High-heeled footwear (often abbreviated as high heels or simply heels) is footwear that raises the heel of the wearer's foot significantly higher than the toes. When both the heel and the toes are raised equal amounts, as in a platform shoe, it is technically not considered to be a high heel; however, there are also high-heeled platform shoes. High heels tend to give the aesthetic illusion of longer, more slender legs. High heels come in a wide variety of styles, and the heels are found in many different shapes, including stiletto, pump (court shoe), block, tapered, blade, and wedge.
According to high-fashion shoe websites like Jimmy Choo and Gucci, a "low heel" is considered less than 2.5 inches (6.4 centimeters), while heels between 2.5 and 3.5 inches (6.4 and 8.9 cm) are considered "mid heels", and anything over that is considered a "high heel". The apparel industry would appear to take a simpler view; the term "high heels" covers heels ranging from 2 to 5 inches. Extremely high-heeled shoes, such as those exceeding 6 inches, strictly speaking, are no longer considered apparel but rather something akin to "jewelry for the feet". They are worn for display or the enjoyment of the wearer.
Although high heels are now usually worn only by girls and women, there are shoe designs worn by both genders that have elevated heels, including cowboy boots and Cuban heels. In previous ages, men also wore high heels.
In the ninth century, Persian horseback warriors actually wore an extended heel made up for keeping feet from sliding out of stirrups. This also kept riders still when they needed to stand up and shoot arrows.
Mediæval Europeans wore wooden-soled patten shoes, which were ancestors to contemporary high heels. Michelle Reyes, curator at Toronto's Bata Shoe Museum, traces the high heel to Persian  horse riders in the Near East who used high heels for functionality, because they helped hold the rider's foot in stirrups. She states that this footwear is depicted on a 9th-century ceramic bowl from Persia.
It is sometimes suggested that raised heels were a response to the problem of the rider's foot slipping forward in stirrups while riding. The "rider's heel", approximately 1 1⁄2 inches (3.8 cm) high, appeared in Europe around 1600. The leading edge was canted forward to help grip the stirrup, and the trailing edge was canted forward to prevent the elongated heel from catching on underbrush or rock while backing up, such as in on-foot combat. These features are evident today in riding boots, notably cowboy boots.
Since the Second World War, high heels have fallen in and out of popular fashion trend several times, most notably in the late 1990s, when lower heels and even flats predominated. Lower heels were preferred during the late 1960s and early 1970s as well, but higher heels returned in the late 1980s and early 1990s. The shape of the fashionable heel has also changed from block (1970s) to tapered (1990s), and stiletto (1950s, early 1960's, 1980s, and post-2000).
Today, high heels are typically worn, with heights varying from a kitten heel of 1.5 inches (3.8 cm) to a stiletto heel (or spike heel) of 4 inches (10 cm) or more. Extremely high-heeled shoes, such as those higher than 5 inches (13 cm), are normally worn only for aesthetic reasons and are not considered practical. Court shoes are conservative styles and often used for work and formal occasions, while more adventurous styles are common for evening wear and dancing. High heels have seen significant controversy in the medical field lately, with many podiatrists seeing patients whose severe foot problems have been caused almost exclusively by high-heel wear.
The wedge heel is informally another style of the heel, where the heel is in a wedge form and continues all the way to the toe of the shoe.
Pros and cons
Reasons against wearing high heels, which are almost exclusively health and practicality reasons, include:
- They can cause foot and tendon pain.
- They increase likelihood of sprains and fractures.
- They make calves look more rigid and sinewy.
- They can create foot deformities, including hammertoes and bunions.
- They can cause an unsteady gait.
- They can shorten the wearer's stride.
- They can render the wearer unable to run.
- They can also agitate lower back pain.
- Altered forces at the knee caused by walking in high heels may predispose to degenerative changes in the knee joint.
- Frequent wearing results in a higher incidence of degenerative joint disease of the knees. This is because they cause a decrease in the normal rotation of the foot, which puts more rotation stress on the knee.
- Thin or metal-tipped heels can cause damage to soft floors.
Reasons for wearing high heels, which are almost exclusively aesthetic reasons, include:
- They change the angle of the foot with respect to the lower leg, which accentuates the appearance of calves.
- They change the wearer's posture, requiring a more upright carriage and altering the gait in what is considered a seductive fashion.
- They make the wearer appear taller.
- They make the legs appear longer.
- They make the foot appear smaller.
- They make the toes appear shorter.
- They make the arches of the feet higher and better defined.
- They can improve the muscle tone of a woman's pelvic floor, thus possibly reducing female incontinence.
- Practical benefits for people of short stature in terms of improving access and using items, e.g. sit upright with feet on floor instead of suspended, reach items on shelves, etc.
During the 16th century, European royalty started wearing high-heeled shoes to make them look taller or larger than life, such as Catherine de Medici or Mary I of England. By 1580, men also wore them, and a person with authority or wealth was often referred to as "well-heeled".
