Heels are GOOD for you?!

[Driver8]

New research will bring joy to the hearts of Sex and the City's Carrie and Charlotte, and shoe-loving women everywhere - high heels may actually help their wearers avoid painful knee conditions.

Fears that stilettos could lead to knee arthritis are unfounded, according to researchers at Warwick University who say 3in heels reduce the risks of joint problems.

Prof Margaret Thorogood, from the university's medical school, said high heels did not cause knee problems but being overweight before 40, doing demanding physical work and previous knee injuries did.

In fact, there was a link between regular dancing in 3in heels and a reduced risk of knee problems.

article

[Dr. Shoe]

After picking myself up of the floor and wiping away the tears of laughter. I felt that I had to make a reply.

I have never before seen such a sloppy and lazy piece of journalism. In the original press release Dr. Charles Scuderi takes pains to point out that "dancing in high heels is good for you" is probably a statistical abberation. Also note that only 29 women who were waiting for treatment for bad kness were interviewed, hardly an adequate statistical cross section.

Here is the original article going back 4 months (new ideed!)

30/9/2003

New research confirms what women all over the world have no doubt been waiting to hear: wearing high heels does not increase your chances of developing osteoarthritis of the knee.

But beware: the study also confirms that being overweight, especially when you're younger, greatly increases the risk.

Twice as common among women

According to authors of a study appearing in the October issue of the Journal of Epidemiology and Community Health, about 2,4 percent of people over the age of 55 suffer from osteoarthritis of the knee, in which the joint's cartilage breaks down and causes the bones to rub against each other. By the age of 65, however, the condition is twice as common among women, a discrepancy that has led to much speculation about what different risk factors may be at play.

That speculation has run the gamut from birth control pills to socioeconomic status and, of course, to those uncomfortable-looking pumps that have become more ubiquitous since the end of World War I.

How the study was conducted

The researchers interviewed 29 women between the ages of 50 and 70 who experienced knee pain and were on a waiting list for knee replacement surgery, as well as 82 women who had no known knee problems.

Each woman was asked about their height and weight at different stages of their life, about previous injuries, occupational activities and use of hormones and birth control pills.

They were also subjected to a grueling series of questions regarding their shoe history: How old were they when they started wearing high heels? How often did they wear them? How high did they go? The women were shown a rogues' gallery of 38 different styles and heights of shoes (front and profile) and life-size pictures of heels and asked to identify their preference. If they had worn any of the shoes, they were asked to divulge whether they wore them for dancing, for social events, or for work.

All of the women reported wearing shoes with heels at least 2,5 cm high at some point in their life. Only 7 percent said they had never worn heels as high as 5 cm, and 36 percent said they had never worn 7,5 cm heels.

Other factors contributed to arthritis

Some of the findings were expected: knee osteoarthritis was associated with previous knee injury, arthritis of the feet, heavy smoking, certain occupational activities and, most importantly, being overweight.

High-heeled shoes, on the other hand, seemed to actually reduce the risk of knee osteoarthritis, although this was probably a statistical aberration.

With regards to weight, a body mass index of 25 or above between the ages of 36 and 40 was most significantly associated with osteoarthritis of the knee.

Certain activities such as lifting and bending also seemed to be associated with the condition.

Clinical speculation?

It's not entirely clear why some people thought that high heels contributed to osteoarthritis. It was clinical speculation, hypothesises study author Ray Fitzpatrick, a professor of public health at the University of Oxford in England. One factor may have been that more women had osteoarthritis than men, but perhaps there was also a non-specific belief that there's something unnatural about high heels.

Fitzpatrick counsels women (and men, for that matter) to turn their attention to the weight findings.

We're not the first people to find that, and I think it's now quite clearly the single most preventable risk factor, he states. And by that he means overweight at any age, not just a younger age as was highlighted in this research. This is a small study, and I wouldn't want you to think that current overweight is less important, Fitzpatrick cautions. They are of similar importance, current overweight and overweight at an earlier stage.

Weight - the real issue

Weight is a major issue, confirms Dr Giles Scuderi, chief of adult knee reconstruction at Beth Israel Medical Center in New York City. Weight is a major cause of degenerative arthritis of weight-bearing joints.

