Head over heels for Stilettos – Is it worth the pain?

Common conditions, Lifestyle, Pain

high heels

Most of us would desire to wear that pair of Louboutin’s or to own a pair from Lady Gaga’s shoe stash. Whether you want to steal a celebrity style secret or wear a pair to match your outfit, there’s no denying that women of all ages love them.

What high heels do 

They change your posture so that your lower back is arched, your pelvis and chest is thrust forward, the buttocks are tightened and the calf muscles firm. This makes you taller, feel slimmer and overall changing your silhouette. With the right pair, it also enhances your authority and presence.

As amazing as it sounds, wearing high heels can be a daily struggle for many women. Wearing the wrong size, shape and fit causes undue stress and pain in your calves, knees and back. Most women are unaware of the amount of stress high heels can place on their body. Back pain, hip pain, knee pain, ankle pain and/or foot pain can all stem from incorrect shoes.

Walking – Correct Pattern of Movements

The pattern of how our body parts move while we walk is called the gait. From the time your heel strikes to the next time the same heel strikes again, there are a series of movements occurring at your hips, knees and feet.

GAIT

Posture, Centre of Mass and Gravity
 

Correct posture improves muscular function and brings stability to your moving body. Your stability is also determined by a mid-point in your body that has the most gravitational pull, this shifts according to body movements.

 
Body Stability
Think of a car as the moving body and the gravitational force acting at its centre. If this car had to tilt sideways, the centre of mass and line of gravity would be shifted to the heavier side, causing an imbalance in forces.
car and gravity.
Wearing High Heels
 

Your ankle is forced into an unnatural downward position and the body adapts itself to maximise limb stability. Putting you in a highly unstable and vulnerable position to sustain an injury during movements.

When standing straight up without heels, your body creates a 90-degree angle on the floor, which is normal stance. Think of your body being a rigid column, putting on a pair of heels would force your body to tilt forward. The angle between the floor and heel would decrease from 90 degrees to 70 degrees.

angles with floor

However, the body is NOT a rigid column. Our posture adjusts to maintain stability and these adjustments pose greater stress on our back, knee, ankle and foot.

Postural Changes

High heels change the alignment of your spine, hips, knees and ankles pushing your centre of gravity forwards. This causes excessive pressure on the front of your knees.

posture-with-high-heels

Muscular Imbalances

Prolong use of high heels can cause excessive shortening of calf muscles resulting in the thickening of the Achilles tendon. Walking around barefoot or in flat shoes may cause pain and discomfort. If you are experiencing this, it may be time to seek treatment before it is too late.

achillis tendonitis

High Heels vs No Heels

During normal stance, body weight is spread evenly from the heel and ball of the foot. So, the center-of-pressure (COP), where the most weight is distributed, is located in the middle of the foot.
 
When standing in high heels, the shift in angle causes the body’s weight to tilt forward. The center of pressure is shifted to the ball of the foot. 90% of the body weight is now focused on the ball of the foot.
 
pressure areas
 

High heels and joint problems

The higher the heel, the greater the stress potentially causing strain, pain and stiffness of the ankle and knee joint structures. It is also been reported that wearing heels more than 3 inches over time puts women more at risk of ankle and knee osteoarthritis. The effect is worsened in overweight cases.

Painful conditions due to High Heels

  • Bunions

Bunion is a condition when your big toe joint begins to lean inwards and becomes enlarged. It is more likely to be triggered by wearing very pointy shoes or  shoes that are too tight on your toes. You start with swelling, redness, tenderness and pain at the base of your great toe even when you’re barefoot. Over time, your big toe deforms and pushes inwards towards the other toes. This changes the normal positioning of your toes, spreading pain in the front of your foot and a loss in foot aesthetic will also occur.

