High Heels and Health

By: Dr. Michael Cohen

Fashion aside, if I may for a moment, I have just been looking at the Spring / Summer fashion collections for 2012 in Europe and it seems there are two heel heights on offer for the season, completely flat and 12 centimeter high. As much as my wife assures me the shoes are stunning, my immediate concerns are with how to maintain the health of my clients who choose to wear these designs, especially the truly very high ones. From Versace to Prada, Bruno Magli and Stuart Weitzman it seems the heels are even higher this season. In Milan Italy I noticed the pavements are dented from the summer months when due to heat the asphalt has softened and high heels have sunk into the pavements lining street after street creating small dents. The truth is I know women are going to be wearing these shoes (and not only because it seems there’s little else on offer) so the only solution is some practical advice on how to maintain your health while you maintain your fashion identity.


Firstly, scientific research shows that the increased pressure on the foot from a 3 inch heel is about 76%. This can lead to a multitude of issues with feet from stress fractures to ankle injuries, bunions to tendon damage. At the next level, calf pain and muscle problems, hip problems, disc and sacrum pain, then rib, mid-back, neck and head pain. Wearing high heels and symptoms of headache, back pain, foot pain, leg pain, disc pain can be correlated so it’s important to read the signs and look for help.

Time Out

Discomfort from high heels can start within minutes, and pain is a warning sign that something is not right. It’s the body’s natural mechanism for helping you regulate activities within comfort, and when the pain threshold is reached, then the body’s natural ability to cope has been exceeded.

A 12 centimeter heel in the pages of Vogue Magazine was once a special occasion shoe option, but in this year’s collection it has appeared as an everyday shoe. My suggestion is that if you are standing for more than 1-2 hours in a 12 cm stiletto, you will very likely be causing misalignment in your spine that may lead to issues that require treatment.

Check One - Visual

The first check to see if the shoe you are wearing is going to impact your spine and nervous system is a visual check. Is your foot at a contorted angle? Is your back swaying and arched mid-back? Is your buttock pushed out behind you instead of aligned with your back? Is your head forward with the full length of the back of your neck forming a pronounced reverse “c” shape? All of these visual signs are indicating that you are misaligned in the shoe. As a test, take off the shoes stand at ease and relook at the posture of your body.

Check Two - Balance

Can you balance on one foot while wearing the high heeled shoes? And with both feet on the ground are you able to lift your big toe upwards? If you are unable to do both of these tasks, your centre of balance is significantly out of its normal range and this could render you more likely to suffer an significant injury in a fall or moment of lost balance.

Check Three - Pain

Secondly, check for discomfort. Starting with your feet. Do they feel squashed or under pressure? Is the ball or underneath part of your foot sore? Do your ankles feel locked? Are your calf muscles tight or shins strained? Is your lower back feeling sore or do you feel the need to put your hands on your hips or lower back for stability? Are your shoulders tight? Do you have any dull or significant aches in your neck or head?

Prevention Care

Spinal misalignment can cause nerves to function suboptimally and pinch or become stuck in joint areas that are not moving properly. In Chiropractic care we call this a subluxation. The best way to assess whether your shoes are impacting your health is to have an assessment by a qualified healthcare practitioner trained to look at nerve function.

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About the Author Dr. Michael Cohen, Chiropractor is the Clinic Director of Chirosports Coogee and a co-founder of the Chirosports group. He graduated in 1990 from the Sydney College of Chiropractic (now known as Macquarie University) and the University of NSW and was awarded the prestigious “Clinician of the Year” award for excellence in clinical studies and application. Prior to establishing Chirosports, Michael had been Assistant Director at the Centre for Chiropractic where he worked as a L

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