Oddly, years of regular dancing in 7,5 cm stilettos turned out to have a statistically significant association with knee osteoarthritis but, again, Fitzpatrick urges caution. I'm not sure that we take that too seriously, he says. I wouldn't want that to be over-interpreted.

So while scientists still don't know why women have a higher rate of knee osteoarthritis over the age of 65, it's safe to wear those heels at any age and perhaps even when you're dancing. However, there have been no studies done on how likely you are to fall down.

However, the article does confirm some of my own research that it is a myth that heels are bad for you as was always supposed.

http://www.health24.co.za/news/Arthritis/1-891,24801.asp

[Dawn HH]

Driver 8 and Dr. Shoe:-) Your posted report seems to me to be flawed a bit. I think they should have had a cross reference of men in their findings instead of just polling women ( a small cross-section at that.) My Mom had arthritis in all of her joints all of her life and was told three times in her lifetime that she was a total cripple and would never be able to walk again. Being of stubborn German background, she proved the doctors wrong each time and came back to not only to walk, but to have complete use of her body again after telling the doctors " Just watch me". I would say that shows the sturdiness of the German people and I'm glad to have that in my background. Needless to say, she past the arithritis on through my genes at birth. Therefore, I must stick to wearing 3" to 4" chunky, sturdy heels. Dawn HH

[Firefox]

Aha, they are recycling this old crap again. They must be desparate to fill white space. While heels may not be as bad for the knees as they thought, they can still be a primary source of foot trouble and also exacerbate any weight or ill fitting shoe problems. The headline is totally misleading if you read the text, but then aren't most headlines?

[Dr. Shoe]

Exactly my point. Although I do agree that heels are not as bad for you as commonly thought, they do not have any positive benefits except for those who suffer from shortened achilles tendons, even then, they have to wear shoes that don't flex the toes too much.

As for the research, if I were to offer a dissertation based on that kind of research then I would not expect to get a degree. You cannot get a reliable statitistical cross section from 111 people.

As far as interviewing men is concerned, I believe that the research objectives was to see if the habitual wearing of high heels is to blame for osteoarthritis in the knees. As men in general do not habitually wear heels then they would not have been included in the research. Moreover, a pre-research analysis showed that women are far more likely to suffer from the condition leading to the myth that HH cause these problems.

[genebujold]

Women equally more likely to suffer from osteoarthritis of the knee as they are to suffer from osteopororsis. Both estrogen and testosterone cause osteoblasts to depost calcium in the bones. Low testosterone in males is fairly rare, while low estrogen in women usually occurs during menopause. Progesterone also causes osteoblasts to function. Men have about half the level of progesterone that women do, but their testosterone doesn't take a nose-dive in their forties, either. Furthermore, their testosterone and progesterone levels remain constant throughout the month - not so women's! Thus, over their life-times, men don't suffer weak bones. Women do. It has NOTHING to do with heels!

[Dr. Shoe]

That is quite correct. Osteoporosis (?) is far more common in women than it is in men which is tha main reason for HRT.

[Firefox]

I also agree with the previous two posters. We need to look more closely at foot disorders. Foot neuromas or joint deformities. Primarily caused by ill fitting high fashion shoes. Many more women have foot problems than men. Osteoporosis of knees or back is largely a red herring which can be attributable to an other factors, especially female prepondancy to such afflictions.

[Heelfan]

Yes, I agree with Firefox. But I would like to emphasize that the ladies' foot problems caused by high heels are almost always because they are too tight-fitting and/or too pointed rather thasn because they happen to be high-heeled. Heel height should not be blamed for problems caused to ladies feet when the real root answer lies in the size, fit and width of the shoe, irrespective of height. Cheerfully yours, Heelfan

[Firefox]

But actually, heels compress the bones in the foot in a way in which they are not designed to be compressed for that long. So, we shouldn't dismiss the possibility of foot problems even when the the shoes do fit perefectly. I've seen a lot of unjustified praise of heels on the forums. That's probably born of the subliminal notion we want to see people wearing them. It pays to get the rose tinted cleaner specatcle cloth out, when those notions overtake reality.

