IOWA STATE (US)—Stilettos, wedges, and pumps may be fashionable, but prolonged wearing of and walking in high heels can contribute to joint degeneration and knee osteoarthritis, a new study suggests.

“Obviously with research like this, you can’t say with any certainty that if you wear high heels regularly you will develop osteoarthritis. We don’t know that,” says lead researcher Danielle Barkema, an Iowa State University kinesiology master’s student.

“There are probably people [high heel wearers] who do and those who do not. However, based on this information, wearing high heels puts individuals at greater risk for developing osteoarthritis. And it seems to be that the higher the heel height, the greater the risk.”

Barkema selected three different heel heights—flat, two inches, and 3.5 inches—and had each of the 15 women in her study complete walking trials. She measured the forces acting about the knee joint and the heelstrike-induced shock wave that travels up the body when walking in heels.

Using sensors, accelerometers, and lab equipment such as a force platform and markers/cameras, Barkema was able to capture motion and force data.

While previous studies have examined the effect of high heels on joints, this study suggests that heel height changes walking characteristics such as slower speeds and shorter stride lengths. And as the heels got higher, they also saw an increase in the compression on the inside—or medial side—of the knee.

“This means that prolonged wearing and walking in heels could, over time, contribute to joint degeneration and knee osteoarthritis,” Barkema says.

“I think Danielle’s exactly right. Wearing high heels regularly puts a person at risk and the higher the heel, the greater the risk,” adds kinesiology professor Phil Martin. “The loading that’s being produced in the joint with every step that they take is higher—or at least, these data suggest that. These are not direct measures of loading within the joint, but they’re an alternative way of looking at that kind of loading.”

Barkema also found that in addition to lower extremity joint problems, wearing heels—especially those two inches and higher—alters body posture by changing joint positions at the ankle, knee, hip, and trunk, which can create strain on the lower back.

“Visually, it’s quite apparent that somebody’s posture is altered when wearing high heels,” she says. “We noted those changes in posture [in the study], as well as various joint angles, such as the knee and ankle angle. The most dramatic change occurs at the ankle.”

Details of the findings will be presented, in part, at the annual meeting of the American Society of Biomechanics in August.

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