Toe alignment correction

  • Metatarsalgia

This is a symptom caused by excessive stress and inflammation on the front of the foot while standing in high heels. It is felt on the metatarsal heads and pain gradually increases over weeks rather than suddenly. The front area of your foot may also feel tender when you press on it. The pain lasts during weight bearing and depends on the extent of stress on your metatarsals.

metatarsalgia

  • Hagland’s Deformity

High heels with back straps that are constantly rubbing against the upper part of your heel cause Hagland’s deformity.

You’ll notice:

  • A bump on the back of the heel
  • Pain in the area where the Achilles tendon
  • Swelling and redness in the back of the heel

foot deformity

This will eventually lead to bursitis. A Bursal is a fluid-filled sac that separates tendons from bones. An inflammation of this sac is called bursitis. Bursitis will cause Achilles tendonitis and make the bump even more prominent and painful.

  • Hammer toes

Excessive and prolonged weight and stress deform the toes into a bent position which does not correct even at rest. The muscle and ligament imbalances over the toes cause inflammation and rigidity leading to arthritis.

hammer toes in shoes

Walking on a Marble – Morton’s Neuroma

This condition is caused due to excessive thickening of the tissues around the nerves of your toes. The most frequent location is between the 3rd and 4th (3rd web space) and less commonly in 2nd and 3rd metatarsals (2nd webspace) as the foot is narrower between the third and fourth metatarsals. This means that the nerves that run between these metatarsals are more likely to be compressed and irritated.

You will feel pain worsen when walking barefoot or if the metatarsal heads get squeezed together in your narrow fitted shoes. Pain comes and goes intermittently. You may experience severe pain attacks from two to several times in a week.

Mortons-Neuroma

Although there are many painful conditions associated with the use of high heels, the demands for it keep increasing because of fashion trends and downright vanity.

It would not be wise to sacrifice fashion for health and comfort. But with every problem, there is always a solution. Wearing just the right height of heels will help ensure good foot placement and minimize injury to your body. If you are a fan of high heels, you may want to seek expert opinion on how to maintain foot health or wear insoles to ensure good arch support and equal weight distribution. The solution may not be a perfect one, but we always aim to create a solution nonetheless. It’s easy to say ‘no, stop doing it’ but why people come to us is as we create imperfect solutions in order to let people keep doing what they love.

Low Back Pain – The Mystery Revealed

Common conditions, Lifestyle, Pain

low back pain

It’s fascinating how our bodies are unique. In this diverse life on earth, humans fall into the category of “vertebrates”, simply put – the one with a backbone. Our spine is made up of 24 moveable bones called vertebrae. Each vertebra stack over another at the facet joints to form your spinal column which ends on your sacrum (tail bone).

osteopathyspine

Spinal Column

The spine is divided into three segments:

  • Cervical (Neck) – 7 Cervical vertebrae
  • Thoracic (Upper and mid-back) – 12 Thoracic vertebrae
  • Lumbar (Low back) – 5 Lumbar vertebrae

The inward curve of your lower back is called lordosis which is unique to the human spine and helps us stand straight. The other slight upward curve of your upper back is called kyphosis. The reason why you have an “S” shaped spine with these natural curves is to prevent excessive stress on one particular spine segment. It provides the right balance and distributes any mechanical stresses imposed on your body during sitting, standing, running, lifting and other daily activities.

Vertebral sandwiches 

Between two vertebrae lies a fluid-filled cushion called spinal disc. Its function is to prevent the bones from rubbing against each other. All the discs of your vertebrae have a spring-like effect and are great shock-absorbers due to its gel-like elastic texture.

Disc problem

Connections – Spinal cord and Nerves

Your brain continues down as the spinal cord which runs through your spine within a canal formed by all vertebrae.  Several nerve roots branch out next to the discs from your spine and supply signals to the arm, trunk, and leg muscles for movement. These nerves are the connections our brain makes with all the structures of our body.

