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Home/Foot & Ankle/Stiletto Heels Harbinger of Osteoarthritis
Foot & Ankle

Stiletto Heels Harbinger of Osteoarthritis

February 6, 2015 2 min read Premium comments

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Stiletto Heels Harbinger of Osteoarthritis
Source: Wikimedia commons and Oxfordian Kissuth
Secondary

Most women who wear high heels know, from the pain in their feet, that the heels are not good for them. Radhika Sanghani, an admitted lover of stilettos, writing for The Telegraph in the UK reports that Stanford University scientists have found that when a woman puts on a pair of high heeled shoes she is putting dangerous levels of strain on her joints. If the woman is overweight, the damage is even worse.

Sanghani quotes a study published in the Journal of Orthopaedic Research in which scientists scanned the knees of 14 women as they walked wearing different types of shoes.

When they examined the angle of the knee as the women’s feet struck the ground they found that the higher the heels, the more likely it was the knees were bent when shoes touched ground—increasing the strain on the knee joint. The wearing of heels of three or more inches made the women’s knees look, to them, more like aged or damaged joints.

“Wearing high heeled shoes has been implicated as a potential contributing factor for the higher lifetime risk of osteoarthritis in women, ” said lead author Matthew Titchenal, Ph.D. candidate of Stanford University’s Biomotion Laboratory. “In this study, many of the changes observed with increasing heel height and weight were similar to those seen with ageing and osteoarthritis progression. This suggests high heel use, especially in combination with additional weight, may contribute to increased risk, ” he said.

According to Sanghani, Jane Tadman at Arthritis Research UK has implicated high heels as a probable risk factor for osteoarthritis of the knee, and back pain. “Wearing high heels shortens the Achilles tendon, causing restriction in ankle movement, and jams the toes into the front of the shoe, which can cramp and deform them” she said.

Sheila Jeffreys, author of Beauty and Misogyny, said that even successful women still feel compelled to wear heels which “‘make walking difficult, distort women’s gait, make it difficult to run or escape danger and cause falls.” She is critical of the promotion of footwear that cripples one half of the population and makes it increasingly difficult for them to walk.

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Discussion

14
DS
Dr. Sarah MitchellOrthopedic Surgeon · Mayo Clinic

This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?

8
JT
James Thornton, MDSpine Fellow · HSS

Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.

5
RP
R. PatelSports Medicine · Stanford

We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.

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