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How to Tackle the Effects of Wearing High Heels

#posture #women

With high heels very much in fashion and even part of the dress code in some professions, it can be easy to dismiss the effects of prolonged wearing on our bodies. Big on high heels? In this article, we discuss the consequences of prolonged wearing of high heels and reveal essential steps you can take to mitigate the effects.

Take a moment to consider the natural human form.

Stand up for a few seconds - preferably shoes off and bare foot. Feel the floor beneath your feet and the effect of your weight being distributed across your heels, the balls of your feet and your toes. Notice the subtle, subconscious adjustments being made at the feet, ankles, knees, hips and lower back to maintain your upright position.

Now lift your heels gradually off the ground as you shift your weight onto the tips of your toes.

What do you notice that's different?

The further you go towards standing on tiptoes, the more you should notice the effects of this transfer of weight. The pressure on your toes, the balls of your feet, the ankles and knees. The tightening of the calves. The increased difficulty of keeping balance. Looking at your reflection from the side, you may even notice your lower back and chest shift forward.

Effects of prolonged wearing of high-heeled shoes


When wearing high-heeled shoes, our body weight is distributed over a smaller area towards the front of the feet. This shift in weight distribution has ramifications all the way up the body as individual body parts compensate for the change.

Wearing of high heels of adolescents has also been shown to lead to postural disorders such as forward head posture, excessive curvature of the lower back (lumbar hyperlordosis), forward-tilted pelvis (pelvic anteversion) and inward-falling knees (knee valgus) [1].


Studies indicate an impact on walking gait that influences various dynamics through the feet, legs and knee. With increased heel height, researchers observed a reduction in both step length and stride length decrease [2], while prolonged wearing generally results in a less fluent walking gait [3].

Body parts and muscles

The postural imbalance described serves to place greater pressure on the knees and hips, which can lead to increased pain in these areas. In addition, the postural shifts lead to muscular changes, including a shortening of the muscles at the back of the leg and a lengthening of those at the front - resulting in an impact on muscle strength and muscle fatigue [3].

Meanwhile, pressure on the forefoot can also lead to damage of the toenails, blisters and worsening of bunion protrusion, as well as an increased risk of osteoarthritis [4].

Balance and risk of injury

The shifts in the centre of pressure (COP) associated with wearing high heels have been shown to have a negative impact on a person's control over standing upright and maintaining a leaning stance [5]. Similarly, prolonged wearing of high heels leads to a weakening of certain ankle muscles, which can also compromise balance [6].

This reduction in postural control and balance indicate a greater risk of injury due to falls.

"... in both the upright and leaning stance, the COP alterations when wearing high-heeled shoes denote a postural control worsening which may be associated to a decreased postural stability and an increased falling risk."

- Emmanouil, Analina & Rousanoglou, Elissavet 2018 [5]

How to tackle the effects of wearing high heels

The obvious solution is, of course, not to wear high heels in favour of flats a low-heeled shoes. But with high heels in fashion and prevalent in some workplaces, this isn't always a desirable option. So, on balance, what can we do to mitigate the effects of wearing high heels?

1. Wear shoes with heels of no longer than 5 centimeters

For optimum body balance, the height of the shoe heel should range between 3 and 5 centimetres [5]. So, where possible, try to keep new shoe purchases within this range.

2. Reduce the amount of time spent wearing high heels

If you really can't lose those higher-than-five heels, then keep usage to a bare minimum. Carry them in a bag if you need them for work or an event and keep something more comfortable for travel. Numerous studies show that the negative effects increase with prolonged wearing [5].

3. Perform ankle-and-calf-strengthening and balance exercises

To strengthen weakened ankle muscles, try this simply workout a few times a week:

  • towel scrunches - place your foot on a towel and pull the other end towards you using only the toes before repeating with the other foot (3 sets)

  • heel walking - walk around your apartment on your (bare) heels for 20 steps (3 sets)

  • toe tappers - while seated, simply tap those toes as fast as you can for 12 seconds until you feel the burn on your calves (3 sets)

  • heel raises - stand with your feet facing forward shoulder-width apart, shift your weight onto your toes and hold for two to three seconds (3 sets of 10 repetitions)

  • one leg standing - stand on one leg for 30 seconds before repeating with the other (3 sets)

" ... it is clinically important for wearers of high heels to regularly perform ankle strengthening exercises, such as towel scrunches, heel walking, toe tappers, and heel raises, and to limit the frequency of wearing high-heeled shoes as preventative measures."

- M.‐H. Kim, Y.‐T. Choi, Y.‐S. Jee, D. Eun, I.‐G. Ko, S.‐E. Kim, E.‐S. Yi, J. Yoo 2015 [6]

1. Implications of high-heeled shoes on body posture of adolescents. Rev. paul. pediatr. vol.31 no.2 São Paulo June 2013

2. The effects of different high heeled shoes during gait at the kinetic and kinematic impact, IEEE 15th Student Conference on Research and Development (SCOReD), Putrajaya, 2017, pp. 481-486

3. Justin Caba, 'Negative Effects Of High Heels: New Research Confirms What Wearing High Heels Can Do To Women's Ankles', Medical Daily, July 2015

4. 'Effects of high heel wear and increased weight on the knee during walking', Journal of Orthopaedic Research, Volume33, Issue3, March 2015, Pages 405-411

5. Emmanouil, Analina & Rousanoglou, Elissavet 2018, 'Effect of high-heeled shoes on postural control in the upright and the leaning body stance', Physical Medicine and Rehabilitation Research. 3. 10.15761/PMRR.1000184.

6. M.‐H. Kim, Y.‐T. Choi, Y.‐S. Jee, D. Eun, I.‐G. Ko, S.‐E. Kim, E.‐S. Yi, J. Yoo 2015, 'Reducing the frequency of wearing high‐heeled shoes and increasing ankle strength can prevent ankle injury in women', The International Journal of Clinical Practice, vol. 69, no. 8, pp. 909-910.