The stiletto high heel shoe has been a very popular shoe style for generations of women. The popularity of high heeled shoes above 2 to 3 inches has not diminished with each new female generation. Furthermore, some women state once you get use to high heels they are comfortable. It is quite amusing to hear mothers warning their young daughters not to wear high heels.
My older female patients with foot problems complain they were foolish to wear high heels but at the time they couldn’t resist wearing high heels because they looked better wearing their high heels.
I recommend that regular high heel wearers to start using lower heeled shoes or flats. Unfortunately this can lead to new complaints such as “it hurts the back of my heel” or “my calf muscles get sore”. The mechanical explanation for this pain is that the calf muscle shortens to adapt to the regular use of high heels.
In the July 17, 2010 issue of the Economist magazine there was an article on “Stiletto Stiffness”. The article reviewed the research conducted by Dr Marco Narici. He was able to recruit 80 females that regularly used 2 inch high heels 5 times a week for 2 years. From this group he picked 11 females who complained of pain while walking without heels. This group of 11 high heel wears was compared to a control group of 9 females who never used high heels.
Dr Narici expected the regular high wearing group to have a smaller calf muscle volumes as well a shorter calf muscles. He thought the high heel wearer’s calf muscles would not produce as much muscle force compared to the control group. Dr Narici found that the calf muscles fibres were 13% shorter in the high heel group compared to the control group. However, what surprised Dr Narici were the calf muscle volumes and calf muscle forces were similar between both groups. The difference was the high heel group had thicker Achilles tendons as compared to control group. A thicker and stiffer Achilles tendon makes up for a shorter calf muscle therefore producing similar muscle force as compared the control group. These results explain the discomfort in the back of the heel and calf muscle that regular high heel wears will experience when they are not wearing their high heels.
Sadly, I don't think this new information on the heel and calf pain caused by the regular use of heels will stop young women from wearing high heels. I suppose, I will hear the next generation of women tell their daughters not to wear high heels.