The Royal National Orthopaedic Hospital has a new scanner that allows doctors to view the foot and ankle in 3D in a full weight bearing position. That means they can even view the foot when the patient is wearing shoes. The scan they released yesterday shows clearly why high heels are problematic when it comes to foot health.
Women who regularly wear high heels often suffer from foot and ankle problems as body weight is transferred to the ball of the foot, adding pressure to sesamoids (the tiny pea sized bones under the big toe). Frequent wearing of high heels also squashes the toes, forcing the foot into an unnatural shape, which can cause intense pain and possible long-term damage such as clawing of the toes.
I have always encouraged my students to minimize their use of high heels, but I also have given them instruction in how to walk in them. I think most of the damage can be minimized by wearing heels in moderation, as the doctors in the study suggested, but also by learning how to direct the body in movement in ways that avoid undue pressure on any one point. Most women in my experience tend to avoid using the heel in high heels, and that leads to problems. Simply turning out very slightly in the hip joints while walking in heels helps to distribute the weight more evenly across the whole ball of the foot, and so might lessen the damage to the big toe shown in the video.
Last year, researchers at the University of the Witwatersrand in Johannesburg, South Africa, published a study titled “Shod Versus Unshod: The Emergence of Forefoot Pathology in Modern Humans?” in the podiatry journal The Foot. The study examined 180 modern humans from three different population groups (Sotho, Zulu, and European), comparing their feet to one another’s, as well as to the feet of 2,000-year-old skeletons. The researchers concluded that, prior to the invention of shoes, people had healthier feet. Among the modern subjects, the Zulu population, which often goes barefoot, had the healthiest feet while the Europeans—i.e., the habitual shoe-wearers—had the unhealthiest. One of the lead researchers, Dr. Bernhard Zipfel, when commenting on his findings, lamented that the American Podiatric Medical Association does not “actively encourage outdoor barefoot walking for healthy individuals. This flies in the face of the increasing scientific evidence, including our study, that most of the commercially available footwear is not good for the feet.”
One of the newest designs discussed in the article is the Vivo Barefoot, which has a surprising link to the Alexander Technique.