Risky Business: Common Pitfalls of High Heel Shoes #HeelFree

“I cannot tell you how bad your feet will get in the future if you don’t bother helping yourself now, and if you’re already in pain and decide not to do anything about it, I guarantee things will only get worse with time. This is not to scare you, but to emphasize how important your feet are and teach you to look at your feet in a different way than you may have before.”

Dr. Sara Johnson, chiropractic physician

Dr. Johnson’s message summarizes much of what I’ve been pondering since my #HeelFree campaign began: the importance of foot care and how seldom we, as a culture, tend to consider it.

The average woman in the U.S. spends around $25,000 on shoes in her lifetime. If she gets bimonthly pedicures, she’ll spend about $1,345 per year on prettying up her toes. Time and money invested in protecting her feet from damage? Not shockingly, I couldn’t find a study on that. I’m guessing very little. Chance she’ll suffer to some degree as a result? Pretty darn high.

Why all of this is the case became pretty obvious as I delved into my personal history and the history of heels overall. In short, we’re all taught that high heels are sexy, attractive and practically essential in certain situations. As a result, we tend to feel more confident wearing them.

Here’s a little secret: Our legs don’t need to be elongated, clenched or upheld at a particular angle to be beautiful and perfect as they are. No “buts” about it. 

No one seems to say that, so I’m not going to stop saying it. (You should’ve seen the clerk’s face at the grocery store just now…)

As I’ve mentioned, my goal is not to shun anyone who wears or makes high heels, but to encourage more women to think about these factors. With knowledge, we can make our own informed decisions. Part of that knowledge is understanding the risks.


Common Risks of High Heels (2″ or higher)

♦ Your feet contain 25% of your bones. (WOAH, right?) Stress or misalignment of any of these bones or the surrounding tendons, ligaments or muscles can affect the rest of your body.

♦ So it’s no wonder that high heels are the leading cause of foot pain and injury in women.

♦ Because heels change the way you walk, placing added strain on various bones, they commonly cause knee, back and hip pain as well. They may also up your risk for osteoarthritis of the knee—a type more common in women than men.

♦ Over time, high heels can shorten the muscles in your back and calves, causing more pain plus, potentially, stiffness and muscle spasms.

♦ Frequent wearing can shorten your Achilles tendon, which could contribute to tendinitis, shin splints and plantar fasciitis.

♦ Along with pain comes inflammation, the root cause of many diseases. High heels can also make pain and inflammation from other causes throughout your body worse.

♦ Pain and inflammation tend to have emotional consequences, too, so heels can cause heightened stress, anxiety, depressive moods and mental fatigue.

♦ Pressure from high heels on the nerves in your feet can trigger numbness and pain in your toes.

♦ High heel-wearing negatively affects your walk even when you remove them and go barefoot, shows research. This is because of heels shorten leg muscle fibers, increasing strain on your calves.

♦ Up to one-third of high heel wearers suffer permanent residual problems.

♦ Two such problems are bunions and hammertoes, especially if you wear particularly tall or pointy heels or if either condition runs in your family.

♦ One-third of women who wear high heels at least three times per week have reportedly fallen while wearing them—complications of which are on the rise. High heel-related injuries, including broken bones, doubled between 2002 and 2012.


Image credit: The Washington Post

And yet, almost no one suggests not wearing them.

I find it interesting that virtually no articles on high heel risks suggest giving them up as a viable way to prevent or minimize these problems. Most simply suggest cutting back on how often you wear them and lowering the height—I’m guessing because they realize that for many women, giving them up is simply not perceivable. Or maybe my friend Scott was right: they’re concerned about losing profit. (Heels bring them loads of business.)

No one should tell us what to wear, of course, but shouldn’t they at least mention that bypassing heels is not only an option, but the surest way to prevent high heel side effects? Otherwise, it’s a bit like saying, “It’s okay to wear pants so tight you can barely breathe, just don’t wear them daily” for less abdominal angst, or, “Look both ways when you cross the street, most of the time,” for lower risks of falling or getting hit by a car.

Trust me, I’m glad there’s plenty of information out there for high heel fans to wear them more safely. I just wish women were encouraged to consider comfortable, health-promoting shoes without any sense that doing so might end their world, style- or confidence- wise.

Many women who switch to lower shoes do so because they’ve already experienced problems or can’t wear heels for health reasons. Huge kudos for that. Many women keep on wearing heels anyway. But there’s also this little thing called prevention. I’m a fan.

We really can feel confident without heels. It may take effort for some of us (it has for me), but it’s worthy. There’s serious strength in feeling strong and authentic as we are, no shape/height/weight altering devices required. As a bonus, the less we rely on high heels, the lower our risks become for crippling our feet and bodies over time.

To learn more about high heel risks, click the hyperlinks throughout this post.

