Is Wearing High Heels Bad for You?

It’s important to understand how your footwear affects your body — especially around the foot and ankle. Choosing the right shoes helps prevent injuries and deformities.

High-heeled footwear is a popular choice for work, events, and daily use. But you’ve probably heard people say, “High heels are bad for you” — without knowing exactly why. This article explains how and why wearing high heels may be harmful, especially when it comes to long-term wear.

Why High Heels Are Bad for You

The structure of high-heeled shoes places uneven pressure on different parts of your feet. This can lead to:

1. Foot Pain from High Heels 

One of the most common issues is heels pain. Many high heels have narrow toe boxes and elevate the heel unnaturally, affecting your walking gait and putting strain on your joints, tendons, and fascia.

Persistent Big Toe Pain

Narrow toe-boxes push your toes together, causing:

• Bunions: The constant inward pressure on the big toe joint can accelerate or exacerbate the development of bunions, which are bony bumps that form on the joint at the base of your big toe. These can be incredibly painful and often require medical intervention.
• Toe Numbness: When nerves in the toes are repeatedly compressed or pinched due to the tight space, it can lead to tingling sensations or toe numbness, due to stretching of the cutaneous (skin) nerves. This suggest nerve irritation and can progress to more severe, burning pain.
• Hammer Toes or Claw Toes: The unnatural bent position forced upon the lesser toes over time can cause them to become permanently curled, resulting in deformities known as hammer toes or claw toes. These deformities can lead to painful corns and calluses on the tops of the toes.

These issues contribute to toe pain from high heels and may require medical attention if left untreated.

Heel Pain / Back of Foot Pain

Wearing high heels over a long period can ironically lead to heel pain. When the foot is held in a plantarflexed (downward) position, as it is in high heels, it causes the calf muscles and Achilles tendon to shorten. Over time, this leads to tightness in both, resulting in sharp pain around the plantar heel and the back of the foot (posterior ankle).

A shortened Achilles tendon can also reduce ankle flexibility, making it uncomfortable to walk barefoot or in flat shoes. This limited range of motion may increase the risk of developing Achilles tendonitis or even tendon rupture. Another common condition linked to frequent high heel use is plantar fasciitis, which occurs due to inflammation of the plantar fascia tissue under the foot.

Arch Pain

High heels often lack proper arch support, or their elevated design places the foot’s arch in an unnatural curve. This misalignment can lead to excessive strain on the plantar fascia, a thick band of tissue that runs along the bottom of your foot, connecting your heel bone to your toes. This strain could result in debilitating arch pain.

Skin and Nail Conditions

The constant pressure on the toes within the confined space of high heels affects not only the bones and nerves but also the skin and nails.

Constant pressure from wearing high heels can cause painful skin callosities to form along the inner and outer edges of the foot — especially around the big toe and little toe. It can also lead to ingrown toenails, where the nail edge grows into the surrounding skin, causing discomfort and possible infection. On top of that, the warm, enclosed environment inside tight shoes creates the perfect setting for fungal infections, which can make toenails discoloured, brittle, and harder to manage.

2. Ankle Strain and Pain

High heels shift your body’s centre of gravity forward, away from its natural stable alignment. This forward tilt increases instability, placing immense stress on your ankle joints and the surrounding ligaments. This increased stress could increase the risk of ankle sprains or twists, even with a slight misstep. Over time, the repeated strain from high heels may cause ankle instability and faster wear of the joint cartilage, which could contribute to early-onset arthritis in the ankle.

3. Knee Pain

The changes in gait and posture caused by wearing high heels extend their negative impact up the kinetic chain to your knees.

When you wear high heels, the altered alignment of your leg causes increased pressure on the inside (medial compartment) of your knee joint. This uneven distribution of force accelerates the wear and tear on the knee cartilage.

Over time, this added stress could contribute to the development or worsening of conditions like osteoarthritis in the knee, a degenerative joint disease characterised by cartilage breakdown and pain.

4. Lower Back Pain

Perhaps one of the most widespread and debilitating consequences of wearing high heels is their effect on your lower back.

High heels can cause your pelvis to tilt forward, which then increases the natural curve in your lower back. This change in posture puts added strain on your spinal muscles, ligaments, and the discs that cushion your vertebrae.

This constant stress on the lower back posture can lead to persistent back pain. The widespread effects of this lower back pain can be severe, impacting your ability to stand, sit, walk, and sleep comfortably, leading to reduced productivity, chronic discomfort, and a significant decline in overall quality of life, which will require a lower back specialist to diagnose and provide treatment.

5. Balance Issues

The elevated and narrow base of high heels reduces how much of your foot makes contact with the ground, which decreases your overall stability and increases pressure on specific points of the foot. This can also affect your joint position sense — your body’s awareness of movement and balance — making it harder to stay steady. As a result, you’re more likely to stumble, trip, or fall. For those who already have balance issues, these falls can lead to serious injuries like fractures.

How to Mitigate the Risks of High Heels

If giving up high heels entirely is not possible, you can take the following steps to minimise their negative impact on your musculoskeletal health:

1. Limit Wear Time

One of the simplest yet most effective strategies is to limit the duration you spend in high heels. Opt to wear them only when absolutely necessary for specific occasions or events. For daily commutes or tasks that involve a lot of walking or standing, alternate with lower, more comfortable shoes that provide adequate support and cushioning.

Choose Wisely

When selecting high heels, make conscious choices that prioritise comfort and support, such as those with wider heels. Platforms can also help by reducing the actual heel height experienced by your foot. You should also look for shoes with more cushioning in the sole, a broader toe box to prevent compression, and a lower heel height.

2. Stretch and Strengthen

Proper stretching and strengthening exercises may help manage some of the negative effects of high heels. Focus on stretches for your calves and feet to maintain flexibility in your Achilles tendons, and strengthening exercises for your core muscles and the muscles in your lower body.

3. Seek Professional Care

If you are experiencing pain or discomfort in your feet, ankles, knees, or lower back that you suspect is related to wearing high heels, it’s crucial to seek professional advice. A foot and ankle specialist can assess your issues and help you manage your condition.

Don’t let chronic pain impact your quality of life. Our team at Centurion Orthopaedic Centre can provide thorough assessments to address your discomfort and provide personalised treatment plans, including management methods, physical therapy, and specialist interventions.