In Canada today, there is widespread awareness about foot hazards in factories and construction sites. Employers in these, and other, hazardous workplaces typically have strict rules requiring employees to wear protective footwear. Interestingly, there is very low awareness of the use of high heels in workplaces. This may sound ridiculous but I am quite serious. High heels are a major cause of short and long term foot injury in workplaces across Canada.  
Sleek and fashionable, high heels are the footwear of choice for many teachers, retail associates, businesswomen and other workers who want to look professional and stylish. However, high heels are usually narrow, often tapered and always shift the wearer’s weight unnaturally forward. As a result high heels can cause a variety of painful foot conditions, including:

  • Bunions
  • Corns
  • Plantar fasciitis
  • Nerve impingement
  • Overuse injuries
  • Metatarsalgia

High heels force your weight forward onto the ball of your foot, making it impossible to heel strike properly. They shift you onto a part of your foot not meant to bear your full weight for prolonged periods of time. The height of the heel shortens the calf muscle causing you to use other muscles and compensate at the knee, hip, pelvis and lower back, to stop you from falling forward. Prolonged high heel use puts you at a higher risk of injury even when you’re not wearing heels.
Although I suggest cutting out high heel use all together, I know this isn’t an option for most heel wearing patients. In this case I always remind my patients the higher the heel the more compensation the body has to make. More importantly, I teach them safe high heel use. Here are some tips I give my patients on how to balance their love of heels and protecting their feet.

  • Be selective – If you have a day of standing or extensive walking planned, leave your high heels at home.
  • Commute in comfort – Wear comfortable, well-fitting shoes to and from work and save your heels for the office. If you go out for a walk at lunch switch out of your heels.
  • Give your feet a break – When you are sitting at your desk kick your heels off and stretch out your feet.
  • Choose short and wide – Keep the heel height low (less than 2.5 cm/1 inch) and always select heels that have a wide base to increase the stability.
  • Make sure they fit – Only wear heels that fit perfectly. An improper fit may cause more pressure on your foot and lead to any of the foot complications listed above.

When it comes to high heels, I recommend my patients follow the 80:20 rule. Wear comfortable, well-fitting, supportive shoes 80 per cent of the time and your favourite heels 20 per cent of the time. This allows you to enjoy the sleek look of heels without hurting your feet.
By Amy Chapman, C. Ped (C), Kingston, Ontario