Revolutionizing Spine Care…Changing Lives

Fashion Week Travels on High Heels


Twice each year, “Fashion Week” occurs in the major fashion cities – New York City, London, Milan and Paris. During the month of February, clothing designers show off “what’s hot,” or rather, what will they believe will be hot for the coming fall and winter, by staging elaborate fashion shows and media events.

Each show combines music, elaborate choreography and dozens of svelte models dashing around the stage. Many of these models spend hours on their feet, walking the runways while wearing high-heel shoes. While these shoes look great with the clothes, they can be painful to wear and there is even some concern about their effect on other parts of the body including the spine. Even if you’re not a “fashionista,” if you’re a woman, you probably wear high-heels at some point during the week.

They may be very flattering to one’s legs but do these shoes damage your back? We chatted with Dr. Jessica Shellock, a spine surgeon at Texas Back Institute, to get her perspective on high heels and their effect on spine health. Keep reading to get her stylish medical opinion.

In Fashion, Nothing Exceeds Like Excess

According to the Wall Street Journal, the just completed New York City Fashion Week shows featured diverse collections which have “prescribed a utilitarian yet luxe antidote to the polar vortex.” This included alpine sweaters, puffer coats in leather, fur and embroidery and cozy flat-soled boots. Well-known fashion designers such as Donna Karan, Tory Burch, Michael Kors, Ralph Rucci, Diane von Furstenberg and Marc Jacobs presented their collections and each garnered glowing reviews.

There were many highlights of the NYC Fashion Week shows. These include:

  • Designer Stuart Vevers fireman’s coat, complete with toggle buttons and constructed of black motorcycle-style leather for Coach.
  • Ralph Rucci had one of the more spectacular coats of the week. The Wall Street Journal fashion editor – Christina Binkley – noted it was lined with Barguzin sable with an outer layer of Nappa leather. She opined, “The coat looked as suitable for driving a dogsled as for hurrying down Fifth Avenue.”
  • Plaids were big at the show with Tracy Reese and Marc by Marc Jacobs contributing several designs using this garment staple.
  • Pants in this year’s show seemed by many to be inspired by actress and icon Katherine Hepburn. They were wide-legged and often long.
  • Jackets and tops will have “voluminous sleeves and curvaceous backs” next fall and winter.
  • Fur bags will be hot next fall. Designers Tory Burch and Derek Lam all had new variations on this old theme
  • It wouldn’t be Fashion Week without the unusual. Designer Rodarte created gown with Star Wars images of Yoda, R2-D2 and Luke Skywalker printed on the skirts! Tres chic!

Can High Heels Ruin Your Back?


Many of those (very) thin models who pranced across the runway during Fashion Week, showing off the latest of haute couture, were balancing their exaggerated gait on a pair of high heel shoes. While the history of high heels is storied – they first came to be used in 9th Century Paris to keep horseback riders’ feet in the stirrups – most women wear them because they give the illusion of longer, more slender legs.

However, after an entire day at the office or several hours on the fashion runway, many women wonder if this illusion is worth the pain. Plus, some non-medical analysts have suggested that high heels can permanently injure one’s back.

“Wearing high heel shoes does not injure a woman’s back,” noted Texas Back Institute physician Dr. Jessica Shellock.

“However, for people that are already predisposed to back pain, wearing high heels might lead to episodes of increased pain. There’s more of a risk of developing foot problems (i.e. bunions) with longstanding use of high heels than back problems,” she said.


One hears stories of women who have had back surgery being forced give up wearing high heels. Is it advisable to avoid high heels after back surgery?

“I think it’s reasonable to limit or avoid high heel shoes for at least a short period after back surgery, notes Dr. Shellock.

“Wearing high heel shoes causes a woman to hyperextend her back for balance. Depending on the specifics of the surgery, a woman might have restrictions from her surgeon such as avoiding hyperextension. The hyperextension might also increase muscular pain in the area of a surgical incision, so in my practice I try to encourage patients to avoid heels for at least a number of weeks after surgery and stick to shoes that have better cushioning and more ankle support.”

Dr. Shellock continued, “From an even more practical standpoint, I think we can all agree that high heels put us at more risk for a potential ankle injury than comfy flats or sneakers. The last thing I’d want a post-op patient to experience would be a “twinge” of back pain or leg pain that led to a trip or fall and subsequently caused an inadvertent ankle sprain!”

Are there medical conditions related to the back muscles and spine which can result from high heels?

“It’s the fact that we tend to hyperextend the back when we wear high heels so that we can maintain our balance. This puts extra strain on our muscles and can lead to back pain,” notes Dr. Shellock.

“Plus, in patients that have facet-mediated pain or spinal stenosis, for example, extension of the back is what usually exacerbates symptoms. Wearing heels would lead to extension as we discussed and would therefore be likely to aggravate the pain. As with most things in life, moderation is probably the way to go!”

The very stylish Dr. Shellock concludes with some practical advice.

“With that being said, I absolutely love wearing high heel shoes myself. However, I limit my use! If I know I’m going to be on my feet in clinic for 8 hours then I might wear some equally stylish but slightly more comfy wedges or boots and save the killer heels for date night!”

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