In practice, some of my patients that complain of back pain realize that it coincides with a night out when they wore their high heels. I often get asked that question “could my back pain be due to the fact that I wore high heels yesterday? “. While I was browsing the internet, I found this research report on the topic and thought it may be appropriate to talk about it and stir up some discussions. The easy answer to the comment is that it may create muscle fatigue or calf tightness, that it changes the alignment of the spine and creates compensations but does it really? More and more researchers are looking at the topic. This research actually looked at the impact of wearing high heels on the erector spinae muscles ( muscles close to your spine) and the way your pelvis gets affected when you walk.
Women have been wearing high heels since the 17th century either for social or work events. There are some reports that 59% of women actually wear high heel shoes for 1- 8 hours per day. We have thought that high heel actually changes and raises your centre of mass of the body which will change the stability of the posture and will affect the lumbar muscle timing which will result in fatigue and pain. It will tend to have an effect on the low back curve called the lordosis by increasing it and will change the way women walk or pelvis mechanics. Are these true facts, what did the research say!
So this study looked at 31 young women ( 20-25 years of age) and 15 middle aged women ( 45-55 years of age). Subjects were asked to wear stilletos 1 hour per day during the week before participating in the study. Then they came to the lab and they made them walk 3 different ways. 1) with no shoes 2) with shoes with a 4cm heel ( low heel) 3) in shoes with a height of 10cm ( high heel). Both low and high heels had a base of 1cm. They made them walk 6 times and took the average and also looked at their stance for 10 sec. They analysed the muscles of the low back and the motion of the pelvis.
The most important results of this study were that when women wear a 10cm heel stiletto style , it increased significantly the low back muscle activity when they walked in both aged group. This would then have clinical implication and may lead to cumulative fatigue, limitation of motion, create accumulated strains and change the joint loading profile. There is now research behind the thoughts. Another interesting result is that motion of the pelvis changed in the young age category but was not seen in the middle age category which may indicate that women adapt to the mechanical changes that wearing heels brings on us after many years!
This research I thought was interesting and relevant to the demographics of my clinic. I am not saying do not wear heels but just be aware that you may suffer the next day. I guess the say ” one must suffer to be beautiful ” may apply!
Please share with me, do you see a difference in your back pain depending on the height of your heel and how long you wear them?
Mika A, Oleksy L, Mika P, Marchewka A, Clark BC. The effect of walking in high- and low-heeled shoes on erector spinae activity and pelvis kinematics during gait. Am J Phys Med Rehabil. 2012 May;91(5):425-34.