OVERVIEW
Wearing heels is not, on its own, a clinical problem. Wearing them for long hours, most days, over years is a different matter — because of where the load ends up.
A raised heel tips your pelvis forward and pushes your centre of gravity ahead of the knee. To stay upright, the muscles at the front of the thigh work harder and the knee stays slightly bent for longer. That combination raises the pressure inside the kneecap joint with every step.
HOW HEELS CHANGE THE KNEE
How heels change the knee
- Increased joint pressureBody weight moves forward, so more compressive force passes through the front of the knee — particularly the patellofemoral joint behind the kneecap.
- Altered alignmentThe pelvis tilts and the low back arches to compensate. Over time this affects posture at the hip and spine, not just the knee.
- Calf and Achilles shorteningRegular heel wear keeps the calf in a shortened position. Coming back to flat shoes can then feel stiff or painful at the heel.
- Long-term wearSustained load can contribute to cartilage wear and, over many years, is associated with earlier onset of knee osteoarthritis.
PROTECTING YOUR KNEES
Protecting your knees
- Keep heel height at or under two inches for regular wear
- Treat higher heels as occasion wear rather than daily footwear
- Choose a wider heel base and a cushioned sole over a narrow stiletto
- Carry flats for the commute and change at your destination
- Stretch your calves daily if you wear heels often
- Strengthen your quadriceps, glutes and core — a strong leg tolerates more load
IN SHORT
Heels are not the enemy; unbroken hours in them are. Vary your footwear, build leg strength, and treat new knee pain as information rather than something to push through.
A note from us: This article is general information, not a diagnosis. Individual causes and responses vary, and a clinical assessment is required to determine what applies to you.