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Member Research & Reports

Member Research & Reports

UAB Study Shows that Injury Rates from Wearing High-heeled Shoes Have Doubled

A 2003 survey reported that 62 percent of American women wore shoes with a two-inch or greater heel on a regular basis—and those shoes are taking a toll. New research from the University of Alabama at Birmingham shows that high-heeled-shoe-related injuries doubled between 2002 and 2012.

[Photo: Dr. Gerald McGwin]

“Although high-heeled shoes might be stylish, from a health standpoint, it would be worthwhile for those interested in wearing high-heeled shoes to understand the risks and the potential harm that precarious activities in high-heeled shoes can cause,” said lead investigator Dr. Gerald McGwin, professor and vice chair of UAB’s department of epidemiology.

In addition to discomfort in the lower leg, ankle, and foot, walking in high-heeled shoes has been shown to significantly reduce ankle muscle movement, step length, total range of movement, and balance control. Many studies have documented that the long-term use of high heels alters the neuromechanics of walking and places greater strain on the muscles and tendons of the lower legs, which can lead to musculoskeletal disorders later in life.

Dr. McGwin’s team looked at data from the Consumer Product Safety Commission’s National Electronic Injury Surveillance System (NEISS) of injuries associated with wearing high heels seen in hospital emergency departments between 2002 and 2012. There were 123,355 high-heel-related injuries seen during that period. The peak year for injuries was 2011, with more than 19,000. People between the ages of 20 and 29 were most likely to suffer an injury, followed by the 30-39 age group.

The vast majority of the injuries—more than 80 percent—were to the ankle or foot, with just under 20 percent involving the knee, trunk, shoulder, or head and neck. More than half were strains or sprains, with fractures accounting for 19 percent of all injuries. While White females as a group had the largest number of heel-related injuries, the rate of injury for Black females was twice that of Whites.

“Our findings also noted that nearly half the injuries occurred in the home, which really supports the idea of wearing the right footwear for the right occasion and setting. Also, to reduce the time of exposure, we recommend that those wearing heels be aware of how often and for how long they wear them,” said Dr. McGwin.

Co-investigators in the study are Mr. Justin Xavier Moore, pre-doctoral fellow in UAB’s department of epidemiology and graduate research assistant in the department of emergency medicine; Mr. Brice H. Lambert, research assistant in the department of psychology; and Ms. Gabrielle P. Jenkins, former research specialist and teaching assistant in the department of epidemiology and current doctoral student at the University of North Carolina at Chapel Hill.

“Epidemiology of High-Heel Shoe Injuries in U.S. Women: 2002 to 2012” was published online in May in The Journal of Foot & Ankle Surgery.

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