[JeffM]

I dont know a lot about the anatomy of the foot so my ideas may be way off the mark. It seems to me that if the foot is "designed" to push off with the ball and then the toes when walking or running then they should in normal life be very strong and able to take those sorts of stresses involved. If that is the case then surely the foot should be able to take those stresses when forced into a high heeled postion because there is not a lot different from that when pushing off when walking or running. So it comes down to the toe being too small or too pointed and not the heel height. Jeff

[genebujold]

I also agree with the previous two posters.

We need to look more closely at foot disorders. Foot neuromas or joint deformities. Primarily caused by ill fitting high fashion shoes. Many more women have foot problems than men. Osteoporosis of knees or back is largely a red herring which can be attributable to an other factors, especially female prepondancy to such afflictions.

Ahhh.... Now the higher incidence of foot problems among women than men is another issue altogether, and is almost certainly primarily caused by the fact that, generally speaking, women wear heels, men don't.

However, there's another culprit here which may play a second-hand role...

Progesterone!

Women have, on average, twice as much running through their body at any given time than men.

But that's not all! During the latter half of their cycle, about a week before menstruation, the level of progesterone peaks at a level several times higher than the steady-state level in men.

Progesterone signals the body to "get ready - a baby's coming." Among other things, it's presence results in the release of another hormone (can't remember the name) which literally loosens the joints in the body by softening the cartilege and allowing both muscles and tendons to stretch more readily. The main reason is to soften up the pelvis and allow it to flex so that the baby can be born.

A side effect, however, involves damage to joints which are under stress.

Although this effect is perhaps 1/5th what it is during pregnancy, it still takes it's toll on a woman's toes when they're crammed into a shoe that was never designed with the health of the foot in mind.

This is one of the reasons I HATE the pointy-toed styles out these days. Not only do they look horrible (personal taste), but when combined with the higher heel, they're wreaking havoc on women's toes - a fact they will pay for in pain later on in their lives.

The babydoll / roundtoe shoes with a moderate heel, however, pose no such problems.

And, Heelfan, as far as heel height not being an issue - the same multiplication of effect caused by female hormones on the toes also effects the ankles of habitual female high-heel wearers. The many bones in the ankle actually restructure themselves in the female far more so than in the male, to better help distribute the stress of walking at a pronounced angle.

Which means two things. First, women are more able to adapt to walking in higher heels as a percentage of foot length (more angle on the ankle). Second, they're more prone to permanent damage/disfiguration as a result, which means that when they give up heels late in their lives, they'll have a harder time walking without pain (because by then, the bones in the ankle are pretty much locked into their position).

Again, go with a moderate heel and rounder toes and you shouldn't have this problem.

[genebujold]

I dont know a lot about the anatomy of the foot so my ideas may be way off the mark.

It seems to me that if the foot is "designed" to push off with the ball and then the toes when walking or running then they should in normal life be very strong and able to take those sorts of stresses involved. If that is the case then surely the foot should be able to take those stresses when forced into a high heeled postion because there is not a lot different from that when pushing off when walking or running.

So it comes down to the toe being too small or too pointed and not the heel height.

Jeff

The problem is that a push-off while wearing flats puts the ankle at a significantly different angle than a push-off while wearing heels.

Reference my previous message for more details on why this can be bad.

And there's another solution: Vary your heel heights! If you're always in 4" heels, you're in long-term trouble.

Given my bad ankle, wearing flats is painful. But I do it throughout the day because it means preserving long-term capability. After all day on my feet, however, I look forward to the thought of sliding into a pair of three-inch heels - luxurious!

[Dr. Shoe]

Ahhh.... Now the higher incidence of foot problems among women than men is another issue altogether, and is almost certainly primarily caused by the fact that, generally speaking, women wear heels, men don't.

Absolutely

Which means two things. First, women are more able to adapt to walking in higher heels as a percentage of foot length (more angle on the ankle). Second, they're more prone to permanent damage/disfiguration as a result, which means that when they give up heels late in their lives, they'll have a harder time walking without pain (because by then, the bones in the ankle are pretty much locked into their position).

Actually, the idea that women can adapt to heels quicker than men is largely myth. Although theoretically that could be true, a large number of [male] actors who have worn heels for a role have reported surprise to the ease that they have adapted, similarly, many women find that they simply cannot wear heels without experiencing pain no matter how perfect the fit. The idea that "you're a woman so therefore you can wear heels is untrue."

