KICKING OFF OUR HEELS – High Heels: Good, Bad…or Depends?

With the news just in that French shoe god Christian Louboutin has launched a new range of nail glosses – in bottles with long spiky tips, of course – we’ve been playing Google ping-pong between the AW14 shoe collections and autumn’s new nail colours.


christian louboutin nail polish

Quite Maleficent…the new Louboutin rouge for nails

We love high heels but they might not love us quite so much.  A woman’s foot betrays her shoe-wearing history (often not pretty) and we had no idea heels and health were quite so closely linked – but they are, as osteopath Susannah Makram reveals.

Susannah is author of the Spine Youth Code (SYC), and one of the practitioners at 96 Harley Street where her own bespoke solutions-based brand of osteopathy + naturopathy has helped numerous patients.

Her thought-provoking guest post on the link between high heels and inflammation points out that things may not be as clear-cut as we’d like to think.  Are heels all bad?  Even flats, as Susannah points out, can be demanding too, when the body is in motion.  

The key – like Cinderella’s dilemma – is finding the right fit for our feet (and “sole mate”, but that’s another story for another day).

Either way, barefoot in the park this summer is sounding good.

* * *

Susannah Makram, 2 Harley Street, London W1

You can find her at Harvey Nichols Beyond MediSpa (Wednesdays), London SW1 – Knightsbridge

and Bulgari Hotel & Residences, London SW7 – Knightsbridge

High Heels and Inflammation…Why Pick On My Louboutins? 

“Nothing feels like a dip of the ankle; a toe stepping firm on a fine quality insole; a forefoot, as it slides down till reinforced leather, somewhere by the ankle and assisted by touch, holds the entire foot in place.

The posture adopted, of the body as whole, is not as nature intended when we are wearing high heels. There are a multitude of external factors that can account for putting our bodies through undue stresses and so – you may rightly ask – why pick on my Louboutins?


“We spend approximately one third of our life in bed

and the other two thirds in shoes”

“To categorise shoes into “high-heels” and “flats”

does not account for craftsmanship”


As a registered osteopath for almost nine years now, my opinion of high-heels is that they get a bad wrap. To categorise shoes into “high-heels” and “flats” does not account for craftsmanship. There are materials to consider as when as all of the various shapes and sizes, reinforcements and embellishments. Structurally, you might stumble upon, by sheer luck the shoe designed to hold your body in near perfect alignment.

We spend approximately one third of our life in bed and the other two thirds in shoes. On that basis we should probably pay attention to these externals in particular when it comes to pain prevention.



jimmy choo


–          Women who regularly wear high-heels suffer from foot and ankle problems because body weight is transferred to the balls of the foot, which adds pressure to the small bones in the forefoot.

–          Conditions that arise & can cause pain are:

Toe clawing, skin rashes, corns, calluses, bunions and Achilles problems.

These can arise from inflammation as unnatural pressure is added to the small bones in the forefoot. Over time the natural pad in this area is lost and skin thickens locally as collagen builds up. Not chic.

As an osteopath I specialise in treating knee, back and neck pain. Biomechanically, to varying degrees, there is a shift forwards in the body’s centre of gravity with a heel lift. This affects all of these joints to a degree which can lead, over time, to inflammation of bone and surrounding soft tissues, a decrease in joint space and symptoms of local or referred pain.

jimmy choo summer

Every body has a design that is unique and not all high heels are created equal

Information is key.

Every body has a design that is unique and you can prevent injury. You can prevent pain too by using your body’s strength to counteract its inherent weakness.


“Flats can be equally demanding when the body is in motion”


When you make your next shoe purchase – and let’s face it; this tends to happen sooner rather than later! – Remember:

Not all high heels are created equal. Bring them along to your next consultation.

You know this. Remember that one time you felt like Cinderella? How much wear did you get out of that pair?

Rule of thumb:

Adjustment is Key

Flats can be equally demanding when the body is in motion. Do not stereotype or take expert opinions at face value. Investigate and make an educated decision.


Remember that one time you felt like Cinderella?

How much wear did you get out of that pair?



