Monday, June 17, 2013

High heel hangover

Just in time for wedding, graduation, and prom celebrations...
run for it
image: StyleBistro

In cities across the globe, women love their high heels, or at least recognize their style. They are the fashion designer's dream and the medical doctor's nightmare.

Wearing high heels is also a great example of sexual selection -- a behavior that has become common to attract the opposite sex or compete with others of your own sex, not to enhance survival.

Au contraire, it's actually bad for your feet, ankles, knees, and back. And that's just from walking in them successfully.

It doesn't consider injury due to greater-than-normal falling, tripping, or injury due to inability to walk naturally or run away from a threat...

Designed for practicality first

Walking naturally was never the intention. In the 15th-17th centuries, elevated platform-like overshoes called pattens or chopines were used by wealthy folks in Europe and Asia to keep their clothing out of the muck and filth of unpaved Renaissance streets.
a Dutch patten from the 1400s, worn over
regular (soft) shoes to avoid mucky streets
image: AllAboutShoes
a Turkish woman wears chopines with help of a
servant AND a walking stick.  image: AllAboutShoes

Like the Louboutins of today, these overshoes were impossibly expensive and nearly impossible to walk in, generally requiring the presence of a servant, or at least a walking stick, for support.

Actual heeled shoes weren't designed for walking, and they weren't designed for women.

Soldiers in the Persian army used higher heels to be able to shoot arrows from atop their horses because their shoes gave them STABILITY (!!) as they stood up in the stirrups.

The same logic goes into cowboy boot design today.
macho heels on John Wayne and Dean Martin
image: Painthodge-Tumblr
As Persia communicated more with western Europe, the style of these riding shoes became trendy among European aristocrats in the 1600s. Real men wore high heels.

an early men's high heel
image: Bata Shoe Museum
Apparently, both the height gained with the shoes and the connection with Persia made men feel more macho, and the desire for this new style filtered down to the lower classes (Bling Ring, anyone?). This of course meant that the aristocracy had to wear even taller heels just to retain their distinguished status, and so heels got higher.

The higher thinner heels were, as you might guess, impractical on cobblestone streets, and that was part of the point -- the less you needed to be practical, the more important you must have been because someone else did your work for you. The more important you were, the better you outcompeted other guys and the more interesting to women you might be, thus enhancing your biological fitness (that's the sexual selection aspect!).

Apparently, in the 1630s, women's fashion included a masculine clothing trend, and the new style featured shorter hair, epaulletes on jackets, and high-heeled shoes.

kinky boots nothwithstanding, men have moved toward
practical shoes.   image: Sara Krulwich, The New York Times
Decades later, however, as men's shoes took on a squarer, more practical shape, women's shoe design went the opposite way, making unnaturally thin toeboxes that made women's feet look small and dainty as they peeked out from under long skirts.

As in previous decades, a woman who wore impractical shoes and thus clearly did not need to work was seen as desirable, and a wife who did the same reflected a successful husband.

Walk this way

Calling getting around in high heels impractical is probably an understatement: "'re not only crushing your toes, but you're crushing them and then putting weight on them, and that's a problem," says Stuart Mogul, DPM.

how we compensate when wearing heels
When you wear high heels - shoes with a heel two inches or higher - your foot slides forward in your shoe, forcing the toes into the unnatural shape of the shoe and redistributing your weight from your whole foot to just your toes.

The increased weight on your toes causes your body to tilt forward; to compensate, you lean backwards and arch your back, which creates a posture that can strain your knees, hips, and lower back.

On the up side, the strained posture also makes your legs look longer and slimmer, your feet smaller, your stomach flatter, and your curves accentuated. High heels bring sexy back. These "supernormal stimuli", of course, may be exactly why wearing heels makes men go crazy and women feel sexy. And powerful.

She avoids tilting forward by taking short steps, leaning backwards,
and arching her back, which pushes out her chest and rear.
The price of being attractive suggests sexual selection
The shift of our full body weight onto our toes also changes the way we walk.

A 2010 study in Australia found that women who wore high heels most days walked differently, even when wearing flat shoes, than those who regularly wore flat shoes.

Women that wore mainly flat shoes look longer strides and used their tendons to walk, which did not overly engage their calf muscles.

