Vital Signs: down to earth with baby

As she has also had operations for severe bunions, I can't believe her doctors didn't advise her to stay out of them for the foreseeable future.

According to news reports, she was diagnosed with a herniated disc, and journalists were quick to speculate that her penchant for wearing high heels during her pregnancy may have been to blame.

While I think her actions were foolish and will certainly exacerbate her conditions, I don't think wearing heels caused her back problem. Slipped discs are relatively common, affecting around one in five people in the UK, and the most likely causes mainly involve overuse: from heavy lifting and twisting, to sitting for long periods in positions of bad posture. While there is evidence that wearing heels certainly causes backache and a variety of other problems, there is none to show they cause slipped discs.

What is known is that the hormone relaxin, released during pregnancy, can make women more prone to back problems. Its role is to relax the joints in the pelvis to aid delivery but a side-effect is that it also causes other joints to loosen, occasionally leading to inflammation and pain. Women who insist on wearing high heels are putting themselves at risk of long-term damage, as well as strains to their ankles and ligaments.

High heels significantly alter posture, shorten the calf muscles and place increased pressure on the back and knees, increasing a woman's risk of joint degeneration and osteoarthritis.

One study published recently found that women who wore high heels five times a week for two years had calf muscles that were 13 per cent shorter and Achilles tendons that were substantially stiffer and thicker than those of women who wore flat shoes. This resulted in a drastic shortening of the distance that heel wearers could flex their feet up and down, and explains why habitual heel-wearers feel calf pain when walking barefoot.

Combine these effects with a shifting of centre of gravity during pregnancy and it's easy to see why wearing them while expecting is not a clever idea.

Such is the problem that the Society of Chiropodists and Podiatrists has issued some guidelines on foot care during pregnancy. Shoes with extra shock absorption, a supportive arch and firm heel are essential, and a heel of about three centimetres high is ideal to shift weight forward, helping to relieve discomfort. If you do feel you cannot go without your heels, then limit the time you are standing in them as much as possible, and slip them off at the first opportunity.

If you are pregnant, then I can only advise that you avoid them altogether, particularly during the last three months. If back pain and bunions don't worry you, then bear in mind that a hard fall in heels could put your pregnancy at risk too.
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