High Heels: Could They Be a Pain in Your Neck?

454With, Dr. Eric Keene PT, DPT, CSCS

I’m just going to be up front and say: most Physical Therapists discourage people from wearing heels. With that being said, that doesn’t mean you have to throw out all of your Louboutins, Manolos or Jimmy Choo’s.

First, I’ll go through why they aren’t good for your body; but then, I’ll introduce some strategies so that you don’t have to cut them completely out of your wardrobe.

Overall, something down at the feet can make big effects up the body. It’s the pebble that creates ripples in the water – a cascade of compensations up the body. High heeled shoes can be contributing factors in causing foot, knee, back, or even neck pain – all stemming from joints responding and compensating from what’s happening at the feet.

Depending on the size of the lift, the shoe will shift your center of mass onto your metatarsal heads, promoting ankle plantarflexion (pointing). This puts pressure on an area of the foot that wasn’t designed for full weight bearing. This plantarflexion causes the knee to compensate with bending and then the pelvis to tilt anteriorly to compensate. The anterior tilt of the pelvis causes a hinge point in the low back where the weight of gravity will get stuck and can cause pain (an increased lordosis). The thoracic spine will compensate for the pelvis and lumbar spine by shifting backwards, and lastly the neck and head will shift slightly forward to compensate for the thoracic spine. This can cause neck pain and in some cases even headaches.

After reading that, I know that I’m going to stop strutting around in my high heeled shoes (just kidding). I recognize that if you like wearing heels, regardless if you know the negative biomechanical repercussions, you’re still going to wear them. Why is that? Because they make your calves look fantastic – that’s what they are designed to do.

Here are some tips so you can continue to wear high heels but minimize the deleterious effects on your body:

  1. For work: Instead of putting them on in the morning to commute to work, wear a flat shoe and pack your work heels in a bag.
  2. For events: wear the heels for event, but have a flat shoe with you in the car or purse and switch as soon as soon as possible (especially for dancing)
  3. For everyday: vary the size of the heel you use. Don’t always wear that 3 inch heel, girlfriend. Wedge shoes are also an option because they distribute pressure more evenly throughout the foot due to increased contact area.

Overall, it comes down to less exposure. Wear them less. Strut your stuff in those heels in those social events; but, when you don’t have to wear them, don’t.

Elite Health Services, located in Old Greenwich, (and now Westport!) CT is a world-class provider of certified functional manual physical therapy, personal fitness, golf & triathlon performance training, massage therapy and wellness related services.  Our team of highly skilled and dedicated professionals take a no-excuses approach to providing exceptional care and delivering exceptional results. To learn more visit EliteHealthServices.com

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