THE female of the species' love affair with her high heels is nothing new. Catherine de' Medici donned a pair in 1533 for her wedding to the Duke of Orleans, while, more recently – and unforgettably – they brought Naomi Campbell down to earth with a
bump on the catwalk.
But this season it seems the sky's the limit. Shoe god Christian Louboutin has just created his most vertiginous design yet, at six inches. But Louis Vuitton has managed to top that, with a pair of shoes grazing the seven-inch mark. All last week we saw Gwyneth Paltrow tottering around the world in a series of skyscraper shoes, the highest of which was a seven-inch pair of boots that were so tricky to walk in she needed the support of her bodyguard to stay upright.
It's enough to have every podiatrist in town running for the hills. Apart from the dangers of falling over and twisting your ankle, high heels are said to cause (or accelerate) bunions, arthritis and back problems. Long-term wearing of high heels can also lead to a shortened Achilles tendon, which means some women find it desperately uncomfortable to go back to flat shoes. Just last week, Brooke Shields (below left) was receiving surgery for a tendon injury caused by years of walking around on her tiptoes.
None of which is news for Edinburgh podiatrist Jackie Johnston. "I have some clients in their 70s who cannot walk without high heels on," she says. "They have to put their shoes on to go to the toilet. That sounds funny but if you think about the number of falls you have as you get older, they're at huge risk of major injury."
But, she adds, "I also have some patients in their late 60s who have worn high heels all their lives and have perfect feet." This, apparently, is because their feet were biomechanically perfect to start with. "But there are not many people like that."
And before you start feeling all smug in your cute little ballet pumps, she has this word of warning. "Your foot will naturally go flat but it's not very happy to go flat when there's a very hard sole underneath it, because it doesn't allow the natural arch to take its proper shape. So these little pumps the kids are running around in are just as bad as the high heels – perhaps even more so."
Ankle breaks and fractures are all in a day's work for Colin Howie, head of orthopaedics at NHS Lothian. But he says the danger of wearing heels is not just about the height of the heel but also the width. "If you are on a stiletto, the base that you balance on is very small and it's very easy to turn over on your ankle and twist it." Knee pain is also common because wearing heels while walking downhill forces you to hold yourself differently.
The dangers are exacerbated in the soft, still developing bones of the young, and Howie advises steering clear of heels until the foot stops growing – at the age of 16.
"Feet are made for walking and you should wear shoes that are comfortable to walk in," he says. "We were designed to run short distances over boggy ground to catch our tea. What that means is that we were designed to walk on soft surfaces.
"Concrete has only been around for the last 200 years or so, and we haven't evolved to cope with that. So it's important to wear shoes that absorb shock and possibly have a smaller heel to enable you to walk better on hard ground."
But for those who can't give up their high heels, it's not all bad news. Earlier this year an Italian urologist studied 66 women under the age of 50 and found that those who held their feet at a 15û angle to the ground – the equivalent of a two-inch heel – had as good a posture as those who wore flatties. Notably, they had even stronger pelvic floor muscles – and thus a better sex life.
"Women often have difficulty in carrying out the right exercises for the pelvic zone and wearing heels could be the solution," says Dr Maria Cerruto. "Like many women, I like high-heeled shoes. It's good to know they have potential health benefits."
The full article contains 747 words and appears in Scotland On Sunday newspaper.
