Beauty Is Pain: Long Term Affects of High Heels

Little girls love to be like Mommy. She puts on Mom’s lipstick and eyeshadow. She attempts to style her hair like Mommy  as she fumbles around in her over-sized blouse  from her mother’s closet. To top off the look, she obviously needs those red high heels.

But at that young age, (and even as adults) the detrimental affects of wearing high heels all the time are not even considered. It is said that beauty is pain, but how much are you willing to sacrifice to wear this kind of footwear? Read about how these shoes influence the way you walk, your posture, activate muscles and how that relates to future problems.


The shape of high heels places your foot in a more unstable position and in a position that decreases the amount of shock absorption while walking so the body has to compensate in other ways to accommodate for these issues1. The forces on the foot are shifted forward so less support is given when one leg is on the ground while walking. More weight is also placed on the front of the foot, particularly the big toe. Without making adjustments, you are more prone to loss of balance and joint degeneration1.

Feet and Ankles

Narrow toe boxes, rigid heel caps and steep arches of high heel shoes can lead to foot deformities (hallux valgus and Haguland’s deformity) and pain2. The calf and a muscle on the outside of the lower leg are both activated more to stabilize at the ankle and to prevent the foot from arching too much, which can lead to muscle overuse2.


Because the center of gravity is more forward with high heels, the knees are more bent to maintain stability. To control the amount of knee bending, the quad muscle is activated more, which requires more energy expenditure2. Since walking in heels increases the amount of work needed from the muscle, it will fatigue quicker. There is also increased forces on the inner knee, where ortheoarthritis typically occurs.


One of the compensations during walking is increased hip movement. Just as the quads, if your hip flexors are overused, they can become fatigued and also become tight. If they are tightened it can tilt your pelvis forward and increase the lordosis of the lower spine3.


Many people complain of back pain, and high heeled shoes may be one of the sources of it. As said before, your center of gravity is shifted forward so your trunk will lean more forward, which can strain the back. Also, if the lordosis of the back is accentuated, that can also cause pain as well3.

It is amazing how a change at the feet/ankles influences the entire body up the chain! Remember everything is connected so if you change one thing, something somewhere else has to adjust to balance it all out. In the long run, these changes will stress and strain the joints and muscles, which can lead to pain, injuries, skin damage (calluses, bunions, blisters), and arthritis.I’m not saying to swear of heels completely, but if you wear very high heels, limit your time in them and if you choose to wear heels more often, keep it them lower.


1. Hsue BJ, Su FC. Kinematics and kinetics of the lower extremities of young and elder women during stairs ascent while wearing low and high-heeled shoes. J Electromyogr Kinesiol. 2009; 19(6): 1071-8.

2. Kerrigan DC, Johansson JL, et al. Moderate-heeled shoes and knee joint torques relevant to the development and progression of knee osteoarthritis. Arch Phys Med and Rehabil. 2005;86(5):871-875.

3. Vanderheiden T. High-heeled shoes – bad for the body fashion at a high price. 2008. Available at:

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