As musculoskeletal specialists, osteopaths are trained to assess the biomechanics and structure of the body and give feedback as to the potential causes of back pain as well as provide a diagnosis.
In reality the cause of back pain is often elusive, the case history and assessment of the structure and function of the body give us some clues as to what is contributing to the picture and there are usually multiple factors from the more recent history of a person, right through to their birth. However, there is one common factor that I come up against regularly with a fair proportion of my business clients – high heels! This footwear item is a fashion and power statement with 31% of women wearing them for work daily (in the US). The Spine Institute reports that heel wearing has decreased by 20% from the mid 80’s to the mid noughties, but it is still a common footwear item for 49% of 18-29 year olds who wear them every day.
For some of the ladies who enter my office for treatment for their lower back or neck pain, the evidence that their shoe choice has on their spines and the rest of their body’s is quite clear. Although as mentioned there are often other contributing factors such as a sedentary and deskbased occupation which simply adds the postural problems which result from footwear. But why is it that when these ladies leave knowing that their shoes are contributing to their spinal problems, are they still reluctant to change their footwear? The reality is the answer is complex, but there are factors such as self esteem and confidence of which feelings can be enhanced by what we choose to wear.
Here’s the science bit. When we wear shoes which are raised at the heel we must compensate for the shift forward that our weightbearing would encounter – and we compensate for that by having to pull ourselves backwards. This means that our lovely lower back curve is greatly exaggerated, because if it didn’t, we’d just fall forwards, we also push our chest out to help balance this shift in weightbearing. Added to this compensation for forward weightbearing, we have the tightening of the dreaded hip flexors (my clients will often hear about these). These muscles adapt (as all of our body does) to the predominant postural strains we put on them. When we are sat at our desks all day long, these muscles become shortened effectively pulling our lower backs forwards and down when we stand up – the same strain which results from wearing heels – so we can’t get away from the fact that office work and high heels are a bit of a problem for our spines.
If you really want to wear heels for work, then here are some tips:
-Choose an inch lower when you buy new ones – higher the heel, the more the compensation.
-Choose a wider heel – stilettos are the worst, more surface area causes less pressure.
-Make sure you do Pilates or yoga regularly to align your body and relax muscles.
-Can you wear heels less often? Flats for the office, heels for meetings?
-Walk in your breaks preferably in flats to loosen up your joints and muscles.
-Have your spine and posture assessed by an osteopath – that way problems can be spotted earlier!
Claire Hawes, osteopath and senior musculoskeletal practitoner can be seen at Back to Balance, Newcastle Business Park, call 01914661441 for appointments (evenings available), £10 off initial consultation when you mention this article at booking. www.back-to-balance.co.uk