The idea that high heels can be hazardous to your health isn't new—orthopedists have warned women for years that high heels can contribute to the development of a variety of conditions from corns and calluses to hammertoes, arthritis, chronic knee pain, sprained ankles and back problems.

Researchers link high heels and knee osteoarthritis, a painful, degenerative joint disease.

In 1998, a team of Harvard researchers linked high heels and knee osteoarthritis, a painful, degenerative joint disease characterized by the breakdown of the cartilage surrounding the knee. In that study, D. Casey Kerrigan, MD, associate professor of physical medicine at Harvard Medical School, and her team looked at very narrow, stiletto heels.

Wide heels no better
The researchers decided to look at the chunkier heels now in fashion to determine if they too are harmful to women's knees. The latest study, which appears in the April 7, 2001, issue of The Lancet, demonstrates that wide heels increase the risk of developing osteoarthritis in the knee as much as, or more than, spindly-heeled stilettos.

"Wide-heeled shoes give you the perception of more stability when you're standing, and they feel comfortable, so women wear them all day long," Kerrigan said. "They are better for your feet than stiletto heels, but just as bad for your knees."

Study measures knee torque
The study subjects were 20 healthy women with an average age of 34 and an average weight of 130 pounds. Each woman received one pair of shoes with a heel approximately 1.75 inches wide and another pair of shoes with a heel width of about half an inch. Both pairs were 2.7 inches high.

Study participants were then asked to walk 10 meters or about 32 feet, once in narrow-heeled shoes, once in wide-heeled shoes and once barefoot. Researchers measured knee torque, how much the knee twisted during each walk.

Low-heeled shoes or no heels are a woman's safest bet against osteoarthritic knees.

Both types of shoes increased knee joint pressure—26 percent more for wide-heeled shoes and 22 percent for narrow-heeled shoes. This kind of repetitive stress to the knee elevates the risk for osteoarthritis, according to physicians. Low-heeled shoes or no heels, researchers conclude, are a woman's safest bet against osteoarthritic knees.

"It takes a long time to feel the effects of knee osteoarthritis, and once you do, it's too late," said Dr. Kerrigan.