S is for Support

Day-in Day-out wear

In general shoes should provide support by way of their design eg. Laces, buckles, fasters, grips etc so that feet do not slip up and down the shoe at the back

There should be a minimum of 6mm in front of the longest toe and the end of the shoe

Speaking of inflammation…

I love the fact that I can use the principles of osteopathy & naturopathy to make sure the specific cause is treated.

As an osteopath I hone in on the pathophysiology; mechanism of the pain, as it presents itself. How did it come to be? Why is it occurring now?


“You can have inflammation without pain,

but there is no pain without inflammation” (ouch!)


 The 7 Causes of Pain

There are about seven causes for pain.

These are further divided, to be regionally specific.

Those are divided even further, into categories and subcategories.

In all of these an element of inflammation comes into play. A type or stage of inflammation indicates the presence of homeostatic imbalance. We create the right environment for optimal homeostatis (balance), as a Naturopathic Doctors and as Osteopaths.

This means that the body will heal itself as it does in nature, to the best of its ability.

One cause of pain is metabolic.



We interrupt this paragraph to bring you…The Nudes, part of the new Louboutin nail laquer collection at Selfridges


You can have inflammation without pain but there is no pain without inflammation.

Clinically, the most common tests to diagnose inflammation include measuring erythrocyte sedimentation rate (ESR), white blood cell count, and albumin levels (and other biomarkers) These tests are nonspecific; that is, an abnormal result might result from a condition unrelated to inflammation.

The 3 Stages of Inflammation 

There are three stages of inflammation:


Sub-acute &



Naturopathic Nutrition for Inflammation

Creating the right environment is key.

The visible – swelling, inflammation, redness

The invisible – pain, heat

So – what can we eat to cool down the heat?

Food is information, keep it simple. If you are eating wholefoods – that is unprocessed foods, that are as close to their natural state as possible – then adding these powerhouses into the mix will prove that you can treat inflammation from viral or bacterial infection or as a response to injury. This is a general guideline – some of my favourites. An expert will guide you through the best foods and nutritional supplement for your body’s needs.

Good Things

Fresh Ginger root (refreshing and zingy, raw or as close to it)

Garlic (fresh and as close to raw as possible!)

Cumin (dry seeds, whole or crushed)

Turmeric Root (Curcumin)

Capsaicin (the oily compound in cayenne pepper)

Bromelain found in fresh pineapple stalks

Cloves (Dried whole or crushed or as clove oil)

Upping your intake of foods high in daily recommendations of certain minerals does have an anti-inflammatory effect. (Research)

This is compounded by the synergistic effect of food combining and ensuring gut health is optimal.

Load up on those berries, bifidobacterium and broccoli

Magnesium (Glycinate), Alpha-lipoleic Acid and CoEnzyme Q10 (antioxidant)

Magnesium dense foods include raw cacao, pumpkin and sesame seeds

Foods rich in antioxidants include berries, especially blue berries and broccoli

Foods with live bacteria cultures to optimise gut health include (dairy) probiotic yoghurts with Lactobacillus acidopholus & Bifidobacterium bifidum cultures or kefir and (non-dairy) fermented vegetables eg kimchi and sauerkraut kombucha (the drink).



Follow Susannah Makram on Twitter @SusannahMakram

Contact Susannah on 07951013648



3 responses to “KICKING OFF OUR HEELS – High Heels: Good, Bad…or Depends?”

  1. For last couple of years, I have been continuoulsy wearing heels (not high heels) inbetween 1.5 – 2.5 inches… I have not experienced any such problems so far (TW) . Should I skip wearing this much of heels as well ?

  2. Roxanne says:


    I chanced upon this article and really liked the information provided here. So I shared it on my blog’s FB page:

    Hope you don’t mind me sharing it!


  3. Pamela says:

    Dear Susannah,

    I am an addicted wearer of high heels. And, I mean addicted. I wear heels that are between 3.5″ & 4.25″ constantly (10 to 12 hours per day). While my calves and the arches of my feet show the graceful rewards of such a habit, I will admit that I also have suffered from corns, hammer toes, shortened Achilles tendons and thigh muscles that constantly ache (not sure why the thighs ache). My knees are beginning to occasionally experience pain, as well. It is this latter condition that my lead to treatment (arthritis, perhaps a knee replacement). But, to be honest, it will have been worth it – as I said, “I am a willing victim of my addiction”.