Let’s just cut right to this one: sure, if in moderation!
There is a common prescription out there against high heels, which has some admitted merit. We’ll discuss that first though, because before I just give the okay we should understand the limits.
The argument for heels is very simple. Normal function in gait requires our ankle to dorsiflex, or come up towards our faces, anywhere from 10-20° on average. If we regularly use this gait and stand in a neutral position, maintaining this range is usually not a large problem. However, prolonged timed spent in any position can lead to the muscle becoming use to this position. And depending on time spent there you can see a temporary or even semi-permanent loss of this range. This loss of range can lead to pain in the foot and calf. It can even lead to loss of strength and weakness given this chronic shortening of a vital muscle for daily activity. One common diagnosis associated with this tightness and loss of force production is plantar fasciitis, and I’m sure you’ve heard of it!
Here is where we have to look at this with a grain of salt though. There are a lot of specifics in the scenario I described above! First, you’d have to spend a lot of your time in those heels to develop this shortening. Not that this isn’t possible. I know many people who wear heels for the majority of their waking hours. But it certainly means that occasionally wearing them is not likely to cause major problems. For those that do wear them often, some simple stretching and strengthening exercises can be used to compensate for fashion too! Calf work for both flexibility and resistance can be a great way to get the best of both function and fashion for many people!
So is it possible for heels to cause problems? Sure! But it is equally possible for a minimalist shoe or a cross trainer to do so. It’s what you do outside those shoes as well that counts the most. So if you’ve been having pain and you think shoes may be playing a role, don’t forget that a good PT might be able to keep you in them!