3d rendered illustration of the male nerve system

Ouch! My back hurts

This is the problem. We are aware of the fact that our bodies can adapt and heal itself. Yet, we often fail to listen to our body and push ourselves beyond our body’s tolerance capacity. We start with aches and pains, realizing when it’s too late that there’s something much worse happening. This may sound harsh, but you may be giving yourself back pain by not listening to your body.

What’s happening to your back?

Stress

How much weight can your spine take? Do you really know your spine’s load bearing capacity?

Loss of Spinal Bracing

When you engage in an activity, all the supporting structures of your spine like the ligaments of your spine, back muscles and abdominal tighten to brace your spine. In order to maintain strong spinal support, soft tissue needs to maintain their optimal length. When muscles and ligaments shorten or lengthen beyond their optimal length, they lose their capacity to brace the spine imposing greater stresses. This results in a shear force on the spine which may cause discs to pop.

Excessive effort for Strenuous activity

When lifting, the heavier the load and the further away the weight is placed from your body, more effort is imposed on your back muscles increasing mechanical stress to your spine.

incorrect lifting

Curve gone wrong

The soft “S” shaped curve of your spine is lost. Poor postural alignment can severely affect the lower lumbar curve. The curve could either get exaggerated or flat. exaggerated posture

The position of your pelvis, your hips and the muscles around them play a major role in maintaining a normal low back curve.

Disc problems

Injury to your spinal discs is one of the most common reasons why you have low back pain. Faulty exercise methods, high impact sports activities, lifting heavy weights or even sleeping incorrectly could predispose great amount of stress on your spine. The disc injury could be of various types and degrees that could affect the spinal cord and compress the nerve roots causing pain to be felt immediately in your back or down the back of your legs.

disc problems

Think of a normal burger with all its contents perfectly fitted within the bun. Now imagine pressing onto it causing all its contents to bulge out.

disc bulge

Lack of Nutrition

Weak bones

The load bearing capacity of your spine also depends on the amount of bone mineral content.  The risk of injury is expected to be more among people with low bone density. Lack of vitamin D (sunlight), calcium and other minerals are reported to be less in women than men, thus putting women more at risk of back injury than men if proper care is not taken.

Disc Dehydration

The disc as previously discussed is a fluid-filled gel-like cushion structure between each vertebra. The outer part of the disc is gelatinous and the inner part of the disc is filled with water. During the day, as you engage in various activities, water is slowly squeezed out of the disks. This loss of water is then recovered by your spine by successfully re-hydrating your discs while you sleep. When you are dehydrated and your discs are unable to re-hydrate, they become rigid and lose their capacity to absorb shock thus leading to disc degeneration and back pain.

Protect your Back

Although there are several treatment methods used by clinicians, identifying the source of your back pain at an early stage and taking appropriate precautions is the best solution. You may want to consider getting your spine assessed by an expert and if necessary get early treatments. We always believe it is better to be preventive than reactive!

Heal your heel – An insight to Plantar Fasciitis

Exercise, Lifestyle, Pain

Heel pain

Have you ever walked on broken glass? Or experienced walking on a bed of nails? Not something that you would ever wish for yourself or anyone. But this is exactly how you would relate to if you have bad heels. It’s frustrating, extremely painful and debilitating. Many of us who have experienced plantar fasciitis have had the firsthand experience of how the pain takes over your mind and stops your world.

What you need to know?

Heel pain is a symptom and the most common reason why you might have it is because of plantar fasciitis. So what is this difficult-to-pronounce “Plantar fasciitis” (“Plan-ter fash-ee-eye-tus”) all about?

Plantar Fasciitis and heel spurs

Before I explain what plantar fasciitis is, let me provide you with a simple understanding of what your body is made of. Most of us know that our body is made of muscles, tendons, bones, joints and so on. The most overlooked part is “fascia.” Fascia is the largest sensitive band of tissue that covers and cushions each and every internal structure of your body. Kind of like your body’s internal cling film.

