Did you know high heel shoes were created for men? In the 10th century, the Persian cavalry wore high-heeled shoes to keep their feet in stirrups. By the 17th century, men wore them as a symbol of power. Eventually, women began to wear them too. Over the years, they became common place, and by the 1800s, women of all social classes wore a pair.
Why Women are More at Risk
Today, the high heels' industry is valued at about $34 billion and is estimated to grow 1.4% yearly. In many occupations, including banking, modeling, in-flight services, and marketing, women are expected to wear high heels daily. And some companies even have High Heel's policies, forcing female staff to wear high heels or lose their jobs.
But this increases health risks for people wearing high heels, making them more likely to develop foot conditions like plantar fasciitis.
Plantar fasciitis–an inflammation of the tissue beneath the bones of your foot, causes pain and swelling around your heel. And the pain can ruin your day, stop you from working, and cause disability.
Here's more about plantar fasciitis and high-heel shoes, including how to protect your feet.
What Actually Happens in Plantar Fasciitis?
Plantar fasciitis is inflammation (and sometimes degeneration) of your plantar fascia. Globally, it is the commonest cause of heel pain.
Plantar simply means feet. And fascia is the soft tissue all over your body--between your skin and bones--that holds your body’s tissues together. Plantar fascia is a thick, web-like tissue linking your heel to your toes. It provides a cushion for your feet, helps keep you stable, and acts as a shock absorber.
Plantar fasciitis occurs when your plantar fascia is irritated, inflamed, or injured. This is commonly due to over use, repeated use or other a sudden increase in use. But other risk factors also play a role. Initially, doctors thought heel spurs caused plantar fasciitis, but later, X-ray studies showed that this wasn’t true.
What Are the Symptoms of Plantar Fasciitis?
The main symptom of plantar fasciitis is heel pain that has been described as stabbing, shooting, or disabling. Some people have also described a dull, constant ache in their heel.
The pain is typically worse in the morning when you try to walk, known as first-step pain. The pain can also occur after long periods of rest, such as after a long flight or a full day seated at your desk. The fascia tightens when you rest your feet for long periods, and when you try to walk afterward, you feel pain.
The pain worsens when you apply pressure to your heel, for instance, if you hit it against the floor. And it is relieved when you wear supportive footwear, but it can get worse when you walk barefoot or in thin footwear like flip-flops.
You may also experience symptoms like a stiff, swollen heel and Achilles tendon tightness. And although the condition often affects one foot, but can happen in both feet at the same time.
Risk Factors for Plantar Fasciitis
Sometimes, plantar fasciitis springs out of nowhere. But it's more common among people with certain risk factors, including the following.
Health Risks Linked to High Heels
While high heels can help you create the perfect look—stylish, smart, and sophisticated, that comes with a price. Wearing heels can hurt your feet, especially when very high, with poor cushioning, no arch support, and unstable soles. There’s evidence that wearing high heel shoes for long periods of time can increase your risk of several foot conditions, including plantar fasciitis.
“‘High heel shoes, typically, do not cause plantar fasciitis, because over 80% of body weight in high heels is on the ball of the foot instead of the heel, which is where plantar fasciitis is commonly exhibited, “says Nelya Lobkova, a board-certified podiatrist in private practice. Nonetheless, wearing high-heeled shoes for a long time can cause a strain in the plantar fascia or worsen tightness in your fascia,’’ she adds.
Here’s more about conditions linked with wearing high heels regularly.:
Plantar fasciitis: Although high-heeled shoes have not been proven to cause plantar fasciitis, they have been linked to this condition in many studies.
A recent study using Magnetic Image Resonance (MRI) and mathematical modeling showed that as researchers raised the height of heels from 3 to 7 cm, the plantar fascia strain increased. The researchers concluded that this increased pressure could increase the risk of plantar fascia injury or inflammation in people who wear high heels.
Falls and injuries: Data from various studies show that wearing high heel shoes increases your risk of falls and injuries. High heel shoes reduce your step length and balance, making it easier for you to trip or fall. Evidence suggests high heels are also responsible for many emergencies, with a higher rate of injuries in recent years.
Pain and calluses: A 2015 study of women who wore high-heeled shoes at work for five years or more found they were more likely to have calluses and pain in their feet than women who didn't wear heels at work.
An extensive analysis also showed that women who wore high heels were almost two times more likely to experience foot pain.
Tips for Protecting Your Feet
it's a good idea to protect your feet at all times-whether you wear high heels or not. Here are tips to help minimize the strain on your feet each day and reduce your plantar fasciitis risk.
- 1Wear supportive footwear: Inappropriate footwear can increase your risk of fasciitis and worsen symptoms. Supportive footwear with a moderate heel (0.5-4 cm), cushioning, arch support, and a solid sole give your feet more protection from hard surfaces and pressure. You should also wear the right size, not too small or too big. If you have to wear high heels to work, consider getting the most comfortable, supportive pair you can afford. And keep supportive footwear nearby, so you can switch as soon as possible.
- 2Stretch before and after exercising: Stretching helps improve blood flow to your feet and loosen stiff tissues. Doing this can ease tightness in your plantar fascia, and reduce pain.
- 3Try foot strengthening exercises: Exercises that strengthen your feet and hip muscles can improve your walking and reduce pain. Exercises like toe curls and ankle circles help strengthen the muscles around your heel and hip.
- 4Limit walking barefoot or wearing flip-flops on hard surfaces: Being barefoot can expose your feet to injuries, and the hard floor can injure your plantar fascia. Flip-flops don't provide enough support. Consider wearing more supportive casual shoes instead.
- 5Change your sneaker regularly: It is a good idea to get a new pair after walking or running in them for more than 250 to 500 miles, or if they show signs of wear and tear.
- 6Use foot orthotics: If you develop plantar fasciitis, consider using foot orthotics. For example, you can wear a soft, flexible splint that stretches your foot while you sleep. You can also use arch supports to prevent your arches from flattening when you wear shoes. Doing this can help reduce the symptoms of plantar fasciitis and make it less likely to reoccur.
- 7Perform a self-massage: Gently massaging your feet can improve flexibility and soothe the plantar fascia. Long massage strokes from your ball to your heel can help relieve stiffness before you get out of bed or after sitting for a long time.
- 8Try RICE and pain relief: RICE stands for rest, ice, compression, and elevation. Raising your feet and apply cold compresses may relieve pain. You may also consider over the counter pain relief, but don’t take them for more than a week without speaking to your healthcare provider.
- 9Seek professional help: If you have any conditions that increase your risk for plantar fasciitis, you should discuss them with your care team.
You should also seek care if you don't get relief from the pain or stiffness after two weeks. Many cases of plantar fasciitis resolve independently, but some cases can be hard to treat. Seeking care early can help your care team to create the best plan for you.
The Bottom Line
High heels do not cause plantar fasciitis, but they can increase your risk of developing it. You can protect your feet by wearing supportive footwear and following other tips for healthy feet. Seeing a professional early can help you get effective treatment if you develop heel pain.
Dr Nsisong Asanga is a physician, field epidemiologist and freelance writing consultant. Her work has been published by WebMD, VeryWell, Healthline, Parents, SELF, Health, Insider, The Independent and other platforms.