Monday, June 08, 2015 High Heel-Related Injuries Nearly Double in 10 Years Maybe it's time to slip off those high heels before you slip off those high heels. A study of injuries recorded by US emergency departments estimates that the number of injuries related to high-heeled shoes nearly doubled between 2002 and 2012, to 8.83 per 100,000. Those rates weren't spread evenly across all age groups. Women 20-29 were found to be most at risk for injury, with an 18.29 per 100,000 rate, followed by women 30-39, who were found to have an injury rate of 11.07 per 100,000. Results were published in the June issue of the Journal of Foot and Ankle Surgery (abstract only available for free). To conduct the study, researchers collected data from the Consumer Product Safety Commission’s National Electronic Injury Surveillance System (NEISS), a stratified probability sample of hospital emergency departments in the US. The NEISS includes information from the medical records, including patient demographics, the body part injured, diagnosis, and where the injury took place. Authors then combed the record narratives for any mention of the words “highheel,” “high-heel,” “heels,” “highheels,” “high-heels,” “pumps,” and “stiletto.” Ultimately, researchers identified 3,294 injuries related to high heels, which they estimate is representative of 123,355 high heel-related injuries across the US over the 10-year study period. Most notable to authors was the rate at which the injuries have increased over time, from 4.85 per 100,000 in 2002 to 8.83 per 100,000 in 2012. Average for the entire time period was 7.32 per 100,000. As for the injuries themselves, most (72%) involved the ankle or foot and were primarily strains or sprains (52.8%); upper body injuries occurred at a 16.6% rate. Almost half—49.5%--of the injuries happened at home, followed by public property (33.1%) or on "a street or highway" (10.3%). Almost all (98%) were characterized as "nonsevere." Authors, who all but admit they don't have their collective finger on the pulse of what's in and what's out, write that "the present study might have observed a fashion trend of the high-heeled shoe, and the apex of this trend could explain the noticeable maximum value of injuries in 2011," when the rate peaked at 12.01 per 100,000. They also wonder if physicians have simply gotten better at identifying injuries related to high-heeled shoes. Aside from injury rates in the age group 0-9 years (an "unexpected" 2.21 per 100,000 rate, according to authors), women 50 and older reported the lowest rate of injury, at 3.44 per 100,000. Authors speculate that the low rate for this group could be deceiving, in that most of their injuries could be linked to the effects of high heel wear over time, and not falls. "Older females might experience more chronic foot and ankle injuries (corns and bunions) and younger females more acute foot and ankle injuries (strains and sprains)," they write. In a conclusion that is part data-driven and part something your mom would say, authors advise caution around where and when to wear heels, and somehow avoid using the words "sensible shoes." "Because many high-heel–related injuries occurred in homes, those wearing high-heeled shoes should be conscious of their footwear while in their own home and should consider the appropriate footwear for the occasion before going to a friend’s or acquaintance’s home," authors write. "Although high heels might be stylish, from a health standpoint, it could be worthwhile for females and those interested in wearing high heels to understand the risks of wearing high-heeled shoes and the potential harm that precarious activities in high-heeled shoes can cause." Research-related stories featured in PT in Motion News are intended to highlight a topic of interest only and do not constitute an endorsement by APTA. For synthesized research and evidence-based practice information, visit the association's PTNow website.