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The Truth about High Heels

by Jon Lewis, Senior Chartered Physiotherapist BSc  MCSP HCPC



High Heels



They say that diamonds are a girl’s best friend but unfortunately high heels most definitely aren’t!

One in ten women wear high heels on three or more days a week, and wearing these stylish shoes is now believed to be one of the leading causes of permanent foot problems in women.

Women who wear high heels do tend to attract favourable notice as the design of the shoe makes them appear taller and slimmer, whilst making their feet look petite and feminine.  However, all of the features that encourage women to wear high heels are actually causing devastating biomechanical problems throughout their bodies, from the feet up.

Foot and Ankle Problems

The pointed narrow toe box of a high heel shoe squeezes the toes into a natural V shape.  This, in time, can lead to permanent deformity of the toes leading to:

Bunions : The big toe is forced inwards causing permanent joint deformity and the formation of bony growth on the inside at the base of the toe. This not only causes significant foot pain but can also alter your entire biomechanics causing pain in your knees, hips and low back.  Only surgery can rectify this once past a certain point, so treatment is recommended as soon as possible.


Mortons Neuroma:  This is a very painful condition caused when tight shoes compress the joints at the balls of the feet.  This causes compression of the nerves between these joints resulting in severe pain in the area. Find treatment for Mortons Neuroma



Mortons Neuroma



Hammer toe:  As the name suggests the toes are forced into claw or hammer like angles, this causes callus formation, joint pain and permanent deformity. Find treatment for Hammertoe


Hammer Toe



Metatarsalgia:  The steep angle of the shoe causes all the body weight to be transmitted through the balls of the feet rather than being distributed evenly through the heel and the forefoot.  This can lead to pain and eventually arthritis.





Ankle sprains and fractures: The steep angle of the shoe makes ligaments on the outside of the ankle particularly vulnerable and prevents them from stabilising the ankle properly.  This coupled with the additional height of the heel can lead to wearers seriously spraining and sometimes fracturing their ankle. More information on Ankle sprains here






Knee, Hip and Back Problems

The effect of raising the heel from the floor moves the body’s centre of gravity forward.  The body compensates for this and in order to remain upright and not fall forward, high heel wearers need to bend their knees and hips and create a greater arch in their back. Find out what physio treatment you can get with Central Health for your injury or accident.





This puts tremendous pressure through the knee caps causing patellofemoral problems and compresses small joints in the spine causing spinal pain.  If high heels are worn often enough then soft tissues will shorten and contract causing the problems mentioned above to become permanent and set off a chain reaction of imbalances throughout the body.




High Heels




Now I am not saying that you should never wear high heels again.  Occasional use of these shoes for special occasions is unlikely to cause any permanent damage (except if you sprain your ankle!). I would recommend however, that you spend a majority of your time in flatter, more comfortable shoes or at least take regular breaks from wearing these shoes and stretch out thoroughly after wearing them.

Jon Lewis



For more information, please visit Central FootClinic and Central Physio

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