More related links:

Standing with Confidence: Body Image, Height and High Heels – a post I wrote for the National Eating Disorders Association

Why I Won’t Wear High Heels Ever Again, via XOXO Jane

Science Weighs in on High Heels, via the New York Times

How to Cultivate “Belly Out” Self-Confidence, on Girl Boner® Radio

Were you aware of these risks? Which have you experienced? If you wear heels, what do you love about them? What are your favorite flats? I love hearing from you! ♥

PS Check out my new #HeelFree Pinterest board for resources and links to gorgeous, comfy heel alternatives. 🙂

Leave a comment


  1. Reblogged this on My Blog and commented:
    Heels are not always HO….but hazardous.

  2. Excellent post, August! I worked in retail and specifically in the shoe industry for about 7 years, and remember time after time women contorting their beautiful feet into high heels with not only too high of a heel, but too small of a toe box, as well as the instep cut too low, so basically the shoe had no support to the foot and the entirety of weight when walking fell on the big toe joint, where eventually bunions, neuromas, and arthritis could develop. Probably 80% of shoe returns I saw that involved a high heel were because they ‘hurt too much’ after being worn.
    Personally, I have endured a lot with my feet. Working on my feet for long hours in several jobs over the decades, I wore supportive shoes and still had issues, so I can’t imagine what long term high heel wear would feel like. In March I finished a year of treatment and physical therapy for severe plantar fasciitis and achilles tendonitis. For much of that time, I couldn’t go for a walk or drive for more than 5 minutes. Ladies, take care of your feet, especially if you are younger. There are lots of cute shoes to choose from that won’t destroy your foot and your posture. If not, you won’t get a choice on what shoe styles to wear later in life, and one of the worst pains I have ever felt are 6-inch needles shooting steroids into the bottom of my foot.
    Keep up the #HeelFree campaign, August. 🙂

    P.S. I love Vionic brand shoes, sandals, dress flats, and athletics. Comfy, accomodate my orthotics I am now required to wear, and still cute! Also recommended by Dr. Andrew Weil Foundation, and my podiatrist. 😉

    • Wow, Kristin – what powerful and important thoughts! I’m so sorry to hear you’ve endured so much pain. I hear plantar fasciitis is particularly painful.

      You’re so right about the plentiful alternatives, if we’re willing to dig a bit deeper – including inside ourselves, to broaden our definition of beauty. Thanks for the recommendation! I’m off to check Vionics out. 🙂

  3. This is a great post, August. Not only informative, but also written in the name of many, many thousands of female feet and backs.
    There was a time when I was younger I wouldn’t wear anything else than high heels. But now I’m older and I learned to feel comfy and pain free might be better than ruining my body. (even though I have to admit: being in high heels nowadays still feels hot and sexy… )

    • So glad to hear you’ve made healthy changes, Aurora! I can relate to that sense that high heels = sexy, though this campaign is making a difference already. 🙂 There’s so much pressure on us all, men included, to deem them attractive and preferable.

  4. Daphne Shadows

     /  June 22, 2015

    I love this. I am now thinking about the 3 pairs of high heels I have. I don’t wear high heels very often at all and the heels I do have are low. Thanks for the information! Its so sad how much our society is based upon profit and not health.

    • Good for you, Daphne! It doesn’t take always take much for heels to cause damage — and the negative effects often show up later, then worsen over time. I agree about those societal messages and priorities – very sad. Wellness is invaluable.

  5. “Look both ways when you cross the street, most of the time.” Love that line. This series has really been eye opening to me–I think I thought I knew the health risks…I didn’t. But I find myself making intentional choices now with my shoes–comfort is so much more important!

  6. Another factor you might want to investigate, August – reflexologists tell us that every part of your body can be manipulated and treated by massaging some area of your feet. Don’t know whether that would have anything to do with the dangers of high heels or not. Keep preaching this message. Maybe you’ll save some young women some problems as they get older.

    BTW, I have bi-monthly pedicures but only spend around $160 a year on them. Don’t know where they’re spending the other $1200 a year.

  7. karenmcfarland

     /  June 26, 2015

    Don’t I wish I could afford bimonthly pedi’s! That would be wonderful. A dream. Love that foot rub! And I might add, I’m totally into reflexology. I think David makes a good point. All our nerve endings meet at the feet. Thus, certain stimulation will encourage healing. I mention this for those heel wearers whose feet may need the attention. It will, besides the chiropractor, give them much relief. To answer your question August, yes, I did know about the perils of heel wearing. Though I love wearing them, I never have made it a custom to wear them all day. Couldn’t imagine dealing with the pain and agony. Bare foot is my mainstay. That’s just a SoCal girl’s perspective. Yet, keep preaching the message dear friend. There are a lot of women who haven’t a clue. Thanks and many hugs to you! 🙂

  8. I wish you all would feel confident without heels. I don’t care for them at all. Give me good ol flats to look at, or tennis shoes even. It’s the legs themselves that are beautiful. I don’t need them elongated or at an angle – just beautiful legs that go from here to there. Now, might I add that I think women’s feet are beautiful, too, just as they are. Some easy self-care and washing perhaps, but legs and feet should be bare – they are already beautiful. Why I ask myself am I not married? 🙂

  9. Hi August! I was delighted to read a version of this article on HuffPo. When the Cannes incident happened, there was a flurry of articles in response, including mine (shameless plug: http://www.shoefitnerd.com/feet/flat-shaming/ ), but then the conversation seemed to have died down. I’m glad you keep it going and I look forward to reading your blog!

  1. 5 Ways to Choose the Best Shoes for Your Feet #HeelFree | August McLaughlin's Blog
  2. Common Risks of High Heels | Larra Smithh's Advice
  3. High heels challenged – Part 2 | Consulting Footpain

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