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Beauty Before Pain: One Therapist’s Perspective on High Heel Shoes

by Athletico1 Comment

“I had surgery 2 weeks ago. When can I wear heels?”

“I wore heels for 30 years, every day at my job. Now I can’t wear flat shoes because my ankles are too tight.”

“I have a growth in my foot that is pressing on some nerves. I just want to wear heels again.”

“Please tell my daughter not to wear 5 inch heels!”

These are a few statements, as a therapist, I hear more often than you may think!  Woman LOVE their high heeled shoes! I recently went to a dancing event where a family friend showed off her dance heels to me. I asked her why she wasn’t dancing, and she told me that she couldn’t stay balanced in her dance shoes! Now I am a girl, and I like to dress up and put on heels, too. However, as a therapist who sees heel lovers suffer ankle fractures and sprains, I have to wonder: Is the thought of “beauty before pain” truly worth it?

Here are some findings from the medical research:

  1. One Therapist's Perspective on High Heel ShoesThe first study found via EMG testing that those in high heels end up overusing their back muscles to compensate, as the low back is angled differently and increased stress is placed through the spine. This may lead to low back pain.1
  2. The second study compared women, who did not have pain, walking in heels versus walking barefoot. When walking in the heels, approximately 23% more compressive force was produced at the knee cap and the inside of the knee joint compared to when walking barefoot. This may lead to knee pain.2

Does this mean I won’t ever wear heels again? I guarantee that is not the case! However, I do take these findings into consideration. Here are some thoughts as to ways we may minimize the effects of wearing high heels:

  • Wear heels for special occasions and wear comfortable supportive shoes on most other days, especially if you are on your feet all day at work.
  • If you are an avid heel wearer, stretch your calves on a regular basis to counteract the downward angle the heel places your ankle in.
  • Put some flats in your purse or desk so you can change out once the heels become uncomfortable.
  • Place a cushioned insert in your shoe to help absorb pressure points on your feet.

Anyone else have thoughts? Perhaps you have an extremely comfortable high heel shoe you would like to suggest? I’d love to hear others’ opinions on heels and your likes and dislikes of wearing them!

Sometimes I just really would like it to be considered fashionable to wear gym shoes with my super cute dress!


  1. Lee, Chang-Min, et al. Biomechanical effects of wearing high-heeled shoes. International Journal of Industrial Ergonomics. 28 (2001) 321-326.
  2. Kerrigan, D Casey, et al. Knee osteoarthritis and high-heeled shoes. The Lancet. 351 (1998) 1399-1401.
  3. Picture found at:, accessed June 2nd, 2013 from post written by Gabriel Bell.
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