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It’s All In The “Heel”

Our feet are meant to place us in contact with the ground. Maintaining healthy and well functioning heels can be a challenge when high heels are worn frequently.  High heels are perceived as making legs more attractive, but function poorly for multiple reasons:

  1. High heels change the amount of surface area that our feet absorb impact as we walk, thus transferring the impact to the knee, hip, and low back.
  2. The heel pad at the back of the foot (the primary shock absorber) is lifted off the floor placing the impact on the bones of the mid and front feet.
  3. The calf muscles (Gastroc-Soleus) are maintained in short position (contracted) which looks good but does not function well
  4. Wearing high heels decreases step length, speed and balance


The summation of just these changes may cause:

  1. Increased pain in foot, knee, hip and low back
  2. Increased inflammation
  3. Decreases circulation returning from feet because of limited calf pump. The Gastroc-Soleus muscle groups serve as a primary venous pump to move used blood (decreased O²) and inflammation out of the feet and legs
  4. Increase in the risk of falls and injury because of decreased balance and agility


Following are recommendations for those who wear high heels regularly:

  1. Stretch (a) Gastroc and (b) Soleus muscles:

a – is with knee locked straight

b – Is with knee bent

  1. Rest and RICE when experiencing heel pain:

Rest: Take heels off as soon as possible

Ice: Ice areas of pain

Compression: compression wrap or ankle compression hose

Elevation: elevate feet above heart to decrease inflammation

  1. Strengthen heels: practice walking the opposite manner, i.e., heels down, toes up, not letting your toes touch, take 20 – 50 steps, 3 or more times per day
  2. Retrain balance – stand on 1 foot; switch, stand on other foot, attempt to perform more than 10 times per day. The inability to stand on 1 foot for more than four seconds increases the risk of falling and decreases the ability to go up and down steps safely.


Another problem can occur when the shoe has a narrow or pointed toe box. This adds compression across the front of the foot, which adds to the compression shifted from the back of the foot. The added compression will increase plantar heel spurs, bunions, pain and inflammation. When you experience the first signs of foot pain such as burning, tingling, numbness or pain when standing, you need to go to recovery mode.


Increased inflammation = increased pain.

Increased pain = less activities because it hurts.

Less activities = more tightness, less strength, less balance, less flexibility

Less strength, flexibility and balance = greater risk of fall or fractures and significant consequences.



Bunions feel better in wider shoes (less compression).

Heel spurs (planter fasciitis) respond best to ice, elevation and ground level or flat shoes with padded inserts (insole should be replaced in three months) to absorb the shock.

Making a change to low heeled shoes may initially cause some pain as the feet start to return to the ground, but this will help in controlling inflammation and experiencing less pain in the recovery process.


In conclusion, heels look great but function fair to poor, creating increased inflammation and pain which decreases strength, balance and mobility and increases risk of chronic and or serious injury.


For a full evaluation and recommendations for corrective actions consult a physical therapist.

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