The Posture of High-Heels

BBC – “Fine Firms for sexist dress rules, say MPs”

It has led people to wonder what really are the affects of high heels on the body?

Immediate thoughts go to the feet themselves and to the effects of having tight shoes, pressure on the toes from a narrow point, or even blisters from mis-fitting designs. What is important is to realise the bigger impacts that walking on a raised level does to the body as a whole.

The dynamics of the foot

There are three main weight points to the foot. These structurally create a triangle above which lies the main arch of the foot.

The three main structural points of the foot

These are illustrated by John Lodge in the book “Rolfing: Re-establishing the Natural Alignment & Structural Integration of the Human Body for Vitality and Wellbeing” by Dr. Ida P Rolf.

Looking at the ball of the foot, there are two key weight points on the inner and outer side. It is important to rest your weight equally between these two points.

You may find that more weight goes on the outer or inner, depending on your foot dynamics. More weight will be on the outer point if you have a tendency to turn your feet out or vice versa.

The ideal is to have even strength and weight between these two points – this enables a horizontal functional plane of movement when you flex your foot and walk.

Effects on the body

Depending on your body structure, high-heels can lead to lower back pain, shortened hamstrings & neck pain. Here’s why..

  1. Shortening the back-line

Did you know that the back of your body is connected by one sheet of fascia (connective tissue) running from the soles of your feet all the way up to the top of the head.

An easy way to stretch this iYoga forward bends to bend down and touch your toes (whilst keeping straight legs).

If you do this, and then roll the soles of your feet one-by-one on a tennis ball for 3 minutes, when you bend down a second time, you will be able to stretch much further because you have released the plantar fascia at the bottom of the feet, which in turn releases the back of the body.

Walking on a raised height such as a heel, leads to a shortening along this back-line, which includes a shortening of the hamstrings and over-development of the calf muscle gastrocnemius.

Research: “On high heels and short muscles: a multiscale model for sarcomere loss in the gastrocnemius muscle” – Zöllner et al. (2015), Journal of Theoretical Biology.

Structural Geek: Did you know..?
There is a structural connection between the calcaneous (heel bone) and the sit bone (ischial tuberosity). Issues at the heel & Achilles can directly relate to tension dynamics & flexibility around the sit bone.

2. Tilting the pelvis forward

The effect of tilting the pelvis forward can lead to lower back pain around the lower lumbars (L4 & L5) as the natural secondary curve in the spine is accentuated, with the tail bone lifted up.

With this rotation of the pelvis, compression also occurs at the top of the spine in the back of the neck, as there is a compensation effect to balance the structural blocks above.

3. “Toe-foot” vs. “Heel-foot”

There are different styles of walking and running where either the toe or the heel is the first part of the foot to make contact with the ground.

This has been explored heavily by running experts. In “Born to Run” written by Christopher MacDougall he connects “fore-foot” running to the original movement pattern of humans. There has since been further debate, with suggestions that variation occurs relating to individual body patterns, however “fore-foot” running has been clearly linked to lower injury rates.

Similarly when walking in high heels, it is best to bring weight onto the ball of the foot, rather than on the heel, with the ball meeting the ground first. This will bring your body slightly forward & you may feel your calf muscles working more. However it avoids impact coming up through your heel & the 2-beat heel-toe tap to each step.

Alongside these long-term physical effects of wearing high-heels, socially it’s fun to strut out in a beautiful pair of heels sometimes. In balancing these factors, here are some key tips to help support your overall health alongside strutting your stuff.

Key tips:

  • Explore the point of weight through the ball of your foot (When wearing heels, does more of your weight go through the outer or inner point of the ball?)
  • Exercise: discover how stable your feet are.. Standing with barefeet, holding on to something to steady your balance, focus on the two weight bearing points in the ball of your foot and very slowly lift your heels up. Keeping straight legs, and aiming to keep contact evenly between the 2 points, see if there is a rolling out or in as you reach your maximum height. To strengthen you ankles, do 20 slow heel lifts, you may even feel the muscles in the top of your hamstrings and back work accordingly.
  • When wearing high heels, check are you making contact first with the ball of the foot, or a heel-toe pattern?

If you love to wear high heels everyday, here are some things to think about (especially if you have tight hamstrings, experience lower back pain or find it uncomfortable walking with barefeet).

  • Change heel height – this let’s the muscles in the back of your legs, and the back of the body, adjust to different heights.
  • At weekends or down time, have time in flat shoes or bare feet, this helps enable a natural re-lengthening.
  • Go to a yoga class – downward dog and other postures lengthening the back of the body will help strengthen your legs & body as a whole.

In conclusion, high heels have a strong influence on posture and the musculoskeletal system. It is great that recent issues have brought light to re-explore these relationships. High heels if worn long-term can lead to structural and health issues. However, when worn short-term and with footwear variation, they can be an alternative doorway into becoming aware of your own body patterns, listening to when you need to stretch out and finding ways of strengthening and supporting your body, to adapt to short-term variations.

Additional reads:

BBCiWonder -“How can I stop high heels damaging my body”

The Guardian: “Heel striking – is it really the enemy of good running form?” by Sam Murphy


Rolfing: Re-establishing the Natural Alignment & Structural Integration of the Human Body for Vitality and Wellbeing – by Dr. Ida P Rolf

Anatomy Trains – by Tom Myers