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The Girlfriend's Guide to Health will be updated every Tuesday.... Stay tuned dear readers and let me rock your world.

Tuesday, July 17, 2012

I Walk the Line


Summer is upon us my sisters. Here is the sun and the sand and the sea and we all know what that means??? Strappy sandals.

Yes, my girlfriends with the onset of the fabulous weather and the warmth of the world upon us comes the need to polish my toes and indeed put my best foot forward.

My girlfriends know all too well how I feel about the footwear. I do love me a fabulous Italian platform or stiletto. I embrace the leather ties that bind and savour every step I take.

I love the feel of a good four inches beneath my toes and the possibility of where any new pair of shoes will take me.

Any day can be made better with a good pair of heels and the perfect attitude.

Yes I know I am perhaps a bit flippant and perhaps a little materialistic when I say that a great pair of shoes really can change my mood.

I have long thought about my love of great footwear.  I don’t think I’m alone in my love of stylish shoes.

A survey done in USA Today in 2009 showed that the average woman owns 17 pairs of shoes and that 39% of women consider themselves a “shoe person”. See my sisters? I’m more the rule than the exception. Why do women love shoes? Simple- if they do not fit it is not your fault. Show me a pair of skinny jeans that can make that same claim.....

As a doctor who wears 4 inch heels to practice medicine I am often asked by my patients (and my sisters) whether my fabulous footwear is indeed a gift or a curse to my future lower joints?

Let’s examine the evidence my girfriends….


We will begin with those bastards at Harvard Medical School, who in 1998 started the whole rampage against the 4-inch heel.

Dr. Casey Kerrigan published a study in the Lancet about the effects of high heels on the biomechanics of the knee and ankle. The study consisted of 20 healthy women who were comfortable wearing heels who were then placed in heels and asked to walk at a comfortable speed for 10 metres across a floor.

The biomechanics of their knees and ankles were measured and plotted against the same readings they had while walking barefoot. There was a significant increase in the stress at the knee and the ankle compared to walking barefoot in these women.

The findings confirm that wearing high-heeled shoes significantly alters the normal function of the ankle. Because of this compromise, compensations must occur at the knee and hip to maintain stability and progression during walking.

These findings suggest that most of these compensations occur at the knee. Now, I have known this for years. Ever since I strapped on my first pair of heels and tried to walk the kitchen floor I realized that I was going to have to learn to walk all over again.

HOWEVER… like anything worth having in life, you put in the effort…. Hour upon hours of practice, clenched butt cheeks and a decent swagger have made me the 4-inch woman that I am today.

The Harvard study however finds that this compensation MAY over time increase the work of the quadricep muscles, prolong the strain through the patella tendon, and prolong the pressure across the knee joint.

Therefore this may lead to increased arthritis and patello-femoral syndrome. However the study did not make any full conclusions.

As for the Harvard study, I realize I am being a bit emotional, but I do have some questions:

Is Dr. Casey Kerrigan a man or a woman? Casey is one of those ambiguous names like Kelly or Adrian or Jesse (or even Ali). Are you a chick or a dude?

This makes a difference. No sister I know would shamefully attack the temple. Casey, if you are in fact a woman than I surmise you have never owned a pair of Jimmy Choo strappy sandals and should spend some of your Harvard hard earned cash on said shoes immediately.

They WILL most definitely change your research focus.

However Dr. Kerrigan, if you are a man…. One small piece of advice which I tell my beloved regularly…. DON’T MOCK THE SHOES….. I don’t come into your Harvard house and piss all over your bookshelves. Don’t come into my closet and take away my sunshine….


In need of a better answer I went looking further. Good news about Science, my sisters- you can always find some sort of study to support your belief system if you look hard enough.

And so I could rely on data from the United Kingdom that places a well-needed platformed heel up the ass of this controversy.

Researchers at Warwick University and Oxford Brookes University investigated the stiletto controversy with the help of 111 women aged 50 to 70, of whom 29 were awaiting knee replacements. Women were asked to report about their taste in shoes, weight, activity levels and other risk factors for arthritis.

The final study, published in the Journal of Epidemiology and Community Health in 2005 found no evidence to suggest wearing high heels was linked to knee problems. Indeed, the statistics suggested women who regularly wore 3-inch heels were less likely to be suffering from arthritis.

Factors that did influence a women’s risk of arthritis were being overweight before 40, doing demanding physical work and having previous knee injuries. In fact, there was a link between regular dancing in 3-inch heels and a reduced risk of knee problems.

Women were also shown pictures of 38 different types of shoes and asked if they had ever worn a particular type regularly, either for work, socially or dancing.

Some 55.2 per cent of the women with knee arthritis regularly wore 3-inch heels, as did 67.1 per cent of women with no pain.

In other words…. If you wear heels you have a fifty percent chance of them killing your knees.

Having spent more than half my shopping hours in the shoe departments of many a respectable store means I am willing to flip that coin….

Finally, Dr. Margaret Thorougood, the lead investigator of this study can be quoted as saying, ““Women who smoke, are overweight and do a lot of heavy housework such as scrubbing are more likely to develop painful knees and arthritis later in life. But women who wear stiletto heels will be reassured to learn that their choice of fashion-before-comfort footwear will not lead to knee joint problems and may even prevent them.”

Ladies…. Let us pray to the goddess that Margaret lives a long and fabulous life filled with guilt free chocolate ├ęclairs and a phenomenal metabolism.

May Dr. Margaret be inducted into the sisterhood hall of fame. Can I please my sisters get an Amen? In the name of Manolos everywhere…. Amen.



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