In modern society, high-heeled shoes are a part of women's fashion, perhaps more as a sexual prop. High-heels force the body to tilt, emphasizing the buttocks and breasts, highlights of a woman's sexuality. They also emphasize the role of feet in sexuality, and the act of putting on stockings or high-heels is often seen as an erotic act. This desire to look sexy and erotic continues to drive women to wear high-heeled shoes, despite causing significant pain in the ball of the foot, or bunions or corns, or Hammer toe. A survey conducted by the American Podiatric Medical Association showed some 42% of women admitted that they would wear a shoe they liked even if it gave them discomfort.
Types of high heels
Types of heels found on high-heeled footwear include:
- cone: a round heel that is broad where it meets the sole of the shoe and noticeably narrower at the point of contact with the ground
- kitten: a short, slim heel with maximum height under 2 inches and diameter of no more than 0.4 inch at the point of contact with the ground
- prism: three flat sides that form a triangle at the point of contact with the ground
- puppy: thick square block heel approximately 2 inches in diameter and height
- spool or louis: broad where it meets the sole and at the point of contact with the ground; noticeably narrower at the midpoint between the two
- stiletto: a tall, slim heel with minimum height of 2 inches and diameter of no more than 0.4 inch at the point of contact with the ground
- wedge: occupies the entire space under the arch and heel portions of the foot.
Men and heels
Elizabeth Semmelhack, curator for the Bata Shoe Museum, traces the high heel to male horse-riding warriors in the Middle East who used high heels for functionality, because they help hold the rider's foot in stirrups. She states that the earliest high heel she has seen is depicted on a 9th-century CE ceramic bowl from Persia.
Since the late 18th century, men's shoes have had primarily low heels. A notable exception is cowboy boots, which continue to sport a taller riding heel. The two-inch Cuban heel features in many styles of men's boot but was popularised by Beatle boots, famously worn by the English rock group The Beatles, which saw the reintroduction of heels for men. Winklepicker boots also usually feature a Cuban heel. There was also a brief resurgence in higher-heeled shoes for men in the 1970s (in Saturday Night Fever, John Travolta's character wears a Cuban heel in the opening sequence). The singer Prince is known to wear high heels, as well as Elton John. Bands such as Mötley Crüe and Sigue Sigue Sputnik predominantly wore high heels during the 1980s. Current well-known male heel wearers include Prince, Justin Tranter, lead singer of Semi Precious Weapons, and Bill Kaulitz, the lead singer of Tokio Hotel. Popular R&B singer Miguel was wearing his trademark Cuban heels during the "legdrop" incident at the 2013 Billboard Music Awards.
The stiletto of certain kinds of high heels can damage some types of floors. Such damage can be prevented by heel protectors, also called covers, guards, or taps, which fit over the stiletto tips to keep them from direct, marring contact with delicate surfaces, such as linoleum (rotogravure) or urethane-varnished wooden floors. Heel protectors are widely used in ballroom dancing, as such dances are often held on wooden flooring. The bottom of most heels usually has a plastic or metal heel tip that wears away with use and can be easily replaced. Dress heels (high-heeled shoes with elaborate decoration) are worn for formal occasions.
Foot and tendon problems
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High-heeled shoes slant the foot forward and down while bending the toes up. The more that the feet are forced into this position, the more it may cause the gastrocnemius muscle (part of the calf muscle) to shorten. This may cause problems when the wearer chooses lower heels or flat-soled shoes. When the foot slants forward, a much greater weight is transferred to the ball of the foot and the toes, increasing the likelihood of damage to the underlying soft tissue that supports the foot. In many shoes, style dictates function, either compressing the toes or forcing them together, possibly resulting in blisters, corns, hammer toes, bunions (hallux valgus), Morton's neuroma, plantar fasciitis and many other medical conditions, most of which are permanent and require surgery to alleviate the pain. High heels – because they tip the foot forward – put pressure on the lower back by making the rump push outwards, crushing the lower back vertebrae and contracting the muscles of the lower back.
If it is not possible to avoid high heels altogether, it is suggested that the wearer spend at least a third of the time they spend on their feet in contour-supporting "flat" shoes (such as exercise sandals), or well-cushioned "sneaker-type" shoes, saving high heels for special occasions.
One of the most critical problems of high-heeled-shoe design involves a properly constructed toe-box. Improper construction here can cause the most damage to one's foot. Toe-boxes that are too narrow force the toes to be "crammed" too close together. Ensuring that room exists for the toes to assume a normal separation so that high-heel wear remains an option rather than a debilitating practice is an important issue in improving the wearability of high-heeled fashion shoes.
Wide heels do not necessarily offer more stability, and any raised heel with too much width, such as found in "blade-" or "block-heeled" shoes, induces unhealthy side-to-side torque to the ankles with every step, stressing them unnecessarily, while creating additional impact on the balls of the feet. Thus, the best design for a high heel is one with a narrower width, where the heel is closer to the front, more solidly under the ankle, where the toe box provides room enough for the toes, and where forward movement of the foot in the shoe is kept in check by material snug across the instep, rather than by the toes being rammed forwards and jamming together in the toe box or crushed into the front of the toe box.
