Study: High Heel Shoes Can Alter How You Walk—Permanently

Feet hurt? Bitching about how much those sexy stiletto high heels kill your tootsies is totally warranted.

What’s more important: feet that look good or feet that feel good? I hope you answered the latter because a recent study shows that wearing heels that are at least two inches high over an extended period of time can seriously impact—and not for the better—the muscles and tendons in your feet.

The study followed nine women who regularly wore high heel shoes for at least 40 hours a week for a minimum of two years. The data showed a substantial increase in muscle-fiber strains and muscle activation compared to ten control participants who wore heels less than 10 hours a week. The long-term implication is this: wearing high heel shoes for long stretches can compromise walking efficiency and may increase the risk of strain injuries.


Bruce Zappan, a podiatrist at Medical Arts Podiatry Associates in Center City, is well-aware of the negative repercussions of wearing heels. He says that wearing narrow, pointy-toe shoes constricts circulation and puts pressure on nerves that converge in the foot, which may result in shooting pain, pinching or numbness. This pressure causes calluses and corns, conditions that can become quite serious if you don’t give your feet a chance to heal: The skin will continue to thicken and an abscess may develop, which can become infected. This infection can spread throughout your body.

Wearing narrow, too-tight shoes can even alter your bone structure, causing the big toe to point towards the second toe. Called bunions, the condition can be excruciatingly painful and may require surgery.

You could also develop hammer toe, in which one or more of the middle toes becomes stuck in a claw-like position as a result of being pushed against the front of the shoe. At first, you might be able to move the toe back into its right position, but over time you may no longer be able to move the toe at all.

Then there’s the damage the actual heel is inflicting. Zappan says that wearing high heels over time can result in the shortening of the Achilles tendon so that wearing flat shoes actually becomes painful. Wearing heels three inches or higher subjects the ankle to instability and makes you prone to sprains. Tension and pain in your lower back are other common complaints because wearing high heels alters the natural balance of your body, exerting more pressure on areas not intended to receive such stress. (Hello, foot and muscle pain.) Ill-fitting pumps can dig in the back of your heel and cause Haglund’s deformity, a bony enlargement in the heel that often leads to a very painful inflammation of a fluid-filled sac between the tendon and the bone.

So yeah—that’s why your feet hurt.

Solutions for High Heel Foot Pain

What can you do to prevent your body and feet from suffering? Zappan’s advice: Avoid wearing too-high heels for long periods of time. If you have a special event on a weekend that requires you to wear fabulous stilettos for three to four hours, that’s no big deal. It’s when you start wearing towering heels all day, every day, that there’s cause for concern. Zappan advises wearing walking shoes to work and changing into more fashionable footwear after you’ve arrived. Wearing high heels while sitting at a desk puts much less strain on your feet than your full body weight pounding on cement sidewalk.

It’s crucial to purchase shoes that actually fit you. “Feet can change like any other part of the body, and you should have your shoe size checked once a year,” says Zappan, pointing out that many women purchase shoes a half-size too small so their feet will appear smaller (bad idea). He advises buying shoes in the afternoon, since feet swell as the day goes on and you want to get shoes that fit your feet at their average size.

You can learn a lot about a shoe’s fit simply by looking at it. If the material looks narrower than your foot beside it, it’s likely you need a wider shoe. A size 8 in one style or brand does not translate across the board. You need to analyze each fit on an individual basis.

Zappan also says it’s important to invest in a high-quality shoe made of natural material such as leather. Soft leather allows for some give so that the foot can move naturally, and the porous material breathes, preventing a build up of sweat and moisture inside the shoe that can cause rashes.

“The most important thing is prevention,” Says Zappan. “As long as you wear heels in moderation, you can save your feet from a lot of damage.”