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High heels have been a fashion trend for quite some time now, which sometimes resembles acrobatics for many women. Even though, the shoes can be works of art, they also can be associated with certain health risks, which vary from altered biomechanics and gait, stability, loss of proprioception, decreased foot strength, and overall discomfort. So here area few things to consider before slipping into the next pair of gravity-defying shoes.


High heels contour the spine into a S-curve, which allows women to accentuate certain parts of their body:

  • Center of gravity is pushed forward
  • Chest positioned forward
  • Lower back positioned forward
  • Hips positioned backward
  • Pressure at the knees
  • Downward force and pressure through the balls of the feet, which depends on the height of the heel
    • higher heel = more pressure
    • Example: 3 inch heel = 76% of pressure on forefoot

In comparison, flat shoes allow the spine to maintain neutrality and equal distribution of body weight throughout the entire foot.

Physiological changes in muscles & tendons

Calf muscles

  • May shorten and tighten over time
  • Collapsing of the arches
  • Difficulty of relaxing the foot completely

Achilles tendon

  • May shorten and tighten over time
  • Inability for the foot to rest at a 90-degree angle
  • Limited foot mobility

Knee joint

  • Extra strain on the knee complex tendons
  • Balancing on a high heel increases the pressure on the inside of the knee
  • Quads work harder and increase pressure on the kneecap
  • Possibility of osteoarthritis over time


  • Sprain may result from twisting of the ligaments in the ankle between the foot and the lower leg
  • Balancing on the heel creates instability
  • Increased chance of falling, especially if older or obese
  • Sudden shift in balance can twist the ankle and sprain ligaments
  • Haglund’s deformity (“pump bump”) – a bony enlargement from irritation to the heel from rigid backs or straps of heels


  • Pressure pushes down and forward on the ball of the foot
  • High heels have narrow and tight toe boxes, which force toes to conform to the shape of the shoe without enough room to relax
  • Loss of strength in intrinsic muscles of the foot
  • Create minor conditions, such as bunions, corns, and hammertoes
    • Bunions: a large bony bump at the base of the big tow, which resulted in the joint being forced to permanently misalign and rub against the shoe
    • Corns: hard calluses that form on the top of the toes or on the side of the small toe
    • Hammertoes: a permanent curl at the middle joint of the middle toes that resulted from shortened and tightened ligaments and tendons; pressure on the ball of the foot will cause pain

We all recall the story of Cindarella and the anecdote about what women were willing to do to fit into the glass slipper. We’ve come a long way in terms of fashionable yet comfortable shoes that do not require risking our spinal health, myself included.

Chiropractic can be instrumental in regaining your postural alignment and in preventing further advancement of bony abnormalities in the kinetic chain from hips, knees, ankles, to the toes.

Dr. Tijana’s favorite way of locomotion

Feel free to contact me here with any questions, at drtijana.dc@gmail.comFacebook, or Twitter!

Be healthy & happy, Dr. Tijana

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