As part of my previously mentioned dissertation there was a significant percentage of women who cannot wear heels higher than 3.5" without experiencing pain. My research did not include male heel wearers as there would have been insufficient numbers to validate the results.

Going by personal experience, I have found no problem wearing heels up to 5" and have several pairs higher than that that do not hurt my feet but just make walking difficult. Everyone who subscribes to this forum appear to be able to wear heels without difficulty, but whether some are in denial about this I couldn't and wouldn't say because when you love to do something, you ignore the pain.

[genebujold]

Well, count me in as being among those for whom wearing higher heels causes pain! I can do 4 inches without pain, but no higher. I get relief from my ankle pain at just 2.5 inches, so I generally stick with 3 to 3.5 inch shoes and boots. Although the one I'm wearing to the left has a 4-inch heel...

[Paul]

I don't about the medical facts, because i'm not that clever. I think my high heels are good for me, because I feel great wearing them, so in my view yes they are. Paul.

[genebujold]

Actually, the idea that women can adapt to heels quicker than men is largely myth. Although theoretically that could be true, a large number of [male] actors who have worn heels for a role have reported surprise to the ease that they have adapted, similarly, many women find that they simply cannot wear heels without experiencing pain no matter how perfect the fit. The idea that "you're a woman so therefore you can wear heels is untrue."

I strongly disagree! As a doctor, you're aware of such things as statistics and logic (it's how I got started in networking, long ago), as both play a deciding role in proper diagnostic technique, as well as common inductive and deductive reasoning - but only if properly used.

Both statistics and logic dictate any arguement based soley on an eyewitness account, whether individually, or collectively, fail to ascribe weight to the arguement because they fail to accurately represent the whole. One person might say, "Brand X is so good, 100,000 people signed a petition declaring that it's good." So, Brand X is it! Not so fast - there might be 300,000 people who signed a petition saying it's terrible, and another 1,200,000 people who don't care, and the rest of the population who've never tried it.

The part after "not so fast" describes the whole population set. The part prior to it is merely a subset, and as I've postulated, not a fair representation of the population as a whole.

Your argument includes references to male actors who can wear heels, females who cannot, and your own personal experience - none of which provide any qualification as to what extent they represent the population as a whole.

Technically, your argument is what's called a "fallacy of composition," which is where attributes of part of a whole are illogically applied to the whole.

Had your examples been truly random samples of the larger population, even stratified random samples (women who wear heels, men who wear heels, women who don't wear heels, men who don't wear heels, with "heels" defined as a heighth between heel and platform greater than 20% of the length of the foot), and of sufficient size pertinant to your population size and ordinality of question, then your conclusion that "the idea that women can adapt to heels quicker than men is largely myth," is itself unsupported because of the fallacies inherent within your supporting arguements!

Since your examples may, or may not be representative of the entire population, we must go searching for data which is.

Such data is found in medical science, which has measured, scientifically, statistically, and logically, such things as joint flexibility and stress-related ankle bone deformation , as well as having determined the reasons as to why.

The conclusions of such studies, which were not subject to any of 39 major types (and many more sub-types), clearly indicate two things:

1. On average, a woman's joints have more mobility than a man's.

2. On average, the bones in a woman's ankle are more accommodating to an unnaturally elevated heel height relative to ball of foot height and overall foot length (ie, "angle").

3. A woman's hormones are responsible for the increased ability of muscles, tendons, and ligaments to lengthen in a woman as compared to a man.

And now, for inductive reasoning: The third statement (common medical knowledge) provides adequate explanation for the first two observations (statistically, scientifically, accurate with respect to the differences between a man and a woman).

Having said all of that, even my own arguement is inductive, not deductive. If it were deductive, I could prove the contrary (your arguement) false. As it is, all I can do is support my position that the contrary (your arguement) is more likely to be false in the face of more objective evidence than what you've presented thus far.

Bottom line - we may never know the exact truth, but we can draw certain conclusions that since women are indeed more flexible than men, down to and including the bones in the wrists and ankles, they can take to high heels more readily than men, but as a result, specifically with respect to their greater angle than what the average man wears, they may also suffer more damage.

I think the best advice is - don't be vain. If it hurts, don't do it. If it feels fine (really fine, not just tolerable for now), go with whatever floats your boat. Otherwise, you face a decision to ratchet it down a notch or risk the long-term consequences.

