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Wearing high heels has its risks.

Published: July 15, 2010

by Meagen Voss

High heels may make your legs look longer and sexier, but now we know more about why wearing the fashionable shoes regularly can make standing barefooted painful.

A British study has found that women who wore high heels daily for years had shorter calf muscles and stiffer, thicker Achilles tendons than women who favored flats. And those bulkier tendons are harder to stretch. Ouch!

The changes were so dramatic -- a 13 percent shortening of calf muscles and a marked thickening of the Achilles -- that the habitual high heel-wearers in the study couldn't stand flat on the floor without discomfort.

Study author and physiologist Marco Narici compares the effect to muscle atrophy that strikes people confined to their beds for a long time. Bed rest keeps muscles in a fixed position, causing some muscle fibers to become shorter.

Women who wear high heels a lot do much the same thing by keeping their heels in an elevated position day after day, Narici says. But the overall size of their calf muscles didn't change, a surprising finding. It was the length of the muscle fibers that was affected.

The results of the study were just published online in the Journal of Experimental Biology.

Shortened muscles aren't the only problems high heel-wearers face. Orthopedic surgeon Donald Bohay, who wasn't involved in the study, says the most common injuries are ankle sprains from women falling off their high heels. But he has also seen plenty of high heel-wearing patients with bunions, hammertoes and nerve damage.

So with all these problems, should women wear high heels? "No, absolutely not," says biomechanics expert Casey Kerrigan. High heels are not the only type of shoe Kerrigan has taken to task, but she led a study at Harvard University that showed high heels, in particular, could contribute to high rates of knee arthritis in women.

"It’s not worth it," she says. "We’re living long enough that all of us are going to get arthritis and anything you can do to minimize the severity is a good thing."

Bohay, on the other hand, thinks that women can continue to wear high heels as long as they take certain precautions. He tells his patients not to wear heels higher than two inches, and if the shoes hurt, then don’t wear them. "I just tell them to be sensible," he says.

Perhaps only a man would dare putting it quite that way. "The easiest way you damn a woman is by describing her as wearing sensible shoes," says Elizabeth Semmelhack, senior curator for the Bata Shoe Museum in Toronto. In her opinion, no matter how many scientific studies show high heels are unhealthy for women, fashion will win out.

"The high heel has gotten as far as it’s gotten, because it is such a highly impractical form of footwear," Semmelhack says. "Its value to our society has nothing to do with its use as a shoe."

High heels, she says, signal sexuality, femininity and status. In order to detach those signals from high heels, Semmelhack says that women with unchallenged status, like movie stars and fashion models, would have to change their footwear preferences. And based on the ridiculously high heels sported by celebrities like Lady Gaga and Victoria Beckham, that change is unlikely to happen soon (even with Gaga's recent spill in Heathrow airport).

But Kerrigan, for one, doesn’t believe that fashion always trumps health. "Smoking used to be very fashionable," she says.

Plus, even runway models know when enough is enough. Last year three models refused to wear Alexander McQueen’s ten-inch heels, citing safety concerns.

High heels, and the complaints about them, will likely be around forever. But if you’re tempted to show off your strappy Jimmy Choos every day, keep in mind that you’ll be boosting your chances of long-term health problems along with your image. [Copyright 2010 National Public Radio]