Foot Anatomy, Biomechanics and the High Heel

Foot Anatomy, Biomechanics and the High Heel

"It’s a fact that women wear high-heeled shoes to highlight and enhance their appealing posture and gait. Physics and recent scientific research explain exactly what role these tall shoes have in creating the infamous high-heeled gait, or strut. Unfortunately, the dynamics behind these shoes also explains the pain associated with wear. Technology and materials innovation are helping mitigate these negative effects on your feet and body."

Supermodels are admired for their provocative struts down the catwalk. This appealing gait requires short bouncy strides, toes pointed to the ground, and hips thrust forward. There is no doubt that those who have perfected this walk have talent, but just like many athletes, their performance requires a good shoe. This shoe is the high-heel, and a new style has been engineered because, as every lady knows, a long night in heeled shoes results in sore feet. The root of all the aches and pain is that attractive walk the devil is in the detail, not in the fashion look!

 (Perceived Heel Height - Actual distance between the bottom of the heel and the bottom of the forefoot)

Heel height is generally understood to be the measurement of the bottom of the heel to the top of the heel. However, from a bio-mechanical standpoint, when we think about heel height we refer to the distance of the displacement between the heel itself and the ball of the foot. Physics allows us to understand that the greater this height differential the greater the amount of pressure applied to the forefoot. The distances below define a percentage increase on the pressure applied to the foot, similar to the way “G” forces work in a plane.

2.5cm heel height = 22% increase in pressure on the forefoot

5cm heel height = 57% increase in pressure on the forefoot

7.5cm heel height = 76%. increase in pressure on the forefoot

It’s appropriate to consider this information and the added pressure on the forefoot from the high heels, can cause muscles in the leg to become fatigued or function abnormally for long periods of time. One may develop “form” issues in the sense of poor posture, stress on the back of the knees, shortened calf muscles, or even spine problems over time.


Let’s Review Some Anatomy (and how high heels affect them):

Feet: The feet can be considered the base or foundation of the body’s skeleton. For those home owners out there, you may know, if you don’t have a good foundation, a home may be subject to unevenness and instability. If there are issues in the foot, then the toe and ankle joints become unsteady, arthritic, and painful which can lead to bunions and hammertoes.

Calf muscle: The calf muscle or Gastrocnemius-Achilles tendon unit is one of the strongest muscle-tendons in the body. It helps one during push off and the propulsive phase of gait (walking). It works best when it is elongated and glides freely. Wearing high heels can shorten this muscle-tendon unit over time, which can then lead to problems when walking barefoot or in other shoes.

Knees: Wearing high heels shift the knees forward, thus straining the back of the knees and hamstrings.

Hips: As the centre of gravity continues to shift forward, the hips become affected and can throw off one’s posture. Many thigh muscles originate from the hips and control how one stands, walks, or runs.

Back: As the knees and hips move forward, the back compensates by hyperextending backwards.

Gait Cycle:

 (Gait Cycle - Contact, Mid-Stance and Push Off)

The alteration in stance induces a change in gait. A normal walking cycle consists of a three-part sequence. The cycle begins with the heel coming into contact with the floor, which is known as contact. The rest of the foot is gradually brought down until it is flat on the ground, as in a normal stance. This phase is called mid-stance. Then the foot progressively rolls pressure towards the ball so the heel raises up, which is known as push off. These three steps switch back and forth between feet to produce a fairly smooth stride.

Each gait cycle in a heeled shoe is faster than cycles in flat ones because of the shift in the centre of gravity. To initiate a walking step, you lean forward until you lose your stability. You begin to fall forward, and you step with one foot to catch your fall and re-establish your stability. 

Because a shift in centre of gravity makes a person less stable in heels, stability is lost more quickly when walking in high-heels, so you have to 'catch your falls', or take steps, more often.

So how do we overcome these negative effects?

Moderation Like our parents may have told us growing up “everything in moderation” or “moderation is key”. Do not wear high heels more than 7.5cm high for extended periods of time. Also, make sure that your feet/ankles are stable when wearing them. When wearing high heels to work, change into a lower shoe when able.

Variation: Yes folks another reason to buy more shoes! But seriously; Don’t wear the same type of heel every day. When shopping, look for more open, peep, and round or square toe shoes. Also, make sure your higher heel shoes have a platform sole this decreases the perceived heel height in the shoe in turn decreasing ball of foot pain (metatarsalgia).

Sizing: Even though you may think you’ve always been a certain shoe size, this doesn’t mean that you are currently that size. Have your feet measured often and try on your shoes in the afternoon/evening to accommodate for any swelling that may occur throughout the day. Other factors that can change the size of your feet include adult growth spurts, pregnancy, and weight gain/loss.

Stretching: There are stretching exercises for every part of your body, including your feet. Perform a range of motion and stretching exercises wherever you can. They can include wall stretches to prevent over contraction of your Achilles tendon, drawing the alphabet using your big toe like a pencil or index finger, and wiggling/extending your toes. Bottom line – move them!


High-heeled shoes are a classic way to enhance appearance because they create a classic poise and walk. They are able to transform the body to move in a provocative way mainly because they shift the centre of gravity and cause the body to use more muscle and movement to maintain balance. Women have forever been complaining about the way these shoes make the body ache, so innovations are finally being made to high-heeled shoes to overcome this.