Wide Heeled Shoes Bad For Knees

NEW YORK (Reuters Health) - Women who wear shoes with wide, chunky heels may feel smug about sacrificing fashion for health, since these shoes are thought to be easier on the ankles and knees.

Now, it seems, the shoe may be on the other foot.

According to a study in the April 7th issue of The Lancet, women who opt for wide heels may have a higher risk of developing knee osteoarthritis, a condition in which the cartilage that cushions the knee wears away, compared with women who wear stilettos.

``My advice is straightforward but may be hard to take for those who are ardent high-heel wearers: Stop wearing high-heeled shoes,'' says Dr. D. Casey Kerrigan of Harvard Medical School in Boston, Massachusetts.

He said that osteoarthritis is one of the most debilitating diseases of old age and rates of the disorder are expected to rise as life expectancy increases. The only way a person can lower their risk is to maintain a healthy weight and avoid high heels, which compromise the dynamics under the foot and cause the knee to twist and turn in ways it was not meant to, he explained. Over time, the protective cartilage wears away.

Indeed, osteoarthritis appears to be twice as common in women as in men, although pressure on the knees is the same when men and women walk barefoot.

The study looked at 20 women whose average age was 34 years and average weight was 59 kilograms--about 130 pounds. Each woman received a pair of wide-heeled shoes and a pair of stilettos of similar heel height, about 7 centimeters (2.75 inches). Researchers measured the forces on the knees during a 10-meter walk in each pair of shoes.

The wide-heeled shoes were found to increase the inward twisting force on the knee by 26% compared with 22% for narrow-heeled shoes. (abstract) This force in turn increased compression on the insides of the knee joints, which are particularly prone to osteoarthritis.

``Wide heels may be more dangerous than narrow heels because they feel comfortable, may provide more stability and may not deform the foot, like narrow-based heels,'' said Kerrigan, the study's lead author. ``For these reasons, they may be worn for greater periods of time.''

SOURCE: The Lancet 2001;357:1097-1098.

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