With heels, corns (hard nuggets of keratin) can build up under the balls of the foot where body weight presses down.
● Capsulitis, or a painful inflammation of the joints where the toes attach to the foot, can occur from the unnatural bend into which heels force our feet.
● Some heels may cause neuromas or pinched nerves where pointed shoes compress the toes.
And those are just short-term problems. While the long-term impact of stilettos on a wearer’s feet has yet to be studied in depth, with millions of women wearing heels on an almost daily basis, the potential dangers of wearing heels is a subject worth examining.
The Long-Term Damage
In one study, Australian researchers studied nine young women in their late teens to early 30s who wore high heels for at least 40 hours a week for work for a minimum of two years, and 10 young women who rarely, if ever wore heels, as a control. All of the women were asked to walk multiple times across a 26-foot walkway that contained a plate to gauge the forces generated as they walked. The control group crossed the walkway barefoot, while the women who wore heels were asked to cross both barefoot and in heels.
While researchers correctly guessed that women who wore heels regularly would walk differently than the control group, even while barefoot, the extent of those differences was surprising. The study, which was published in The Journal of Applied Physiology, showed that:
● Women habituated to wearing heels walked with shorter, more forceful strides than the control group.
● Women habituated to wearing heels have a stride where feet are positioned in a flexed, pointed-toe position, even when these women were walking barefoot.
● Habitually wearing heels resulted in the fibers of the wearer’s calf muscles shortening, so these women put much greater mechanical strain on their calf muscles than the control group.
● For the control group, walking involved primarily stretching and stressing tendons, especially the Achilles tendon; whereas heel wearers walked by mostly engaging their muscles.
What Does It Mean?
These differences are significant. Studies into optimal “muscle-tendon” efficiency while walking happens when the muscle stays approximately the same length and the tendon lengthens, then uses its stored elastic energy to contract when the foot pushes off the ground. By stretching and straining already-shortened calf muscles, heel wearers walked less efficiently both with and without heels and required more energy to walk the same distance as people who were used to wearing flats.
Beyond expending more energy, research suggests that large muscle strains that occur while walking in heels can increase a woman’s risk of strain injuries. The risks aren’t just while wearing the heels, either, and will extend to activities such as exercise workouts when a woman switches abruptly from high heels to sneakers or other flat shoes. Because wearing heels for a majority of the time realigns the body’s leg and foot joints and structures, changing these positions, such as wearing sneakers, increases injury risk.
What’s also significant about the Australian study is the age of the volunteers. Because the youngest heel wearers were only in their late teens, it shows that these body adaptations happen quite quickly, rather than occurring gradually over decades of high heel use.
What Can I Do?
Many of us would rather expose ourselves to risk than donate our prized shoe collections, although wearing flats is a much healthier alternative. To minimize your risk of injury from high heels, you can take the following steps:
● Minimize the heel size that you wear. Instead of wearing six-inch stilettos, opt for kitten heels when possible to limit how much you’re shrinking your calf muscles and tendons.
● Wear heels only a few times a week and alternate wearing those heels with wearing ballet slippers or professional flats to give your feet a rest.
● If you feel that you must wear heels all week, try to remove them whenever possible, such as when you’re sitting at your desk, and stretch your calves.
● Carefully but daily, practice leg stretches to counteract the effect that heels have had on your feet throughout the course of the day
If your shoe fetish causes chronic pain, be sure to make an appointment with your physician to make sure that you haven’t caused serious damage -- before you injure yourself irreversibly.