It may be frustrating, but it is a simple fact. As much as we can see the appeal of high heels too, shoes with raised heels (high heels, stilettos, heeled pumps wedge heels etc.) are toxic for your feet from an orthopaedic perspective. This comes down to two reasons: the enormous strain on the foot and the shortening of muscles and tendons at the back of the foot.
Too much strain at the front of the foot
The roll-through movement of the foot is already an extremely complex process. In fact, every last element must perfectly correlate to correctly execute this action. When standing barefoot, around 1/3 of the human body weight rests on the heels, 40% on the balls of the feet and the rest is taken care of by the instep (15%) and your 5 toes (around 13%). This weight distribution shifts dynamically when walking thanks to the roll-through movement. The more raised the heel on the shoe, (shoe specialists describe this as the heel arch of the shoes), the more weight must be supported by the front of the foot rather than the back. The main part of the foot directly affected by this are the metatarsal bones: the higher the heel is, the more weight they have the bear. When wearing high heels which are over 10 cm high, over 80% of your body weight rests on the forefoot, which is five times more than would be the case naturally (with no heel arch). During the roll-through movement of the foot, your body weight is dynamically shifted through the foot, meaning that the metatarsal bones only bear it for a brief period of time, however, your weight rests almost completely on this area when standing whilst wearing high heels. This causes particularly high strain on the skeletal structure of the foot. Such strains can occasionally lead to stress fractures in the metatarsal bones. More commonly, however, these lead to deformities at the front of the foot, such as splay-foot or the dreaded hallux valgus.
Shortening of the muscles and tendons at the back of the foot
The constant elevation of the heel whilst wearing high heels leads to shortening of the muscle and tendon structure in the rearfoot. The shortening of the tendons and muscles is inevitable if you wear high heels often and do not take part in any recreational sporting activities or counteract this using active muscle stretching activities. These changes occur much more quickly than you would think. The shortened tendon itself becomes thicker and less flexible – a process that becomes increasingly difficult to counteract after years of undue stress. This shortening of the tendons is worsened as a result of too much sedentary activity, which is an issue that almost all of us in the West are affected by.
This is why we only design and manufacture women’s shoes with a maximum heel arch of up to 50 mm. Shoes with this height are just as good for creating the ‘long legs’ look and are popular fashion items. All this without the negative side effects that come with a disproportionately raised heel.
We do not wish to criticise people’s desire to wear heels – luckily, as with many situations, the old principle from Paracelsus applies to high heels too: “dosis facit venenum” – “the dose makes the poison”. So from an orthopaedic perspective: the lower the heel, the better. And from a fashion perspective: when it comes to high heels, wear them as seldom and briefly as possible. Another thing – use regular stretches and muscle strengthening exercises to counteract this.