High heels dilemma - beauty or comfort?

It's officially wedding season, and women across the country are sorting out their outfits and footwear for the parties to come. Last week I was standing in a shop trying to choose the correct shoes for my own wedding in September. Immediately I was drawn to the beautiful pair of satin 5 inch heels (which looked fabulous on and made me a grand height of 5'9). They were stunning! But how was I going to manage, let alone enjoy my wedding day, with my feet cramped into such beautiful torture devices? My brain battled with the dilemma. Beauty verses comfort. And after an agonising internal debate, on this rare occasion comfort won.

Research has suggested that up to one third of women suffer permanent problems as a result of wearing these kinds of heels (heels greater than 2 inches in height). Conditions associated with high heels include, Bunions and Hammertoes (where the toes become misshapen from being squashed in the front of the shoe). Women account for about 90% of the corrective surgery for these conditions. Also very common is Metatarsalgia (pain in the front of the foot) and Morton's Neuroma (painful thickening of nerve tissue between the toes). To give you an idea of the change in pressure, a three-inch heel exerts about 76% more pressure through the ball of a foot compared to a flat shoe.

Moving up the chain, high heels cause shortening and tightening of the Achilles. This can cause Achilles tendinitis/tendinopathy. In addition to thism knee pain, stiffness and injury can be triggered by the change of pressure when wearing high heels.

In Australia, news reports claim that injuries associated with wearing high heels now outnumber those that Australian women are sustaining on the sports field. Ankle sprains and fractures associated with a night out in killer heels are certainly not uncommon at the Central Health Physiotherapy clinics. Not to mention the fractured elbows/knees that have occurred due to falling in heels - usually onto concrete... Ouch. Injuries like these can require surgery and months of rehabilitation to recover.

Lastly, there is the back pain associated with high heels. When the heel is raised high it forces your centre of gravity forwards. So as not to topple forwards, we compensate by leaning back. This puts pressure on the lower back and can result in pain and sciatica (a painful condition characterised by pain, tingling and / or numbness in the back of the leg.)

So what can we do about it? Firstly, be strong when you are in the shop. Without looking down at your feet, or into the mirror, ask yourself are they really comfortable? Will you be that woman with your shoes kicked off before the waiters have even started serving the canapés? Next, try and steer yourself to the thicker heels. This way it will spread the pressure more evenly across your foot and help you to feel more balanced. Purchase soft sole insoles to add a little shock absorbency and to take the pressure off the ball of the foot. Also, consider if they are a good fit - you don't want to feel your foot sliding forwards in the shoe as this will cramp your toes. Once you have them at home, wear them for an evening in. How does it feel to have them on for a little bit longer in preparation for your 10 hour stint in them? On the day, consider taking a second pair of shoes. Even a slight change in heel height and style can have an enormous effect on comfort.

Good luck, killer heels look amazing - there is no question about that! But don't let it drain your energy on an otherwise happy day. Or worst still, leave you with a permanent injury.

Harriet Whines, Physiotherapist, Central Health Physiotherapy