High heels can be the source of more pain then just in your feet! | Total Performance Physical Therapy

High heels can be the source of more pain then just in your feet!

November 28, 2012

You know those high heels that you like to wear to work everyday all day or those ones you wear to special events or to go out with friends just because they make you taller or make your legs look a certain way?  They aren’t just responsible for the blisters and discomfort in your feet that you end up experiencing that gets so irritating by the end of the day or night that you end up ditching the shoes and walking barefoot or in flip flops.  They can also have adverse effects on your knees and back, so much so that you may want to reconsider what you decide to wear on your feet the next time you’re getting ready for work or an event.

High heels change the way your foot is positioned and then in response you may without even noticing adjust the positioning of your knees, your hips, and your back.  This changes the way that the force of gravity pushes down on your body and puts strains on muscles that typically aren’t as active if you are not wearing high heels.  To gain a better understanding of this, you first have to know about how gravity typically affects the body.  To simplify, the force of gravity can be described as a line.  Where this line is positioned in relation to the joints of your body will impact what muscles are activated.  For the purpose of this discussion, we’ll focus on the positioning of this line at the back, hip, knee, and foot.

When you are standing normally barefoot, the line of gravity is through the spine, behind your hip, in front of your knee, and in front of your ankle.  This means that if you were not to contract any of your muscles, gravity would force you to fall backward at the hip, force your knee to be straight, and force your toes to point up.  Since the line of gravity is straight through the spine you wouldn’t tend to fall forward or backward with your trunk and because of this you don’t use much energy to hold yourself up assuming you have good posture.  This is of course over simplified, but with this idea in normal standing there is not much muscle activity in the back, hips, or knees.  Because of the optimal positioning of the body in relation to the force of gravity, ligaments and the joint capsules of these joints are what mainly prevent you from bending forward at the hip or bending at the knee.  The main muscles that are active at the ankle are the calf muscles, which keep your toes from going up too far.

When you wear heels you completely change the way your body is lined up with this line of gravity.  The line of gravity ends up being in front of the spine, behind the knee and behind the ankle.  So in this case, without muscle and ligament activity you would fall forward with your trunk, bend at your knees and point your toes down at the ankle.  So in response to the force of gravity as a result of wearing high heels, the muscles in your back, knee and ankle have to work harder to prevent you from falling into these positions.  Specifically in your back, the group of muscles that straighten your back called the erector spinae, are forced to work harder to keep you from falling forward at the trunk.  At the knee, your quadriceps muscle works to prevent you from bending too much.  At the ankle, the muscle in the front of the leg called the tibialis anterior prevents your toes from pointing too much towards the ground.

So what’s the big deal?  Putting different strains on the body not only forces you to use more energy because more muscles are forced to work to keep you upright, but it can also cause strains on different parts of your body from the toes all the way up to your back.

Foot:  In addition to the blisters and general discomfort, wearing high heels forces you to position your foot in a way that your toes are always pointed down.  When walking this means a large amount of the force that usually goes through the heel of your foot, is now transferred to the front of your foot, specifically the metatarsals (the bones that connect to your toe bones).  This transfer of forces can cause stress fractures and over time can also lead to hammertoes (curving of your toes in a certain direction) and bunions (bumps that grow on the outside of the big toe).

For more information on physical therapy services head to www.totalperformancept.com.

Ankle: When your foot is placed in a position where the toes are always pointed downwards, the tendon of the calf muscles that attaches to the heel bone called the Achilles tendon can become shorter.  This means that anytime you aren’t wearing heels you end up stretching the tendon.  This can lead to small tears and inflammation often referred to as Achilles tendonitis which manifests itself as heel pain. Because less of your foot is in contact with the ground when you are wearing heels, you are also at a greater risk for spraining the ligaments of your ankle which can be painful.

Knee:  When the knee is in a bent position for longer periods of time during walking and standing it can cause more forces to be put through the knee joint.  Some research has shown that wearing high heels can increase the forces put through the knee by 26%.  With increased forces through the knee you won’t only begin to experience pain, but you also put yourself at a greater risk for developing arthritis in your knees.

Back: As mentioned before when you wear high heels, your muscles have to work harder to keep your back upright so you increase the inward curve in your lower back, which physical therapists like to call the lordosis.  The muscles in your back may not be used to taking on the loads that you are putting on them when you force them to keep you upright for extended periods of time when wearing heels and they may become sore causing you to experience low back pain.

Wearing high heels can cause a variety of problems from your back to your toes.  If you have been experiencing symptoms of any of the conditions described above you may need to see a physical therapist.

For more information on physical therapy services head to www.totalperformancept.com.