Wide-Heeled Shoes as Bad as Stilettos

April 5, 2001 -- For many women, the classic stiletto high-heeled shoe makes an outfit sing — and the feet ache.

They can also cause long-term damage. Studies have shown the narrow-based spiky, high-heeled shoes are bad for the knees, causing osteoarthritis, the most common form of arthritis, in which joint cartilage degenerates.

A study released today shows their wider-heeled cousins, preferred by many women as a sensible replacement to the stiletto, are just as bad for the knee, and in some cases may actually be worse.

Results of the study appear in this week’s issue of the British medical journal The Lancet.

Torqued-Out Knees

Dr. Casey Kerrigan, lead author of the study and a physical medicine and rehabilitation specialist at Spaulding Rehabilitation Hospital at Harvard, says the problem with high-heeled shoes in general is that they exaggerate the pressures normally placed on the knee while walking. She calls this “knee torque.”

“The problem is high-heeled shoes knock out the normal functioning of the foot and ankle leaving it up to the knee to pick up the slack,” Kerrigan says. “Unfortunately, people don’t really feel the increased torque in the knee when they walk.”

“So as the population ages and people live longer, arthritis of the knee from wearing the wrong shoes becomes inevitable. In fact, it’s one of the diseases that causes the most disability in older people.”

Normally men and women have similar knee torques when walking barefoot. So any biomechanical differences that may exist between the sexes do not adequately explain why women experience osteoarthritis twice as often as men.

Comfort Doesn’t Equal Health

In her study of 20 healthy women with an average age of 34, Kerrigan found that knee torque was increased by 26 percent when walking in wide-based, high-heeled shoes compared to walking barefoot. That was slightly worse than the 22-percent increase in torque caused by stilettos.

“Because these wider-based shoes are more comfortable, providing more room for the foot and reducing the incidence of bunions, women tend to wear them more often and for longer periods of time,” she says.

But, she adds: “There are only three real ways to prevent osteoarthritis: You can wear proper foot wear, maintain normal body weight, and avoid trauma to the joints and bones.”

“We recommend wearing shoes with low or preferably no heels. It’s certainly easier to change shoes than it is to lose weight or have a knee replaced.”