Ok - enough with the logical exercise this evening...

[Dr. Shoe]

Eh?

[Heelfan]

Huh? Cheerfully yours, Heelfan

[Dawn HH]

Genebujold:-) Boy---you lost me on that one. DawnHH

[Bubba136]

I didn't know Dr. Shoe was a doctor. I thought he was a truck driver. Oh well, live and learn.

[GrayLion]

excellent article gene! thanks. Bernhard

[Dr. Shoe]

I didn't know Dr. Shoe was a doctor. I thought he was a truck driver. Oh well, live and learn.

I don't recall ever saying I was a medical doctor.

My degree is in footwear design.

I hope that clears that one up!

[Firefox]

Nice one Dr Shoe. Anyway, my own degree is in civil/structural engineering. Gene's rather roundabout way of saying woman's bones are generally more flexible and therefore likely to be able to accommodate heels, although if one can do it, don't worry about gender difference, was all very interesting. However, I'd like to add that men's stiffer stronger bones are less likely to be subject to damage or creep (deformation under constant load). Also men's greater muscle to weight ratio means that they are more capable of supporting the foot in a raised position. Hence it is MEN rather than women who are better suited to wearing heels, although anotomically speaking the differences are small such that a healthy woman is better than an overwieght man and redoubled vice versa.

[Dawn HH]

Dr. Shoe:-) I'm glad that your degree is in "Footwear Design", and since you seem to know what you are talking about, I'm with you. Men can and do wear high heels successfully and this forum proves it. I'm just new to street-heeling, but I'm enjoying it very much. BTW, my degree states:---"To teach or supervise music in the public schools in the state of Pennsylvania". I'm retired since 1990.

[genebujold]

Regarding the "Eh?s" and "Huh?'s"... What's up with this? Has it become socially fashionable to declare, "woah, dude! Too much slipstick for my noggin.. Chuh!" when faced with a cerebral challenge steeper than you'd like to tackle? Given your previous comments, I know you're smart enough! But where's the drive? Where's the quest for discovery? For knowledge, understanding, and wisdom? Or am I living about 100 years after my time? Where is Einstein when you need him?

[genebujold]

excellent article gene! thanks.

Bernhard

Why, thank you, GrayLion!

[genebujold]

Gene's rather roundabout way of saying woman's bones are generally more flexible and therefore likely to be able to accommodate heels, although if one can do it, don't worry about gender difference, was all very interesting.

Thank you, Firefox.

However, I'd like to add that men's stiffer stronger bones are less likely to be subject to damage or creep (deformation under constant load). Also men's greater muscle to weight ratio means that they are more capable of supporting the foot in a raised position. Hence it is MEN rather than women who are better suited to wearing heels, although anotomically speaking the differences are small such that a healthy woman is better than an overwieght man and redoubled vice versa.

I agree that it's the men who will suffer less damage than women at any given heel height to foot length ratio, but continue to argue that it's the women who can wear a heel height to foot length ratio in a short acclimation time, and a higher ratio long term.

On average, of course.

And then there's the mass to weight ratio... Which is why an elephant has very thick legs while a horse does not.

[Dr. Shoe]

Regarding the "Eh?s" and "Huh?'s"...

What's up with this? Has it become socially fashionable to declare, "woah, dude! Too much slipstick for my noggin.. Chuh!" when faced with a cerebral challenge steeper than you'd like to tackle?

Given your previous comments, I know you're smart enough! But where's the drive? Where's the quest for discovery? For knowledge, understanding, and wisdom?

Or am I living about 100 years after my time?

Where is Einstein when you need him?

It's not that I didn't want to know, I found your article very informative and had I read it in '96 I might have included some of the ideas in my dissertation (subject to verification). However, my point had little to do with the physical advantages more to do with the emotional and psychological reasons. Moreover, I thought that the thread was getting a tad too heavy and I just wanted to lift it a little!

I'm glad that your degree is in "Footwear Design", and since you seem to know what you are talking about, I'm with you.

Thanks dawn

[Dawn HH]

Paula_HH_cd:-) I see you are a newby here on the high heel forum, and let me be the first one to say WELCOME A-BOARD. You are not the only one in this boat to wear heels and a skirt---so grab an oar and start paddling (posting). Dawn HH