Women who wore high heels took shorter, more aggressive steps, even when wearing flats. The adjusted gait was less efficient and put more pressure on calf muscles, making these women more likely to suffer from muscle fatigue and strain injuries.

High heel hangover & more

"high" potential for increased
calf strain.   image: Skyrock
It's not just calf soreness. Wearing high heels creates unnatural pressure points and throws off your body's natural alignment, which causes your calf muscles to tighten, your toes to weaken, and your ankles to lose stability. Nice, right?

Over time, it can actually shorten the calf muscles and Achilles tendon, to the point that it causes pain when barefoot or wearing flat shoes. Ow.

Keeping your foot in a high heel and pitching it forward increases the pressure on metatarsal bones, which encourages or aggravates structural changes in feet, including bunions -- bony protrusions that often appear at the base of the big toe and distort the shape of the foot.

ready for sandals?
bunions, hammer toes
image: Riverside Online
It increases your chance of experiencing other common problems such as corns and calluses, as well as more complex issues like misshapen hammertoes, collapsed arches, or pain in the ball of the foot that can may grow worse each year.

Cramming your toes into a narrow toe box can cause nerve damage and bunions," says Dr. Natalie A. Nevins, DO, an osteopathic physician. "Extended wear of high heels and continually bending your toes into an unnatural position can cause a range of ailments, from ingrown toenails to irreversible damage to leg tendons."

change in posture, change in pressure
image: MissFitness

"The change to the position of your spine puts pressure on nerves in the back and can cause sciatica, a condition where nerves become trapped, triggering pain and numbness as far down as the feet," Dr. Nevins adds.

Age: another factor

Feet weren't designed to be crammed into tight quarters and balancing on small supports all day, and the effects are cumulative.

And as people age, their feet change, which tends to make wearing high heels even less comfortable. In middle age, we commonly lose the fatty deposits that normally protect the balls of our feet, according to Morris Morin, DPM.

The loss or decrease in the protective fat tissue, combined with pressure placed exactly there from wearing high heels not only causes pain, but "may also increase your risk of stress fractures and osteoarthritis in the feet". It just keeps getting better, doesn't it?

Feel better

If you want to take care of your feet but love to wear heels, you've got options, from the American Osteopathic Association and the combined advice from WebMD experts, along with suggestions from the American Podiatric Association, to protect your feet. After all, what good is that pair of red patent-leather stilettos if all you can do is sit and admire them?

the inside scoop
image: TheMetaPicture
1. If your fashion sense allows, choose shoes with heels 1.5 in (4 cm) or less and a wider heel base, which will spread the load more evenly and feel more stable. A shoe built like this one (right) puts immense stress on your toes, forefoot, arch, heel, and Achilles tendon, among other things.

As's Creative Director Candy Pratts Price puts it: "You can still have it low with flourishes. You don't have to go around in 105 [millimeters] to get high fashion."

2. Wear soft/padded insoles or silicone pads to reduce the impact on your knees and forefeet.

3. Make sure your shoes are the right size so the foot doesn't slide forward, putting even more pressure on the toes. Pick a shoe with a wide enough toe box to allow you to wiggle your toes but narrow heels with a snug but not tight fit to minimize this problem.

4. Wear heels on days that require limited walking or standing.

5. Alternate your shoes and heel heights throughout the day or from one day to the next to reduce stress on the Achilles tendon. If possible, avoid wearing your high heels all day, and change into more comfortable shoes for commuting to and from work.

6. Reduce the "slope" or "pitch" of the heel; platforms that have a gentler heel-to-toe slope should be easier on your arch and might help reduce pain in the ball of the foot.

7. Wear open-toe shoes to relieve pressure on corns and calluses.

8. Stretch regularly. Dr. Nevins recommends standing on the edge of a step with your shoes off. With your weight on the balls of your feet and your heels extending off the edge, drop your heels down to stretch.

Curious about heel designs and dangers?

Have a look at some amazingly creative shoes here and here, which rival the world's tallest heels (right) -- an 11" (28 cm) platform with a 16" (41 cm) heel.

More than just sexy: some anthropological notes on high heels and power.

More on foot problems and shoe shopping tips for healthy feet.

The fashion industry response to foot damage is mild concern and aesthetic podiatry.

Tips to avoid foot pain from high heels.

Tips to recover from high heel hangover.


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