Can Heels Cause Problems in your Posture?

By Dr. Rajiv Jain in Orthopaedics & Joint Replacement

Nov 08 , 2020 | 4 min read

It’s the end of the week, your friends and you have made plans to dance the night away which means you get to wear your latest buy, 4-inch heels which you got on a great sale. You know by the end of the night; your feet are going to ache so you know you’ll be sore tomorrow. But that’s the price of fashion so you think it’s worth it? Do you realise that you’re doing damage to your body far beyond your feet and a quick soak in warm water isn’t going to be enough to repair it?

Our body’s alignment, when standing straight in flat shoes, is at its optimal position. The spine is almost straight, your calves relaxed and your body weight distributed evenly through your body & feet- Our center-of-pressure (COP) where most weight is distributed, lies somewhere in the middle of the foot. The body is at a right angle to the floor (90 degrees).

Now assuming our body is a rigid pillar, the addition of high heels would make us slant forward. The higher the heel more is the slant and thus more acute of an angle (<90 degrees).  But since our body is not a rigid pillar but an anatomical miracle made of joints, tendons and muscles, it automatically changes its stance to counterweigh the changes.

How can wearing high heels affect our body?

Upper body: High heels shift the center of gravity upwards. High heels can make your body elevated, which causes the body to make joint adjustments. In reaction to this shift in the center of gravity, our upper body makes certain re-adjustments such as arching the back, pushing the chest outwards and thrusting of the pelvis & posterior

Lower body: Our legs look longer and have a more defined muscle tone while wearing high heels. The angle of our stance while wearing heels, as discussed prior, is acute. To accommodate the slant, our Achilles tendon shortens which results in flexing our calf muscles that gives the long, muscular appearance. The COP shifts from the middle of the foot to the ball of the foot, with 70 – 80 % of your body weight shifting forward. This results in the bones of your toes (metatarsals) and their surrounding tendons and ligaments weakening.

While the aches and pain that comes after wearing heels can be resolved by a hot bath and stretching, long-term effects of wearing high heels are much more serious. 


1 year: Soreness of feet

3-5 years: Pain in the ball of your foot, changes to your toes (Hammertoes & bunions)

Lifetime: Stiffness of Achilles tendon, lower back pain, neck pain, ankle & knee arthritis, weakness of muscles around hip & knee joints. 

  • Spondylolisthesis: Is caused one vertebrae slide forward over the vertebrae below it. This can cause back pain, weakness or numbness in one or both legs. In rare cases, you may suffer from incontinence (involuntary urination or defecation). It is most common in your lower back (lumbar) where most of the weight is concentrated.


  • Foraminal stenosis: Is a spinal nerve condition in which anatomical changes (such as enlarged joints) reduce the foraminal space, thus pressing the nerves. The pain is non-continuous which builds up and is exaggerated in certain positions. Apart from sharp shooting pain, there is tingling numbness, spasms and cramps that affect the gluteal region (buttocks) and legs.


  • Sciatica: It is the compression of the sciatic nerve that leads to sharp shooting pain which radiates posteriorly to the buttocks and legs


  • Ankle & Knee Arthritis: The incidence of arthritis is higher in women than men. High heels have been considered to be a contributing factor. 

Dr Rajiv Jain, Senior Consultant - Orthopaedic & Joint Replacement Surgery, Max Super Speciality Hospital, Patparganj says that "If you must wear heels or wish to, consider the following suggestions:

  • Stretch muscles prior and after wearing heels. Make sure to stretch for at least 20 minutes, focusing on your lower back, hamstrings, calves and feet.
  • Try to limit your heels to a 2-inch maximum. The higher the heel, the more pressure (weight-distribution) is felt at the ball of the foot. For instance

                - 1-inch heels à 22%
                - 2-inch heels à 57%
                - 3-inch heels à 76%

  • Avoid wearing heels for a long period of time. Even when you’re out, take breaks to sit down or if you must remain to stand, keep a pair of flat shoes handy to switch your shoes out.  Make sure you’re wearing them for maximum 3 hours at a stretch
  • Buy shoes in the afternoon, when your feet are the largest
  • Don’t go for the pointed toe shoes, front heel shoes, extremely high-heeled shoes. Opt for wide-mouth shoes or wedge heels.
  • Get leather insoles to prevent any slipping & make sure your ankles are well supported
  • Mix it up a bit and alternate your flats and heels so that your body is rested and well-adjusted.

While the saree may fall better with those add-on inches, the priority needs to be your health. Your future self will thank you.