Monday, April 23, 2018

Moderation necessary to avoid negative effects of high heels


CLARKSBURG — Warmer weather provides a great opportunity for dressing up, and for many women that includes slipping on a pair of high heels to complete the look. It also means millions of teenage girls are sliding into stilettos for prom.

Although occasional wearing high heels will likely only lead to lingering health problems in the event of a fall, consistently sporting the footwear can affect the feet, knees, hips and back, according to local health-care professionals.

"It affects the biomechanical walking pattern, the gait pattern, of the entire lower extremity," said Justin Brewer, a physician's assistant at the United Orthopaedic and Spine Center in Bridgeport.

The change in walking pattern can place stress on the inside of the knee joint, potentially causing arthritis over time, he said.

The likelihood for developing knee arthritis increases in by 20 percent in those who are overweight, Brewer said.

Others can be genetically predisposed to knee problems and knee arthritis. The risk also increases as the heel height increases, he said.

Studies have also indicated biomechanical stress on the hips and lower back, he said.

According to Clarksburg podiatrist Dr. Keith Newman, his two concerns for those who wear heels 2 inches or higher would be the effects from the increased load on the forefoot and the potential for adaptation of the Achilles tendon.

The Achilles tendon may shorten in individuals who wear heels as it adapts to the shortened position from the higher heeled shoe, he said.

"Some people will adapt over years or decades of use, and then they may not be able to wear flat shoes effectively anymore without pain," Newman said.

For those who want to minimize risk of developing complications from high heels, Brewer recommends limiting use.

"Everything in medicine and everything in life is moderation," he said.

Brewer said the people at his practice who seem to be most likely to have issues from wearing heels are those who are overweight or wear the shoes six to eight hours a day.

Those who are already experiencing pain from wearing heels should discontinue wearing them, he said.

Switching to low-impact exercises like biking, swimming or an elliptical machine will help keep reduce stress on the joints, he said.

"Losing weight, of course, will also help take the stress off the knee," he said.

Those who choose to wear the heels anyway should look for shoes with cushion for the metatarsal bones that connect to the toes.

Newman also recommended moderating the amount of time spent in high heels, but acknowledged that there are people who will wear the shoes regardless of the potential impacts on the body.

Those people "will want to make sure (the shoe is) well-cushioned, because you're pressing your luck over a number of years," he said.

Cushions can also be purchased separately that can be worn on the foot or placed into the shoe.

To help prevent shortening of the Achilles tendon, which connects the calf muscles to the heel bone, Newman recommended a calf stretching regimen. His favorite is a straight-leg calf stretch in which the individual lunges forward toward a wall while keeping the back leg straight with the heel flat on the floor.

He actually recommends these stretches for anyone. "I do them myself. I'm a strong believer," he said.

Of course, those experiencing pain can see their healthcare provider.

"We'll evaluate the patient, get an X-ray, see if they're starting to develop knee arthritis and see what kind of damage has been done to the knee joint," he said.