Don’t blame Jimmy Choo

As a personal trainer, I’ve noticed that many of my female clients often complain about lower back and knee pain. While there are obvious anatomical factors—such as wider hips, which can cause the femur to angle inward, placing additional stress on the knees—I’ve found that other lifestyle factors may also be contributing to these discomforts. One of the most common culprits? High heels.

A recent study by Danielle Barkema, a Kinesiology graduate from Iowa State University, sheds light on how wearing high heels, especially over time, can exacerbate knee problems. The study explored how different heel heights impact knee health, particularly regarding knee osteoarthritis and joint degeneration. This is the NIH study.

The study followed 15 women who wore high heels at least twice a week. These participants wore shoes with different heel heights—flat shoes, 2-inch heels, and 3.5-inch heels. Barkema measured the forces on the knee joint and the shock that travels up the leg during the walking cycle using advanced tools like cameras, sensors, accelerometers, and a force platform.

The findings were clear: as heel height increases, the compression on the medial (inside) part of the knee also increases. In fact, wearing heels greater than 2 inches, even just a couple of days a week, can contribute significantly to the degeneration of the knee joint over time, potentially leading to conditions like osteoarthritis.

But the impact doesn’t stop at the knees. Wearing heels, especially those over 2 inches, alters your walking pattern. This can shift the position of your ankles, knees, hips, and even your trunk, putting strain on your lower back and potentially leading to back pain as well.

So how do you counter act the damage done by high heels?

If you’re dealing with knee or back pain, it’s important to consult with a healthcare professional such as a doctor or physical therapist. In the meantime, considering a change in footwear or incorporating exercises to strengthen the muscles around your ankles, knees and hips which will help alleviate some of the discomfort. A comprehensive fitness plan that includes functional movements and mobility work can go a long way in supporting joint health and reducing pain. An experienced personal trainer that specializes in “corrective exercise” may be a good start.

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