For former stylist turned full-time fashion blogger Marie Denee, heels hold a special place in her wardrobe.
“When a woman puts on heels, there is an extra boost of confidence. Her shoulders drop back, her posture changes. It allows an extra oomph—another level of fashion that comes with wearing heels,” says the 30-year-old founder of The Curvy Fashionista, who is based just outside of Los Angeles. “Even as a plus-size woman, once I put on heels, the muscles that I do have are showing. My legs feel like they are that much longer.”
“I’m not saying they don’t make a leg look good, a leg looks good in high heels,” says Dr. Sheryl Strich, president of the American Association for Women Podiatrists, but adds, “when you are over two and a half inches, you are setting yourself up for trouble.”
Trouble, Strich explains, comes in the form of stress fractures, arch fatigue, knee and back pain, a propensity for bunions, neuroma (pinched nerve), nail fungus, in-grown toenails and even arthritic conditions. These problems occur as a result of the weight distribution caused by heels, where the forefoot now absorbs an unnatural amount of pressure, gravity pushes the toes and nail bed into the front of the shoe and your normal walk and body alignment are altered.
“You are not walking correctly in a high heel because your foot is in the wrong position,” she says. “Your bones are your bones [and they won’t shift], but it is the soft tissue that is going to move around. If your joints are in malalignment, you can set yourself up for arthritic problems down the line.”
According to Christopher Powers, Ph.D., associate professor in the Division of Biokinesiology & Physical Therapy at University of Southern California, most of these conditions will relieve themselves after temporarily ceasing high heel use. However, Powers, who has published three studies on high heel effects, including an earlier study on fall potential, says the greatest danger of heel use comes from high heel-related injuries.
“When you are walking in high heels, your gait pattern changes to a walk that exposes you to increased potential of slipping,” he explains of the walk, which causes your pelvis to tilt forward, knees to bend and stride to shorten. “The higher the heel, the more at risk you are. Even a moderate (1.2-inch) heel height exposes you to a higher risk.”
And according to a recent small-participant study published in Journal of Applied Physiology, long-term usage can permanently alter your natural walk, increasing your risk of falls and strain injury even when you are not wearing heels.
Denee is no stranger to the accompanying pains of high heels and slip potential—in fact, she recalls an incident that resulted in a near injury. Yet she claims to know the risks and has called upon her fashion know-how to navigate around the dangers.
“I always try to switch it up and keep a variety, so heels are not an everyday occurrence,” she says. And when she does wear heels, she frequently wears foot orthotics—something that Strich highly recommends—and wears more wedges, thicker heels and platform heels, which also gain Strich’s seal of approval since they provide more support and distribute weight better than stilettos.
But in the end, both experts Strich and Powers concede that the rules of fashion may, for once, finally agree with the laws of medical science. “Everything in moderation is okay.”