Grand Finale

Finally, the long awaited 3rd and final post!

Believe it or not, what you wear on your feet can drastically effect your hips, low back, and even mid back and neck – especially high heels! The question is, why?

It all comes back to the word I spelled out in the First Blog PostPOSTURE. High heels create postural adaptations due to change in foot position, which alters the center of gravity. Basically, it pushes your weight forward, so you must compensate in some way to prevent yourself from falling forward on your face! This brings us to the hips and lumbopelvic complex!

Check out the picture below. This is a silhouette of a woman wearing flat shoes and high heels. You can see on the right, her lumbar spine arch is pretty exaggerated and the line of her pelvis is slanted at a much greater downward angle. We call this a compensatory Anterior Pelvic Tilt and Lumbar Hyperlordosis. This is the most common way to relocate the center of gravity back over the center of your ankles, so that you don’t fall on your face while wearing heels! The higher the heel, the more drastic this effect. Why is this important? I’m glad you asked.



In most cases, to accomplish this, your low and muscles are working much harder in attempt to keep your upper body from falling forward. There is also increased load on your lumbar facet joints in this position, which are not the joints supposed to be holding most of your weight! There is also decreased lower abdominal recruitment due to the anterior pelvic tilt position. As for the hips, the hip flexors are in a shortened position and tend to rest in an internally rotated position, which also feeds into a pelvic anterior tilt. The result of all of this? A pretty decent recipe for some chronic, achy low back pain if you are a staunch wearer of stilettos! This could originate from muscles or joints, but you’ll have to pay a visit to your physical therapist for that answer.. 😊

Up the chain farther, there may even be changes in your cervical spine! While in heels, the head rests in a more forward position, in some cases, due to the aforementioned postural changes. This is bad. A common cause of neck tightness, neck pain, and even tension headaches is the dreaded forward head posture. Usually there is a much more predominant cause of this, which is for another time and another place, but just know that your high heel wearing could be one factor in this posture!


So, the biggest thing I hope you learned after these 3 blog posts is that high heels alter your posture. As I’ve described, this can cause foot pathology and pain, ankle pain, knee pain, low back pain, and can even play a role in neck pain and/or headaches. This is all due to abnormal forces through your joints because of the change in your foot position and the effect of gravity!

Now, I want to hear from you… Do you wear heels regularly and have you for a long time? Do you have chronic joint pain at any of the joints I’ve discussed? Tell me your story in the comments section or on Facebook! Thanks for reading!