Businesswoman taking off high heeled shoesWearers of high heeled shoes often complain of low back pain, foot pain and leg pain. The reason for foot and leg pain is fairly obvious – the added pressure on the ball of the foot and the shortening of the calf muscles and achilles tendon is bound to cause some discomfort.

The reason that wearing high heeled shoes may cause low back pain is a bit less clear though. It has long been thought that by standing and walking with your heels raised, your hips would naturally tilt forward and create more of a curve in the lower back, leading to pain.

A recent study led by Edeny Baaklini of the Institute for Biomechanics at ETH Zurich in Switzerland challenged this idea by investigating the differences in spinal posture and biomechanics of walking barefoot, with low heeled (4cm) shoes and with high heeled (10cm) shoes.

The results were significantly different to the long held belief that high heeled shoes increase the amount of curve in the lower back, and in fact showed that the higher the heels were, the less the spine curved.

On a positive note for high heeled shoe wearers, the study concluded that they were able to support the current recommendation that heels between 4-7cm high can be worn without affecting comfort, mobility or balance and will not increase the risk of injury.

But it’s not all good news. Even though this study showed that high heels don’t necessarily increase the amount of curve in the lumbar spine, it did show that spinal and lumbar biomechanics are significantly different the higher the heels get. Importantly, it seems that the spine and the pelvis just generally move less with higher heeled shoes.

Although the likely causes of back pain while wearing high heeled shoes were not discussed in the study, one possibility is that the lack of spine and pelvis movement results in joint stiffness and muscular tightness, which can then lead to pain.

So it seems that if you wear high heeled shoes throughout the day – especially if they are higher than 7cm – it would be wise to do some regular stretching of your feet, calves and back to ensure that the altered movement patterns associated with wearing them do not lead to the gradual stiffening of joints and tightening of muscles that can cause back pain.

Here are a couple of basic stretches that could help minimise the effects of wearing high heels throughout the day.

Thoracic rotation

Sit up straight with your arms crossed. Rotate through your upper back as far as you comfortably can. Alternate side to side.

Glute stretchPlace one leg on top of the other, push your knee down gently and lean forward and the hips keeping your back straight. You should feel a stretch in the buttock.

Calf stretch for plantar fasciitisLean against a wall with one foot behind the other. Lean forward to stretch your calves.

Rolling plantar fascia on golf ballUse a golf ball or similar to roll the arch of your foot.

Referenced Article
Edeny Baaklini, Michael Angst, Florian Schellenberg, Marina Hitz, Stefan Schmid, Amir Tal, William R. Taylor, Silvio Lorenzetti. High-heeled walking decreases lumbar lordosis. Gait & Posture, Volume 55, June 2017, Pages 12-14, ISSN 0966-6362