All too often idolised in TV shows like Sex and The City and Desperate Housewives, high heels seem to be as popular as ever. I often sneak a peak in the corner of the room at what the female patients have on their feet. Some have even gone to the lengths of hiding their heels under their jackets or as I discovered in one case changing them in the car park before coming in for their appointment, for fear of having them spotted by me.

So why are high heels considered bad news for your back? Well it really comes down to biomechanics. In simple terms your feet are your foundations. They contain the primary shock absorber for the entire body, most commonly known as the arch of the foot. The heel and forefoot are also designed to sit at the same level – makes sense if you want to have a stable base. So what happens when you slip on those Blahniks, Choos or even harmless enough looking Russell and Bromleys.

 Chiropractors are trained to appreciate and understand the premise that structure and function are closely inter related. High heel shoes not only change the position of the foot but naturally impact on the way in which the foot goes on to function which can over a longer time come back to affect the structure.

“No Carrie, perhaps we no likey”

 The high heel position places an increased amount of strain on the forefoot which can result in hammer toes and possibly bunions, not very sexy! But even more importantly it takes out the slack from the arch which in the normal foot would dissipate the force of each step from travelling up the leg to impact on the ankle, knee, hip and back joints.

The changed foot position causes the muscles of the calf to shorten, and makes the muscles around the knee and hip work much harder. Now although this may sound like a good way to have a work out, it is never that simple. The effects of the changed foot position are amplified the higher up we go.

 Your back is designed to be a particular shape, the curve/hollow at the base of the back along with the curve/rounded midback are designed to cancel each other out thus acting as a shock absorber – all very clever. Unfortunately the high heels cause the wearer to change the position in which their back is held. Heels result in a flattening of the curve at the base of the spine and in order to compensate the upper back has to relocate itself backwards to ensure you are still upright. This new position causes a narrowing of the area in the lower back where the nerves leave the spine and this can lead to back pain and varying types of leg pain including sciatica.

 As we all know, not everyone that wears high heels ends up getting back pain, but in conjunction with other aspects of your lifestyle they can predispose you to getting pain in a number of joints in the lower body if the overall scenario is not favourable.

As I finish writing this blog entry, I have just found a curious article. It’s a quote from a researcher in Italy (where else!). She says that wearing a pair of “moderately high heeled shoes” had beneficial effects for a woman’s sex life by working the pelvic muscles and reducing the need to exercise them. I somehow don’t think i’ll be passing this information on to my offending patients.

From an increased risk of tendonitis in the foot and heel, the risk of early wear and tear of the knee, hip and even spine, it might be worth thinking about some ways to limit the use of your favourite fashion statements to those times when you really want to wear them. Here are some tips to help you keep your joints comfortable whilst still enjoying your favourite shoes.

 1)      Choose your heels wisely: in simple terms the smaller the heel the less impact it is likely to have on your body. Once you are over 1.5 to 2 inches the verdict seems to be that you are likely to experience an even greater set of problems.

2)      Favour flat shoes for day to day wear and only wear your prize heels on special occasions or when you are not on your feet very often.

3)      Wear trainers or supportive shoes when travelling to and from work, you’ll be much comfier.

4)      Make sure you have the right size shoe to fit your foot. Even narrow toe boxes can result in a pinching of the nerves around your toes which can give severe pain.

5)      Always choose leather shoes over synthetic alternatives as they tend to adapt to your foot and be more comfortable.

6)      Strengthen your spine even if you are not currently suffering. Core muscle training such as Pilates or the rehabilitation exercises taught by your local BCA Chiropractor can help achieve this.

7)      Stretch your calf, hip and back muscles to keep yourself supple and minimise the chances of getting pain. It is best to seek a professional opinion on how to do this safely for your individual body. Your nearest BCA Chiropractor can advise on this and can be found through the British Chiropractic Associations website www.chiropractic-uk.co.uk

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