Stilettos Can Be a Real Trip!

Stilettos Can Be a Real Trip! Blog  Gait Analysis

Recently, I spotted a girlfriend I hang out with sometimes at clubs, Maryanne, hobbling across 59th Street and 2nd Avenue crutches-in-hand and with left foot strapped into a big black wrapped shoe-like splint. My first response was to call out to her but, during rush hour, the likelihood of hearing the shout-out seemed impossible; I easily caught up to her as she struggled to juggle briefcase and Zaro’s bakery bag. Here is an excerpt from our conversation; her name has been changed and some of the conversation details have been paraphrased for content.

Me: M, you haven’t been to the Club in weeks. What happened to you?

Maryanne: As you can see, I took a tumble. I was on my way to the Club several weeks ago, dressed to kill in my sequined mini and stilettos, you know, the pretty pink-and-black polka dot ones with the six-inch heels? I guess I was walking pretty fast but caught a look at myself in a store window, and boom, I hit the pavement!
Caught my heel on the sidewalk, took a tumble . Lying on the ground, I thought I could move but, the next thing I knew, EMT’s were hoisting me onto a gurney…my foot was aching and swollen… and so was my spirit…! Imagine, no dancing for weeks and those gorgeous sky-highs are history too, broken at the heel!

Me: I’m so sorry to hear it. How are you feeling?

Maryanne: Well, in addition to weeks of incessant scratching inside of the cast and being relatively immobile, I started rehabilitation for other problems that I found were all related to the years I have been walking in high heels.

Me: What types of problems?

Maryanne: My back was constantly in pain and my knees and feet were killing me…it was turning chronic! I was always looking for a seat at the Club and thought it was just because I was overexerting myself but I was only half right. Unfortunately, it took a spill on concrete to investigate why I was having these problems.
A gait analysis was done to measure physical limitations. The assessment showed me that I wasn’t walking properly and my posture was bad due to the height of my heels. You know how you feel like a supermodel in those spikes so you strut like you’re walking down a catwalk? Well, the back and spine arch to compensate, your pelvis and chest are thrust forward and you stick out your buttocks. Totally incorrect posture! The body should be at a ninety-degree angle to the ground. Also, the normal gait of a person walking in conventional shoes should be a gradual heel-to-toe movement but, when wearing stilettos, ninety percent of weight is centered on the ball of the foot. There really is physics behind the body movement!

Several studies were also done on how knees and joints are affected over time by wearing six-inchers and the prognosis wasn’t pretty. For example, did you know that “prolonged wearing of and walking in heels can contribute to joint degeneration and knee osteoarthritis?”

The body is one amazing machine! Ever hear that song, Dem Bones? The knee bones connected to the thigh bone…” Well, it’s so true and, when one part of your body is out of whack, the rest suffers.

The conversation continued for several more minutes before we parted ways but I couldn’t help but wonder about the permanent damage high heels can do to the body. Many women wear stilettos (the higher the better), opting for Manolos over Comfort Strides but, with the risk of irreparable damage done over time, are the enduring balance issues, walking sensations, pain and degeneration of the body for the aesthetics and stature really worth it? Stilettos always hurt my feet but I can’t live without them…or maybe I can…?

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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)

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Complete tear of rectus femoris
with large hematoma (blood)

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

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