Heels can make you week-kneed

Anil Arora

Most women would agree that tottering along in a pair of killer heels can result in sore feet, painful ankles and a bad back. Wearing high-heels of at least three-and-a-half inches can also prematurely age knee joints and could lead to osteoarthritis. Stanford University scientists have found that every time a woman puts on a pair of stilettos she is putting dangerous amount of strain on her joints and for women who are overweight the damage is even worse. "Killer heels could lead to osteoarthritis in knees and may potentially lead to osteoarthritis: so-called wear-and-tear arthritis, where damage to a joint causes stiffness and pain, say these experts.

The type of arthritis that wearing high heels can cause is called osteoarthritis, which is the most common form of the condition. In a healthy joint, the ends of our bones are padded with cartilage. The cartilage is protected by a fluid-filled joint capsule and synovial fluid. In a joint with osteoarthritis, the cartilage is worn away. Spurs can form around the edges of bones and more synovial fluid sits around the joint. Joints become stiff and movement becomes challenging and uncomfortable. The higher the heels, the more likely it is the knees are bent when shoes make contact with the ground — increasing the strain on the knee joint. 

Wearing killer heels can make the women's knees look more like aged or can damage joints with the effect even more pronounced for overweight women.

Walking for long periods on the balls of the feet causes aches and pains, stress fractures, trapped nerves and increased wear and tear on the joints and soft tissue. Usually cartilage soaks up the impact from walking, running or lifting, so that bones do not rub together and disintegrate. But in osteoarthritis, the cartilage starts to break down and as bones come into contact, the friction makes joints swollen and extremely painful. There are no drugs to cure it and many sufferers rely on anti-inflammatory painkillers to ease the pain. Minimum use of high heels can minimise the pain.

More extreme treatments include steroid injections, to dampen down inflammation.

Jane Tadman at Arthritis Research, UK, says “Research has historically implicated high heels as a probable risk factor for osteoarthritis of the knee, and can also cause back pain. Wearing high heels shortens the Achilles tendon, causing restriction in ankle movement, and jams the toes into the front of the shoe, which can cramp and deform them."

“From the point of view of the foot, knees and back, it’s probably a good idea to limit the height of the heel to a couple of inches, except for special occasions. 

“Many of the changes observed with increasing heel height and weight were similar to those seen with aging and OA progression,” researchers said. “This suggests that high heel use, especially in combination with additional weight, may contribute to increased OA risk in women.”

Knee osteoarthritis (OA), a leading cause of disability, is more prevalent in women than men. Wearing high-heeled shoes has been implicated as a potential contributing factor for the higher lifetime risk of osteoarthritis in women. The hypotheses that change to knee kinematics and kinetics observed during high-heeled walking increase in magnitude with increasing heel height and are accentuated by a 20 per cent increase in weight. Many of the changes observed with increasing heel height and weight were similar to those seen with aging and OA progression. This suggests that high heel use, especially in combination with additional weight, may contribute to increased OA risk in women.

Researchers get more information on the precise gait changes that occur when a woman wears heels, or when they carry added weight. The study does not contribute any further understanding about whether wearing heels is causally related to joint problems in later life. However, there have been reports of an association between “over-wearing” high heels and foot problems such as corns and calluses. Most  specialists would recommend saving your killer heels for special occasions, and sticking to flats or trainers for daily wear.

— The writer heads Department of Orthopaedics, Max Super Speciality Hospital, New Delhi