Obesity, Knee Damage, and High Heels

Assorted ladies high heeled shoes
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Obesity is a risk factor for developing osteoarthritis, and researchers have discovered that wearing high heels can make this even worse by causing permanent knee damage.

High Heels Age Your Knees

One study performed by researchers at Stanford University examined the knees of 14 healthy women as they walked around in shoes with different heel heights. These researchers found that, as heel height increased, detrimental changes took place in the subjects’ knees—changes that were similar to those seen with aging and osteoarthritis.

These changes were also seen with increasing body weight or body mass index (BMI), indicating that excess body weight also takes its toll on the knees. Add this to the damage done by wearing high heels, and these women’s knees were in trouble indeed.

Obesity and Osteoarthritis

Patients with obesity commonly report joint pain, especially of weight-bearing joints such as the knees and hips. Some experts have estimated that approximately 35% of people with osteoarthritis are also obese, and this adds a significant burden both in terms of functional status (getting around, being able to do everyday activities) and clinical status (of the arthritis disease process itself).

Studies have shown a significant association between increased weight and osteoarthritis of the knee and of the hip, and still more research has looked at how weight-loss therapy in obese older adults can improve physical function.

Researchers note that one result of weight loss is improved mobility, and a good part of this is due to less mechanical stress on the joints, with fewer symptoms of arthritis.

What Is the Maximum Recommended Heel Height?

The Stanford researchers found that the heel heights that really aged knee joints—by as much as 20 years!—were those that were 3 inches or higher.

The additional strain on the knees occurs because the knee remains in a bent position when the heel touches the ground (as opposed to the natural gait in which the knee and leg are straight when the heel hits the ground). This strain, repeated with every step taken in high heels, can lead to wearing down of the knee cartilage, osteoarthritis and permanent knee damage.

While lower is clearly better when it comes to high heels, women may want to rethink wearing high heels at all. Wearing shoes that support your feet not only lead to better foot, knee, hip and back health, but also help prevent permanent joint damage. Remember that the bones and muscles in your legs are all connected by those precious joints, so taking care of them now will result in better quality of life for years to come.


Hamerman D. The biology of osteoarthritis. N Engl J Med 1989;320:1322-1330.

Felson DT. Osteoarthritis of the knee. N Engl J Med 2006;354:841-848.

Messier SM, Loeser RF, Miller GD, et al. Exercise and dietary weight in overweight and obese older adults with knee osteoarthritis: the Arthritis, Diet, and Activity Promotion Trial. Arthritis Rheum 2004;50:1501-1510.

Titchenal MR, Asay JL, Favre J, Andriacchi TP, Chu CR. Effects of high heel wear and increased weight on the knee during walking. J Orthop Res 2015;33:405-11.

Lee C. The effects of lower extremity angle according to heel-height changes in young ladies in their 20s during gait. J Phys Ther Sci 2014;26:1055-8.

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