Heel Ergonomics – Part II
This interview continues from Handbag Ergonomics – Part I
MCR: Can high-heeled shoes change the way a person walks?
Cheryl: Yes. The higher the heels, the more the centre of gravity (CG) of the body shifts, increasing the risk of falls. Also, high heels does change the position of one’s body. Her upper back will tend to lean backwards and her lower back will be arched more. Hence one will tend to ‘trot’ rather than ‘walk’ as the heels goes higher. Some ladies like high heels as it pulls the tummy down by anteriorly tilting the pelvis and push up the bottom, hence have instant flat tummy and perkier bottoms.
MCR: Most shoes stores these days sell a lot of high-heeled shoes and wedges, what are the potential health dangers if they are worn for too long and too often?
Cheryl: Ankle and foot injuries while wearing high heels/ stiletto shoes are commonly reported. Commonly high-heel related injuries are calf sprains, twisted ankles and injuries from falls. Wearing high heels long term can seriously harm the feet by damaging the tendons in the heel and causing blisters, bunions, corns and calluses which some of them may even require surgery. Other conditions such as hammertoes, ingrown toenails and ankle and knee joint pains. Heel pains such as inflammation of the plantar fascia (bottom connective tissue of the foot) or plantar fasciitis are very common too.
MCR: What is the most serious scenario that can happen?
Cheryl: Fractures of the ankle or foot on falling and complete tear of ankle ligaments which requires a cast or ankle reconstruction operation to heal. Other more serious injuries that can be sustained on falling can be trauma to the head and shoulder fractures and strain. On a long term basis, research shows that wearing high heeled shoes regularly causes long-term health problems such as a distortion of the lower spine and arthritis in the knees which can lead to postural spinal stenosis and rapid degeneration of the lower spine (also known as lumbar spondylosis) leading to chronic low back pain and/or numbness or any other sensation changes in the legs.
MCR: What advice on choosing shoes?
Cheryl: There are no hard and fast rules about it, but it is recommended that high heel wearers take sensible precautions when going out in high heels or new and unfamiliar shoes in order to reduce injury. These include wearing shoes with ankle straps to help hold ankle and feet in place, making sure your shoes are properly fitted (size-wise), switching to flats during the day to give your calf muscles a break, and placing appropriate measures in shoes (i.e. heel pads, corn pads) to minimise the chance of blisters and painful friction.
MCR: How can physiotherapy help a person with heel pain?
Cheryl: Heel pain can be a result of bad walking posture/gait pattern, excessive walking and running (overtraining), wearing high heels frequently and/or muscle imbalance of the leg (hip, knee and ankle). Depending on the nature of the injury, be it a sprain or an accumulative stress related injury, physiotherapy help by applying various strategies in the reducing the stiffness, pain and discomfort in joints or muscles affected. Strategies include manual techniques, such as joint mobilization and manipulation, deep friction massage, stabilization exercises and electrotherapy i.e. ultrasound therapy. Should wearing heels be required on the job, the physiotherapist may make recommendations on the footwear, and advise on posture correction and specific muscle strengthening for injury prevention. Nevertheless, treatment is always more effective if the problem is detected and treated early as chronic problems (more than 3 months) have poorer treatment results. Therefore, if the pain does not resolve within 3-7 days and seems to get worse, it is time to make an appointment with your physiotherapist.
MCR: Besides heavy bags and high heels, what are the other potential fashion health hazards?
Badly Fitting Bras
Studies have shown that as many as 90% of women are wearing the wrong bra size, many still hanging on to the same bra size they were fitted for years ago – irrespective of growing, losing weight or having children. Wearing the wrong bra could lead to shoulder tension, chest/ breathing restriction, headaches and chest and upper back pain. If the bra is too loose, it is not supportive enough and if too tight and restrictive, it can lead to restrictions in breathing normally, upper back pain and reduction of spinal movement.
The trend for skinny jeans, hipsters/ low riding jeans tend to restrict movement and can also cause bad posture, changing the alignment of the spine. The tight, low riding jeans/ trousers can squeeze a sensory nerve under the hip bone, known as the femoral nerve, and cause a tingling sensation in the thighs (pins and needles) also called paresthesia.
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