Despite the medical issues surrounding high-heel wear, a few podiatrists recommend well-constructed low to moderate heels for some patients. It appears a slight elevation of the heel improves the angle of contact between the metatarsals and the horizontal plane, thereby more closely approximating the proper angle and resulting in proper weight distribution of a medium-to-high-arched foot. Other foot specialists, however, argue that any heel causes unnecessary stresses on the various bones and joints of the foot.
Study suggests potential health benefits of high heels for women
In 2008, Cerruto et al. reported results that suggest that wearing high heels may improve the muscle tone of a woman's pelvic floor, thus having a potential effect on female stress urinary incontinence.  In the original publication, the principal author, Dr. Maria Angela Cerruto of the Department of Biomedical and Surgical Sciences, Urology Clinic, University of Verona, Italy, writes that with her publication she wants to respond to an earlier article in the Daily Mail (29 October 2007) concerning the hypothesis that heeled footwear might cause schizophrenia.
I do not have the skills to refute or confirm this hypothesis, but as a woman reading nonscientific papers, I remain astonished in the face of bizarre medical theories published in nonscientific journals in the absence of any scientific filter or key reading, because they might be misunderstood. [...] I am a urologist and I collaborate with physiatrists, with the aim of better understanding the relationship between posture and pelvic floor muscle activity in women with and without stress urinary incontinence.
In the publication, the study results of Cerruto et al. show that in both incontinent and continent young women (<50 yr old) an ankle plantar flexion might cause a posterior pelvic tilt that is able to maintain a pelvic muscle tone. Comparison with previous study results shows that the pelvic muscle tone induced by wearing heels is comparable with that from wearing flat moccasins, but enhancing the contractile power of the pelvic musculature actively. During the study various shoe sizes and heel heights were investigated, measuring the maximal pelvic floor muscle activity (in µV) for shoe sizes 37–41 (US size 5.5–9.5) and heel heights from 0 (flat moccasins) to 7 centimeters.
Based on study results, Cerruto et al. conclude that heels might affect female pelvic floor muscle activity, reducing myofascial pelvic pain, relaxing the pelvic floor, and improving pelvic organ well-being.
Additional to the publication in European Urology, Cerruto et al. also presented the results of their study at the 2007 European Association of Urology Congress in Berlin.
Feminist attitudes towards high heels
The high heel has been a central battleground of sexual politics ever since the emergence of the women's liberation movement of the 1970s. Many second-wave feminists rejected what they regarded as constricting standards of female beauty, created for the subordination and objectifying of women and self-perpetuated by reproductive competition and women's own aesthetics.
- high_heeled_shoes.htm High-Heeled Shoes Definition by apparelsearch
- William Kremer (25 January 2013). "Why did men stop wearing high heels?". BBC News. Retrieved February 3, 2013.
- Maribeth Keane and Bonnie Monte, Sex, Power, and High Heels: An Interview with Shoe Curator Elizabeth Semmelhack, Collectors Weekly, 18 June 2010
- Kremer, William (2013-01-25). "BBC News - Why did men stop wearing high heels?". Bbc.co.uk. Retrieved 2013-06-15.
- "Wedges - What to Wear with Wedge Heeled Shoes". Shoes.about.com. 2013-05-06. Retrieved 2013-06-15.
- Women Pay Attention to Shoe Heels: Besides Causing Schizophrenia They Might Affect Your Pelvic Floor Muscle Activity!!
- High heels 'may improve love life' – BBC News
- "Dangerous Elegance: A History of High-Heeled Shoes". Random History. Retrieved 1 July 2010.
- Danesi, Marcel (1999). Of cigarettes, high heels, and other interesting things: an introduction to semiotics. Palgrave Macmillan. p. 13. ISBN 0-312-21084-1.
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- Glossary of Terms for Women's Shoe Styles
- Discussion About The True History of high Heels
- Kippen, Cameron. "Beatle Boots". The History of Boots. Department of Podiatry. Retrieved 11 October 2007. "The Beatle Boot saw the reintroduction of heels for men."
- Time article on men wearing heels in the 1970s
- Research by Marco Narici et al. (Journal of Experimental Biology) determined that persistent usage of high-heeled shoes causes the calf muscle to shorten – an average of 13% in their study – while the Achilles tendon becomes significantly thicker and stiffer. See The Economist, 17 July 2010, p. 84 for discussion.
- http://www.europeanurology.com/article/S0302-2838%2808%2900055-9/fulltext%7C Cerruto MA, Vedovi E, Mantovani W. Eur Urol. 2008 May;53(5):1094-5. Epub 24 January 2008.
- Chen CH, Huang MH, Chen TW, et al. Relationship between ankle position and pelvic floor muscle activity in female stress urinary incontinence. Urology 2005; 66:288–92
- Heights of madness – New Humanist
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