Should you go high or low?
by Anastasia Stephens, Daily Mail (25th March, 2003)
Actress Nicole Kidman famously remarked after her divorce from Tom Cruise, 'At least I can wear high heels again' - demonstrating an addiction to height that is shared by many women. But is such a preference dangerous? Are high heels bad for you and flat shoes beneficial?
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So What Sort of Shoe should you wear?
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FOR high heels...
They tone calf and thigh muscles
Jason Henry, a London-based fitness trainer, says walking in heels alters your centre of gravity, training your legs to produce muscle, especially in the calves and thighs.
'Essentially, in heels, you are doing what amounts to a full day of calf raises, adding definition to the shape of your legs,' he says.
'However, the excessive wearing of heels can permanently shorten your calf muscles. To avoid strain, you shouldn't walk more then two miles at a time in heels, and you should keep heel height to under two inches.'
They improve circulation in the legs
For people who suffer poor circulation and are prone to swollen ankles, a shoe with a slight heel (around 1in) can boost the amount of blood and tissue fluid that is returned from the legs to the upper body.
'Blood and tissue fluid is returned to the heart through veins, which are squeezed and stimulated by surrounding muscle,' explains osteopath Gavin Burt. 'Heeled shoes stimulate this system by tightening leg muscles, so may be good for those with a sluggish circulation.'
They may ease low-back problems
Back specialists argue that modest heels (about 11/2in) can improve alignment of the lower back, reducing the risk of low back pain.
'Some people have a spine that is, literally, too straight,' says independent massage therapist Jan Fielding. 'They lack a natural curve in the low back, causing muscular tension and pain. For these people, wearing heels can restore a healthy curve and so ease tension.'
AGAINST high heels...
They can strain the knees and increase the risk of arthritis
Excessive heel height can damage your knees. In a study published in The Lancet, Harvard researchers linked wearing high heels with a height of around 2.7in to a 24 per cent increase in 'knee strain' - a factor that is closely linked to a raised risk of arthritis.
The results imply that very high heels are best limited to special occasions.
They reduce mental alertness
Heels of more than 2in can significantly increase muscular tension throughout the body, constricting blood vessels and limiting blood supply to muscles and the brain.
'So, if you're standing in high heels for extended periods, this reduces the flow of oxygen and nutrients to the brain, contributing to a feeling of fatigue,' says Gavin Burt.
They can compact the spine
In people who already have a pronounced arch in their low back, regular heel wearing can have a marked effect in compacting the spine.
'This can pinch on nerves and compact vertebrae to cause longterm stiffness,' says Gavin Burt.
He suggests regular 'heel breaks' - wearing flat shoes at least every other day.
They increase the risk of foot problems
High heels can also result in a variety of foot problems, including bunions and metatarsalgia, which is pain in the ball of the foot.
Another condition, called Morton's neuroma, is caused by a thickening of tissue around a nerve between the third and fourth toes, and usually develops in response to the weight burden high heels place on the ball of the foot. It is treated with cortisone injections and, sometimes, surgery
FOR Flatties...
Flat shoes with cushioned soles take strain off the joints, encourage muscular relaxation and even combat psychological stress, according to a recent Finnish study.
Comparing people who wore heels with those who wore flat shoes, in similarly stressed environments, researchers found those wearing flat, comfortable shoes felt significantly more at ease and in control when faced with pressure than their heeled counterparts.
They relieve computer eye-strain
While the stress of high heels on the body can lead to tightening of muscles around the eye, which worsens eye-strain when you use computers, flat shoes have the opposite effect.
Flat shoes exert a reflexological effect up to an hour after walking, by gently stimulating the nerves in the feet. This has been shown to induce muscular relaxation throughout the body, even around the eye.
They cut the risk of sciatica
Flat shoes stretch the lower back and reduce the risk of trapped nerves, especially in those with a marked low-back curve.
'Women who have a significant curve in their low back are at greater risk of problems such as sciatica if they wear heels often,' says osteopath
Gavin Burt. 'For these women, flat shoes can have an important therapeutic effect in stretching out their lower spine.'
AGAINST Flatties...
They can increase physical strain in pregnancy
Flat shoes are not advised during pregnancy. 'Women's skeletal structure changes in pregnancy, and it's a common misconception that pregnant women are better off in flat shoes,' explains Sandra Smith, a midwife based in Eton, Berkshire.
'Instead, they should wear a comfortable heel of around an inch. This puts the spine, muscles and joints in a better position to withstand the extra weight of a developing child.'
They may contribute to stiffness of the hips and pelvis
Women with stiff hips and short quadriceps are doing themselves no favours by wearing flat shoes, says Elaine Campbell, a yoga teacher from Brighton, East Sussex.
'Heels of up to 11/2in are best if you have tight thigh muscles because they give you a gentle stretch with each footstep. Worn regularly, this can loosen the pelvic muscles, reducing tension and increasing flexibility.'
So what sort of shoe should you wear?
Alternating high heels with lower ones enables your physique to adapt and benefit from the plus-points of all heel heights.
According to podiatrist Kate Simpson, totally flat shoes are not the ideal for overall health of the feet or legs: a small heel is better.
'Low heels of half to threequarters of an inch are good for both the front and back of the foot,' she says.
'Small heels not only help reduce tension in tendons and ligaments around the foot, they also help the calf muscles - which are tight in many women - to relax.' Higher heels (11/2in-21/2in) are best worn for limited periods, say around three to eight hours, providing you are having sitting breaks for half that time.
At other times, wear lower heels. You can minimise discomfort by making sure your shoes fit well. Seven out of ten women buy shoes that are too small, so always try the next size up.
For optimal fit, buy shoes in the late afternoon, when feet are at their widest, leaving about quarter of an inch between your longest toe and the end of the shoe when standing.
