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J Foot Ankle Surg. 2015 Jul-Aug;54(4):615-9. doi: 10.1053/j.jfas.2015.04.008. Epub 2015 May 12.

Epidemiology of High-Heel Shoe Injuries in U.S. Women: 2002 to 2012.

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Research Assistant, Department of General Surgery, Division of Trauma and Burns, and Departments of Epidemiology and Emergency Medicine, University of Alabama at Birmingham, Birmingham, AL. Electronic address:
Research Assistant, Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL.
Professor and Vice Chairman, Department of General Surgery, Division of Trauma and Burns, Department of Epidemiology, and Center of Clinical and Translational Science, University of Alabama at Birmingham, Birmingham, AL.


The purpose of the present study was to investigate the epidemiology of high-heel-related injuries among a nationally representative population of women in the United States and to analyze the demographic differences within this group. The data used in the present study were collected from the Consumer Product Safety Commission's National Electronic Injury Surveillance System. A total of 3294 injuries, representing an estimated 123,355 high-heel-related injuries, were treated in emergency departments within the United States from 2002 to 2012. The overall rate of high-heel-related injuries for the study was 7.32 per 100,000 females (95% confidence interval 7.08 to 7.56). The injury rate was greatest for young adult females, with the greatest rates observed for those aged 20 to 29 years (18.38 per 100,000 females) and those aged 30 to 39 years (11.07 per 100,000 females). The results from the present study suggest that high-heel-related injuries have nearly doubled during the 11-year period from 2002 to 2012. Injuries from high heels are differential by body region, with most injuries occurring as sprains and strains to the foot and ankle. 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. The results of the present study can be used in the development of a prospective cohort study to investigate the risk of injury from high-heeled shoes, accounting for the exposure time and studying differences in demographics (e.g., age and race).


ankle injuries; ethnology; foot injuries; sprain injuries; strain injuries

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