Your heel and your health

Nicole Kidman has admitted a passion for high heels but are those extra couple of inches doing us good or bad? While it seems flatties can relieve computer eye-strain high heels can improve your circulation and tone up your legs. We weigh up the highs and lows of heels.

HIGH HEELS

For

THEY TONE CALF AND THIGH MUSCLES Jason Henry, a London-based fitness trainer, says walking in heels alters your centre of gravity, training your legs to produce muscle, especially in the calves and thighs.

'Essentially, in heels, you are doing what amounts to a full day of calf raises, adding definition to the shape of your legs,' he says.

'However, the excessive wearing of heels can permanently shorten your calf muscles. To avoid strain, you shouldn't walk more then two miles at a time in heels, and you should keep heel height to under two inches.'

THEY IMPROVE CIRCULATION IN THE LEGS For people who suffer poor circulation and are prone to swollen ankles, a shoe with a slight heel (around 1in) can boost the amount of blood and tissue fluid that is returned from the legs to the upper body.

'Blood and tissue fluid is returned to the heart through veins, which are squeezed and stimulated by surrounding muscle,' explains osteopath Gavin Burt. 'Heeled shoes stimulate this system by tightening leg muscles, so may be good for those with a sluggish circulation.'

THEY MAY EASE LOW-BACK PROBLEMS Back specialists argue that modest heels (about 1 1/2in) can improve alignment of the lower back, reducing the risk of low back pain.

'Some people have a spine that is, literally, too straight,' says independent massage therapist Jan Fielding. 'They lack a natural curve in the low back, causing muscular tension and pain. For these people, wearing heels can restore a healthy curve and so ease tension.'

Against

THEY CAN STRAIN THE KNEES AND INCREASE THE RISK OF ARTHRITIS Excessive heel height can damage your knees. In a study published in The Lancet, Harvard researchers linked wearing high heels with a height of around 2.7in to a 24 per cent increase in 'knee strain' - a factor that is closely linked to a raised risk of arthritis. The results imply that very high heels are best limited to special occasions.

THEY REDUCE MENTAL ALERTNESS Heels of more than 2in can significantly increase muscular tension throughout the body, constricting blood vessels and limiting blood supply to muscles and the brain.

'So, if you're standing in high heels for extended periods, this reduces the flow of oxygen and nutrients to the brain, contributing to a feeling of fatigue,' says Gavin Burt.

THEY CAN COMPACT THE SPINE In people who already have a pronounced arch in their low back, regular heel wearing can have a marked effect in compacting the spine.

'This can pinch on nerves and compact vertebrae to cause longterm stiffness,' says Gavin Burt.

He suggests regular 'heel breaks' - wearing flat shoes at least every other day.

THEY INCREASE THE RISK OF FOOT PROBLEMS High heels can also result in a variety of foot problems, including bunions and metatarsalgia, which is pain in the ball of the foot.

Another condition, called Morton's neuroma, is caused by a thickening of tissue around a nerve between the third and fourth toes, and usually develops in response to the weight burden high heels place on the ball of the foot. It is treated with cortisone injections and, sometimes, surgery.

FLATTIES

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THEY HELP ALLEVIATE STRESS Flat shoes with cushioned soles take strain off the joints, encourage muscular relaxation and even combat psychological stress, according to a recent Finnish study.

Comparing people who wore heels with those who wore flat shoes, in similarly stressed environments, researchers found those wearing flat, comfortable shoes felt significantly more at ease and in control when faced with pressure than their heeled counterparts.

THEY RELIEVE COMPUTER EYE-STRAIN While the stress of high heels on the body can lead to tightening of muscles around the eye, which worsens eye-strain when you use computers, flat shoes have the opposite effect.

Flat shoes exert a reflexological effect up to an hour after walking, by gently stimulating the nerves in the feet. This has been shown to induce muscular relaxation throughout the body, even around the eye.

THEY CUT THE RISK OF SCIATICA Flat shoes stretch the lower back and reduce the risk of trapped nerves, especially in those with a marked low-back curve.

'Women who have a significant curve in their low back are at greater risk of problems such as sciatica if they wear heels often,' says osteopath

Gavin Burt. 'For these women, flat shoes can have an important therapeutic effect in stretching out their lower spine.'

THEY CAN INCREASE PHYSICAL STRAIN IN PREGNANCY Flat shoes are not advised during pregnancy. 'Women's skeletal structure changes in pregnancy, and it's a common misconception that pregnant women are better off in flat shoes,' explains Sandra Smith, a midwife based in Eton, Berkshire.

'Instead, they should wear a comfortable heel of around an inch. This puts the spine, muscles and joints in a better position to withstand the extra weight of a developing child.'

AGAINST

THEY MAY CONTRIBUTE TO STIFFNESS OF THE HIPS AND PELVIS Women with stiff hips and short quadriceps are doing themselves no favours by wearing flat shoes, says Elaine Campbell, a yoga teacher from Brighton, East Sussex.

'Heels of up to 1 1/2in are best if you have tight thigh muscles because they give you a gentle stretch with each footstep. Worn regularly, this can loosen the pelvic muscles, reducing tension and increasing flexibility.'