Plantar fasciitis is a common foot condition involving the inflammation or degeneration of the plantar fascia, the thick band of tissue connecting the heel bone to the toes. This tissue helps support the arch of the foot and plays a role in shock absorption during movement. The typical symptom is a stabbing pain near the heel, which is often most intense with the first few steps in the morning or after a period of rest. Determining whether a shoe heel helps or hurts addresses a common dilemma for people seeking relief, as the answer involves a distinction between slight elevation and high-heeled footwear.
Temporary Relief and Biomechanical Explanation
A small degree of heel elevation can provide temporary relief from plantar fasciitis pain. This effect is due to a change in foot and ankle biomechanics. A slight heel drop, typically less than one inch, slightly shortens the gastrocnemius and soleus muscles in the calf.
Since these muscles merge into the Achilles tendon, which attaches to the heel bone, shortening them reduces the overall tension placed upon the heel. This decrease in pull subsequently lessens the strain on the plantar fascia attached to the same bone. This temporary reduction in strain offers relief during walking or standing, but this mechanism provides only pain management and does not address the underlying pathology.
Long-Term Risks of High Heel Use
While a small heel drop offers a biomechanical advantage, wearing shoes with excessive heel height, such as pumps over two inches, is counterproductive to healing and poses long-term risks. Prolonged use forces the foot into an unnatural, downward position, causing the calf muscles and Achilles tendon to adapt and shorten over time.
This shortening increases the strain on the plantar fascia when the foot is placed in a flatter shoe or walked on barefoot. When the foot assumes a flatter position, the permanently shortened Achilles tendon pulls excessively on the heel bone, stretching the plantar fascia and exacerbating pain.
High heels also shift body weight onto the forefoot, which increases the overall strain on the arch and lacks necessary cushioning to absorb shock at the heel. Research suggests that high heels with a narrow support structure increase plantar fascia strain, making them a high risk for worsening the condition.
Essential Features of Footwear for Plantar Fasciitis
Footwear that supports recovery and provides lasting comfort must possess specific design features that go beyond simple heel height. A firm heel counter is necessary to stabilize the rear of the foot and prevent excessive side-to-side movement or overpronation. Proper arch support is also required, as it helps distribute pressure evenly across the foot, directly reducing strain on the plantar fascia. This support should be anatomically contoured, not completely flat, but also not so high that it causes discomfort.
The sole of the shoe should exhibit mid-foot stiffness, meaning it should only bend where the toes meet the foot, resisting twisting or flexing in the arch area. A shoe that easily twists or bends in the mid-foot fails to provide the necessary stability to protect the plantar fascia.
Optimal footwear incorporates a moderate heel drop, typically around 8 to 12 millimeters (about 1/3 to 1/2 inch), to achieve the beneficial, mild shortening of the calf muscles without the negative effects of a high heel. The shoe needs adequate cushioning and shock absorption material under the heel to protect the area from impact. However, the material should not be so soft that it makes the foot feel unstable.