Plantar fascia is one such superficial taut band of fascia present beneath the skin on the sole of your foot. This elastic band runs from the heel of your foot to the front of your sole towards your toes, supporting the arches of your foot to distribute your body weight onto your feet. It acts like an inbuilt trampoline with great shock absorbing properties.

Plantar fascia

So when there is weakness, pain, loss of hydration, inflammation or tear of this fascia, it causes a direct pressure of your body weight onto your heel causing sole pain. Over time, there could be calcium deposits developing underside of your heel bone called “heel spurs” which could be detected via an X-ray.

heel spur

Are you the reason why you have painful heels?

The exact cause of plantar fasciitis is unknown. However, some of the most common reasons why plantar fasciitis could occur are as follows:

  • Overuse or micro tear –  Fascia damage due to standing for long hours or repeated uphill workouts.
  • Tight calf muscles – This causing excessive pull and strain to the fascia.
  • Faulty shoes– Too hard or soft surface, high heels (Stilettos) or flat shoes with insufficient arch support.
  • Excessive or sudden weight gain – Due to pregnancy or obesity.
  • Flat or very high arched feet – This causes the fascia to over-stretch or shorten.

The “Happy feet” Treatment Approach

Because this condition can be quite the challenge to treat and often take a long time to heal, most clinicians are always finding new effective ways treatments methods.

Depending on the extent of injury to your plantar fascia and the time period of your pain (acute or chronic), some of the best drug-free ways to get you back on feet are:

  • Therapeutic Massage

Plantar-Fasciitis massage

Different techniques of massage will enhance the blood flow to the fascia and promote healing.

  • Ice application

icing plantar fascia

Ice application reduces inflammation as it contracts the blood vessels and when combined with massage it will reduce pain, inflammation and promote healing.

  • Foam Roller

foam roller calf

The use of foam roller to bring about a massage-like effect, this relaxes tight calf muscles.

  • Calf stretches

Osteopathy calf stretch

Although there are several techniques to stretch your calf muscles, one of the simplest one can be done in sitting with legs stretched out. Use a belt or a towel to wrap around the foot and pull it towards your chest holding both ends of the belt or towel. Hold for 30 seconds and relax. Repeat at least 3 times for best results.

  • Ultrasound therapy

therapeutic ultrasound

Ultrasound therapy is the use of high-frequency sound waves on injured tissues causing a deep circulatory effect that will enhance tissue healing.

  • Extracorporeal shockwave therapy

Osteopathy Shockwave therapy

“Extracorporeal” means from outside the body and “shockwave” means a pressure wave. So high energy pressure waves are used on injured tissues to reduce pain and recreate micro-trauma to stimulate the healing process. It is also best used for bone spurs treatment.

  • Kinesiology Taping

Kinesiology taping

Kinesiology taping is a technique used for applying therapeutic tapes on soft tissues to enhance healing without causing any restriction to joint motion. It will help relax your foot muscles, reduce any swelling and provide support to the arches of your foot.

  • Corrective shoes, Insoles and Orthotics

Osteopathic Insoles

An insole provides support to the arches of your foot and helps to correct high or low arches according to your condition. It helps to evenly distribute your body weight on your feet and mostly used as a supplement to wearing good shoes.

  • Strength training exercises

Heel drops and raises

High-load strength training is the newest approach used for treating plantar fasciitis. It’s simple and just requires you to stand with both your feet on the edge of a stair. You start by letting your affected heel hang over the edge of the stair for 3 seconds followed by raising it up to hold for 2 seconds and then dropping it down again for 3 seconds. Aim for 3 sets of 12 repetitions

It is believed to increase collagen formation that helps normalize tendon structures and improve the load-bearing capacity of the plantar fascia.

Now that you know more about your heel pain and it’s available treatments. It would be wise and worth trying some of them. Though you may not be pain-free overnight, but it will certainly help you heal your heel sooner than you think!