I Love High Heels but They Don’t Love Me!

stilettos and low back pain

Does your heart go aflutter when passing a shoe store with stilettos in the window? Are you the one in your group who is known as the “fashionista”, pairing pumps (the higher the better) with everything from skirts to shorts? If you are like Lita Ford, who looks at stilettos more as an attitude than as a high-heeled shoe, think again.

What I am about to tell you will be painful right down to your soles but will save you a lot of wear-and-tear on your stride and spine.

Your choice in shoes is destroying your body!

If you teeter down the street with the hope that beauty overcomes all, think again before donning your next pair of six-inch platforms. Chances are, not only do you have to squeeze your toes into them but they probably also hurt like hell and cause you to walk differently than if your tootsies felt the comfort of a pair of form-fitting loafers.

That being said, most women who wear stilettos will not care much about what happens to their bodies until the unavoidable happens– they either take a tumble or, over time, the inevitable occurs; leg and lower back pain becomes unbearable. Yes, it’s going to happen ladies, and it’s not a pretty sight.

According to ScienceDirect.com, a survey of over two-hundred women who regularly wore high-heels complained of lower back and leg pain. Biomechanical effects of the study of three heel heights further revealed that, “as heel heights increased, the trunk flexion angle decreased significantly. Similarly, tibialis anterior EMG, low back EMG and the vertical movement of the body center of mass increased significantly while walking with high-heeled shoes.”

What does this mean to the young executive as she is hurrying for the number two train at rush hour? In layman’s terms, the higher the heel, the more problems arise all over the body, from trunk to toes.

Osteopathic.org further notes that a shortening of the Achilles tendon which can lead to plantar fasciitis occurs for many women who don stilettos because, “once the heel is pointed upwards, it tightens up.”

Your basic gait, or stride, is probably affected first…and unnoticed by the stiletto-wearer. According to podiatrist Michael Liebow who took an x-ray of a foot taxed by the effect of wearing six-inch heels to work and home, he said that humans are not meant to walk this way! We should be walking at a “90-degree angle to the foot and the ankle joint employing a 60-degree range of motion during normal daily activities.”

Liebow further revealed, “you’re altering the position of the foot and how the foot is to function. Therefore, lots of bad things happen.”

So, now that some of the harm done to the body, gait and spine with every pavement-pounding stiletto step has been revealed, should you give up stilettos or continue to do the “stiletto duck walk”, accepting pain as the price for beauty?

The answer is obvious but, if you feel the need to parade around in those Manolo Blahnik sandals, at least consider these three tips to lessen future chronic pain:

1. Stretch your legs and exercise your hip flexors as these areas get the most work out from high heels.

2. No slumping, says former shoe designer Victor Chu. “Standing up straight, as if you were pulling a string from the top of your head” and “keeping your abdominal muscles taut by sucking your bellybutton in toward your spine” will help you walk heel to toe.

3. Make sure you choose shoes that are the correct size, wear soft insoles and try to wear your stilettos when you know you won’t be doing too much walking, writes Osteopathic.or.
Your feet are your support and they get you where you need to be on a daily basis. When they hurt, so do you. Be sensible with your choice of shoes – your body will thank you in the long run!


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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