How much are your heels impacting on your health
High heels are favoured by plenty of women, but just what effect will they have on your spinal health.
We got the expert, Dr Martin Knight, a back specialist on Harley Street to share his knowledge.
Martin is one of the countries most forward thinking and well respected physicians. He also heads up the Spinal Foundation - a charitable trust raising funds to support the development of Endoscopic Minimal Invasive Spine Surgery.
Martin discusses the long-term effect of wearing high heels, heels during pregnancy and the impact it has on labour.
The impact of wearing high heels on the spine during pregnancy
High heels are distinctly glamorous – consequently women are wearing them increasingly frequently and in many cases constantly. Heel height varies from elevated to extreme and so does the effect upon the health of the foot, heel and spine. This can be particularly important in pregnancy.
The normal Caucasian vertical posture takes the weight bearing axis passes from the earhole through the hip to just in front of the ankle.
As the pregnancy progresses, the abdominal muscles stretch, and the baby’s weight causes the pelvis to tilt forwards and the back has to arch backwards to restore balance with the net effect of squeezing the nerves as they exit the small doorways (foraminae) of the spine and straining the facet joints in the back of the lumbar spine. Loading increases in the back of the disc which may exacerbate symptoms in a vulnerable or degenerating disc. To maintain overall balance and especially where the mother is overweight the thoracic spine may stoop and the neck over arch. All of the above may lead to pain in more than one spot in the spine.
To adapt to the change in weight and balance, mum’s gait will lengthen and may develop a lateral “waddle”. The hamstrings are attached to the knee and pelvis and help to bend the knee and straighten the hip. Where the hamstrings are tight for instance from prolonged sitting, then this will impose forced counter rotation and strain on the pelvis and spine, aggravate irritation of the nerve disc and joints and cause pain.
Due to these changes in posture, gait, hormonal ligamentous relaxation and altered sensory feedback from their limbs 27% of pregnant mothers will fall during the mid-portion of pregnancy often when rushing over slippery floors or carrying objects or children.
High heels heighten the risks of the above by throwing the body line forwards and increasing the compensatory arching spine postures and reducing the stability of the foot and contact with the ground and spatial feedback. The result is greater risk of falling, of irritation and pain in the spine and overload of the foot, ankle and heel (plantar fasciitis).
So to be honest carry out core stabilisation drills and hamstring stretches and use flatter heels throughout pregnancy and try to keep from putting on unnecessary weight.
The long-term impact of high heels on the health of the spines and posture.
During pregnancy ensure a suitable intake of calcium and Vitamin D3 to maintain the strength of the bones. After giving birth you really need to regain control and strength of the abdominal muscles, diaphragm and pelvic floor and the deep muscles in the back of the back so the the pelvis rotation can be restored to normal. The hamstrings need to be stretched and the gait needs to be narrowed. The posture of the whole spine needs to be addressed:
- using a warm up stretch of the hamstrings in flat footwear
- followed by cervical spinal drills (pulling the chin back, pulling the shoulders down by rotating the arms round and backwards and squeezing an “orange between the shoulder blades”)
- lumbar spinal drills to correct the abdominal and deep spinal muscles (squeezing the “bum” and tucking the “tum” in and holding these muscles for 20 seconds 10 times a session 4 times a day).
- Try to get supervised Muscle Balance Physiotherapy
- Try to use high heels only on special occasions
Impact on Labour
The likelihood of normal vaginal delivery is said to depend upon the 4 Ps: Powers, Pelvis, Passenger and Posture. If the muscles balance exercises have been adhered to and the muscle power has been maintained and with it the pelvic orientation and the lumbar posture has been sustained then the chances of a satisfactory vaginal delivery are optimized with minimized stress to the baby.
There is insufficient randomized clinical evidence that posture can dictate or alter the presentation of the baby in the womb. However reduced use of high heels may make for simpler birthing.
Wearing high heels during pregnancy?
The answer is sometimes and only on special occasions and where the ground surface is flat and dry, walking distances and standing durations are short and the distractions can be contained. Remember that your spatial awareness feedback is jeopardized when in high heels, your control of your ankles is put under increased strain and falling with a “baby on board” is no fun and frightening.
The example of celebrities?
Pregnant mums should not really try to imitate celebs because these celebs are less likely to travel, stand for prolonged periods, go shopping, walk the kids to school or the dog round the park, attend work in the same way as the public so the effect will be less on them and who knows maybe they throw them off when out of the lime light.
Tagged in Health back pain Pregnancy Health Heels