Why My Stilt-Walking Circus Days are Now Over!


The stilts being referred to in the title are really Stilettos, shoes that are also known as the pointy knife with slender blade which ladies like myself are known to balance upon for the sake of fashion, managing to look glamorous in the process. This is a difficult technique (for guys that have never tried it) but we manage to oblige the “high life”, in spite of what it does to our bodies, more specifically, to the back and spine.

Most of the time we look more like circus acts than drop-dead seductive – tightrope walking and flying through the air with the greatest of ease takes lots of practice and painful artistry – which is why I have to say, it’s time to come back down to earth. This is what I did after a meeting with a physical therapist.

Besides the obvious crunched-up toes and soles turned into leather from the jackhammering impact of stilettos on our tootsies, the delicate nature of our spines are also greatly impacted, causing anatomical changes in our bodies. When walking in sky-highs, hips and spine are thrown out of alignment, the center mass of our bodies are launched off-balance, our strides become more forceful and shorter and the heel-to-ball-to-toe step-sequence of our feet radically changes…and not for the better!

Below are a few maladies which may affect women who regularly wear stilettos.
Spondylolisthesis is a lower back condition in which a vertebra slides out of its proper position to over the bone below it, “especially in the lumbar region of the spine where the bodies’ weight is concentrated.” Exercises which strengthen lower back muscles can repair this damage but symptoms may only appear as stiffness or as a bit of muscle tightness. According to The Spine Health Institute, this disorder frequently occurs due to stress on the lower back and can cause swayback and numbness or weakness in the legs.

If the scare of Spondylolisthesis doesn’t make you feel like you are trembling on a tightrope, those high ankle booties could also be the cause of a curvature of the spine. “The spine must be well-balanced to work properly,” mentions NYDNRehab.com. Wearing spikes changes your stance, pushing your lower back forward and moving the hips and spine out of alignment. Our spinal discs are like shock absorbers and, when we walk, our back takes the hit.

An imbalanced spine puts pressure on the nerves and can even lead to problems such as Sciatica, a well-known and debilitating condition affecting the sciatic nerve, a large nerve extending from the lower back down the rear of each leg. “Wearing high heels requires you to shift your body weight to adjust according to the tilting of the foot,” mentions MostInside.com. “The arching of back and pelvis puts pressure on lower back muscles” with chronic pain and numbness which means sciatica would be a daily occurrence.

Death by shoe-icide? It looks like our stilts are slowing killing us or, at the very least, immobilizing us!
“Glamour isn’t pretty and fashion hurts,” mentioned a friend of mine while on the topic of stilettos. But are we going too far in our search for height and haute couture?

“High heels throw off your alignment. They change the center of gravity, causing extra stress and strain on the lower back, so you’re not walking in a natural position,” states Dr. John M. Giurini, Chief of the Division of Podiatry at Beth Israel Deaconess Medical Center, in his article, “Are Your Shoes Causing Your Back Pain?”

So, do you opt for attention-getting confidence, a slimmer-looking physique and killer heels or back pain, possible spinal disorders and breaks and pain galore for the sake of beauty? My first choice is stilettos but the right choice is comfort.


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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