Does Wearing High Heels Damage Your Knees?

November 27, 2016

It is hard not to notice when a women walks down the street or through the hospital in 3 inch stiletto heels. It is estimated that over 40% of women wear high heals daily. Most of these shoes are not comfortable after several hours of wear and the potential negative effects of tight fitting shoes on the feet are well established. Wearing heels can also cause the muscles in the back of the leg to tighten, making it difficult for some women to place their heel on the ground when walking in flats.

But does wearing high heels do damage to other joints? Women have a higher rate of osteoarthritis of the knee compared to men. It is not well established if this increased incidence is a result of differences in hormone levels, obesity rates, or anatomy. Could wearing high heels increase the risk of arthritis?

Many women who have knee problems will stop wearing high heels because they hurt. Also, many women find as they get older they no longer wish to wear shoes that are not comfortable and that may increase their risk of falls. However, this does not prove that high heels cause arthritis.

Biomechanics of Knee Motion While Wearing High Heels

There are only a few studies that have looked at the biomechanics of knee motion while wearing high heels. In one study, 14 women were asked to walk in sneakers, 1.5 inch heals, and 3 inch heals. As heel height increased, walking speed decreased. Knee flexion increased at heal strike and mid stance. Knee adduction also increased as heel height increased, indicating possibly more reactive forces placed on the knee joint. Other studies have shown increased knee torque and patellofemoral joint reactive forces when high heels are worn.

These studies do not mean that wearing high heels causes arthritis. However, certainly wearing heals will alter gait and may lead to knee pain. Other than wearing sneakers, what can be done to minimize the effects of this increased stress on the knee?

How to Minimize the Effects of Increased Stress on the Knee

Balance is a crucial part of gait. Can you stand on one leg without loosing your balance? Can you do that in heels? When you walk, you spend a portion of your stride with one leg off the ground. If your balance is poor, you will put more stress on the muscles of your hip and knee as you struggle to compensate. Improving balance and strengthening gluteal muscles will take stress off the knees and hips as you walk in heels. Squats and lunges help to improve your dynamic stability.

Standing in heels changes the center of gravity, requiring more effort by the muscles of the low back to keep you standing straight. Core exercises to strengthen the abdominal and low back muscles are essential to maintaining good posture while wearing heels.

Stretching is also important. The calf and foot muscles tighten and contract to maintain that position. If these muscles are not routinely stretched and lengthened, they may become permanently contracted and stiff.


Although wearing high heels has been shown to place additional stresses on the feet and knees, there is no definitive proof that these added stresses result in arthritis. The added stress on the knees of being overweight is a much more important factor in the development of knee arthritis than shoe wear. Flexibility and strength are key to maintaining good posture while walking in heels. Limit the height of your heels to shoes you can balance in while standing on one leg. Find shoes that are more comfortable, with a wider toe box and thicker heel if necessary. And never let anyone talk you out of wearing shoes that you love.