How High Heels Cause Foot Pain, and Ways to Relieve It

Updated on May 28, 2020
Patty Poet Lajoie profile image

Patty is a licensed physical therapist assistant. Physical therapy helps patients recover from joint pain caused by orthopedic injuries.

Do You Walk On Your Tip-Toes?

You might not think about it that way, but when you put on those heels, that is exactly how you are walking.

Why Wear High Heels?

Centuries ago, Persian men wore a high heel on their shoes so that their feet fit better into stirrups when riding horseback. In the 1700s, women started wearing high-heeled shoes because they made their feet appear smaller. Hidden under a long skirt, with the heels raised, the only part of the foot that was noticeable was the toes, giving the illusion of smaller feet.

A lifted shoe also gives the illusion of increased height. Even if it is only an inch or two, the wearer appears taller to everyone around them—a trait that is often associated with elegance, power, and a greater sense of confidence. If not for these reasons, the wearer may choose to don a heel to give their legs a more toned, elongated appearance. But whatever the reason for wearing them, walking around on your tip-toes changes the body's biomechanics, putting you at greater risk of injury and development of chronic pain conditions.

Click thumbnail to view full-size
The higher the heel, the greater the risk of injury and/or pain.
The higher the heel, the greater the risk of injury and/or pain.
The higher the heel, the greater the risk of injury and/or pain.

A stand-out memory of my early years as a physical therapy assistant was of an 80-year-old woman who had recently experienced a fall and had been admitted to the hospital where I worked.

The woman arrived one afternoon in the Physical Therapy department in a wheelchair wearing a hospital gown and high heels. I studied the shoes for a moment before grabbing a walker from the corner of the room and placed it in front of her. I locked the brakes on her wheelchair and removed her heels and helped her into a pair of hospital-issued, non-skid blue socks.

She stood up directly on her tip-toes. And although I asked her to try to place both feet flat on the floor, she couldn't do it no matter how hard she tried. In fact, when she tried to lower her heels as I asked, she lost her balance and started to fall backwards. By wearing only high-heeled shoes most of her life, the muscles in the back of her legs had shortened so that she couldn't keep her balance when she tried to stand flat-footed. Now, the only way for her to walk "normal" was on the balls of her feet—in a pair of heels.

Walking around on your tip toes changes bio mechanics that puts you at risk for injury, long term pain and discomfort.

How High Heels Change Your Posture and Movement

Whether you choose a two-inch platform heel or a five-inch stiletto, the inevitable effect is that you force your feet into increased plantar flexion (toes pointed away from the body). Your weight is distributed mainly to the balls of your feet rather than across the entire foot. But the change isn't isolated to just the feet; it continues through the ankles, to the knees, hips, and spine, changing your posture and the way you walk.

This altered posture may be visually appealing to some. It makes the body look curvier. It flexes the calf muscles, making the legs look more toned/athletic, and it forces the low back into extension, pushing the buttocks back and the chest forward.

Your body is trying to stay balanced! With a tight butt, and increased spinal curve, your chest is now thrust forward as your body tries desperately to reinvent a posture that will keep you balanced as you totter around on the tips of your toes. Depending on how used to high heels you are, you may experience discomfort even after a couple of hours. Over time, with more frequent use, you may develop mechanical faults like the one seen in the 80-year-old woman that came to my clinic.

Injuries That Can Result From Frequent Use of High Heels

Bio-mechanical Cause of the Pain
Plantar fasciitis
Inflammation of the plantar fascia
Excessive strain on the balls of the feet
Shin splints
Inflammation of the tibialis anterior
Body weight and legs tilt forward, putting extra pressure on the front of the legs
Knee pain
Sheer force on the knees
Quadriceps muscles are always engaged trying to hold the knee straight
Hip pain
Muscle spasms and cramping
Normal hip rotation during walking is absent as the hips work harder to maintain balance instead
Low back pain
Puts extra pressure on the vertebral discs in lumbar spine
Body weight is pushed forward making the body compensate by arching the lower back
Wearing high heels puts your body in an abnormal position, thereby forcing the body to compensate while standing and walking. Even in a brief period of time, these compensations can lead to discomfort, pain, and poor movement patterns.

How to Relieve and Prevent Foot Pain

You may not be ready yet to shelf your favorite heels, and I am not here to tell you that you need to. What I do suggest is that you alternate between your heels and other footwear. Maybe vary the heel heights you wear and opt for sneakers/flats more often than high heels.

You can also perform stretches that will help prevent the muscles in the back of your legs from staying tight and shortened. Below, you'll see pictures and instructions on how to do the stretches. The knee position during the stretch determines which muscles are affected, so you should do both stretches! Hold for at least 30 seconds. Do a set of three of each stretch on both legs.

Stretches to Prevent Shortened Calf Muscles

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Soleus stretch. Bend the knee and pull back on the towel until you feel a pull in the back of your leg, just above the heel. Keep the knee straight to stretch the gastrocnemius muscle. Pull the towel back until you feel a stretch all along your calf.
Soleus stretch. Bend the knee and pull back on the towel until you feel a pull in the back of your leg, just above the heel.
Soleus stretch. Bend the knee and pull back on the towel until you feel a pull in the back of your leg, just above the heel.
Keep the knee straight to stretch the gastrocnemius muscle. Pull the towel back until you feel a stretch all along your calf.
Keep the knee straight to stretch the gastrocnemius muscle. Pull the towel back until you feel a stretch all along your calf.

Stretches and Exercises for Calf Pain

Plantar Fasciitis Stretch and Massage Techniques

If your legs ache at the end of the day, or if your feet hurt in high heels, you are probably wearing this type of shoe too much. Wear them less and wear your flat shoes more. Take your sneakers to work and wear them at lunch time. Kick off your heels every chance you get. Stretch every day to promote good biomechanics and prevent pain and risk of injury. You will be so glad you did!

When do you wear high heels?

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This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2020 Patty Poet


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