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November 2021, Christophe Champs

Whether you wear orthotics or not, shoes are the most basic level of support our feet get.

It’s not an exaggeration to say that your footwear has a huge impact on your health – from your feet to the ankles to the neck and every joint in between.

As soon and as long you wear them, whether you’re standing, walking, or exercising in them... they will bring pros and cons to the table.

This is especially true of heels. Having heels on a shoe creates the same effect as an orthotic heel lift or wedge that you’d get from a treatment plan.

But that’s not always a good thing. Let’s take it from the ground up...

The pros and cons...

Brown Cutout Shoe


Brown Studded Boots


Black Stiletto Heels





Flat shoes keep your foot and body in a neutral and natural position. The ankle joint is well engaged which has a positive impact on your stability and overall balance. Because the ankle has the difficult role to connect a small horizontal foot and a tall vertical body, it’s essential to keep this joint stable and engaged.


The heel impact is a crucial point in our gait. It’s a little like making a first impression, you’ll never have a second chance to make a good one. After landing on your rearfoot in a good position, your foot will simply rock heel to toes.




Not everyone can wear them. Long uses of high heels in women’s life tend to shorten the chain made of your calves’ muscles, Achilles’ tendon, and plantar fascia. The reason why some ladies find that they can’t wear flat shoes anymore without being in pain.







A bit of a heel is good to naturally arch your foot and reduce the tension on the Achilles tendon. A good heel must look like a step, not a wedge and it must be chunky, as stilettos make the rearfoot less stable. It is a shopping addict theory that wedges are better than a proper “step heel”. The heel bone will sit and rest on a proper heel while a wedge is going to push your weight forwards on the ball of the foot, quite often overloaded by a lack of arch support.




Let us not underestimate the action of a little heel. We saw the impact of “reduced drops” in running shoes. Reduced by 1cm only, the drop (difference between the rearfoot height and the forefoot height) without proper calves’ stretches was the source of multiple injuries affecting foot and legs.


As mentioned, the gait cycle becomes disturbed with high heels because the higher the heels the shorter and tighter the calve muscles. This of course goes for 2 inches heels too. Wearing them regularly means that you’re losing your natural elasticity on tendons and several mechanical pathologies appear. This could be things like rupturing or tearing that causes Tennis Leg, Achille tendinopathy, plantar fasciitis. This is bad news, as without any treatment, this shortening can become permanent.


In the clinic, at least once a week I will see a patient who wears a slight heel all week long, making her “Calves-Achilles-Fascia band” shorter. That is until she puts on a pair of flat trainers that stretches this band and naturally decides to be more active on it. The weakest parts of this chain are the Achilles tendon and the plantar fascia. These areas are often the source of Achilles tendinopathy and plantar fasciitis.






High heels elongate and define your legs. Your legs look better, but they won’t work better.




From 2 inches and up, having a heel on a shoe transfers your body weight to your forefoot instead of helping your forefoot to properly support your body and distribute its weight. It’s important to remember that from 2 inches and up, your heel is part of your leg rather than your foot. This makes your legs look longer but in the end your foot ends up much weaker than it should be.



The skin will build up!


The skin build-ups under the ball of the foot affect men and women. It’s created by an excess of compression (hyper pressure) and friction with the shoes – when the toes grasp, and the material of the shoes are rigid, inflexible with unforgiving edges.


Hyper pressures are the result of your body weight on the surface of the soles of your feet. Think of it in terms of this equation: hyper pressure = weight/surface. To reduce the pressure and avoid hard skin, you have two options. Reduce the numerator (lose weight) or increase the denominator (with a custom foot support). So before undertaking a diet, keep in mind that doubling the surface of your foot support with orthotics will have the same result as dividing your weight by two!



Your toes won't like them


A grasping reflex occurs when wearing high heels to avoid your foot from slipping in the shoe when walking. With time, your toes cannot straighten anymore as the deformity can become ‘fixed’ in some ligaments when they’re shortened. In turn your shoes rub on your toes, the toes each other and the skin develops blisters or breaks.



Your knees won't like them


According to the American Academy of Orthopaedic Surgeons, the altered posture of walking in high heels places excess force on the inside of the knee (a common site of osteoarthritis among women). One study found that knee joint pressure increased by as much as 26% when a woman wears high heels*.



Your back won't like them


Heels higher than 2 inches push the centre of gravity in the body forward, taking the hip and spine out of natural alignment. Therefore, high heels may increase the risk of arthrosis, which can be very painful.





In short, wearing high heels is like a sport, after a full day of wearing them, you must stretch your calves.


Although 3- or 4-inches heels are not good for you, you can still wear them but see them in your daily life like a piece of chocolate in your diet! Not too much and your health won’t suffer.

If you’re keen to find exercises that are best suited to your lifestyle, don’t hesitate to get in touch with any of the Physiotherapists, Osteopaths, Chiropractors, Barre/Pilates Instructors or Ergonomic Workplace Specialists who are part of our Trusted Network.



And if you have any questions for me, please email me at

*Source: “Women’s Shoes and Knee osteoarthritis” de Kerrigan DC, Lelas JL et Karvosky ME

Daily mail - heels  PODO.jpg

PODO answered the Daily Mail

From good posture to getting a promotion, Tanith Carey looks at how heels could improve your life . . . inch by inch.

"As soon as your toes are forced forward, your body leans forwards and your calf and buttocks start to tense up to oppose that force,’ explains orthopedic specialist Christophe Champs, of PODO London. [...] "

From wonderful walks in Hyde Park, Regents Park, the Thames path, Hampstead Heath Circular or simply when commuting to work through Oxford street, Piccadilly Circus, Covent garden, Mayfair, Soho... every step matters at Podo London!


Besides educating patients and sharing our tips to make your body works better, the Podo Clinic and Workshop, offers a thorough assessment to assess and analyse your posture, gait, and biomechanics. Providing all type of patients with custom orthotics made in-house, directly moulded onto the feet and ready to wear at the end of a single 90 minutes appointment.


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