Prevalence of Achilles Tendinitis Among Females Due to High Heels

Abstract

Background: Achilles tendinitis is a prevalent musculoskeletal disorder characterized by pain, stiffness, and functional impairment of the Achilles tendon. High-heeled footwear alters lower limb biomechanics, increasing tendon strain and potentially predisposing professional women to overuse injuries, particularly in occupations requiring prolonged standing or walking. Objective: To determine the prevalence of Achilles tendinitis and its association with heel height, wearing frequency, and daily duration among professional women. Methods: A cross-sectional study was conducted among 155 professional women aged 25–45 years in Sargodha, Farooka, and Chiniot, Pakistan. Participants were selected using stratified convenience sampling. Data were collected via a structured questionnaire, Visual Analog Scale (VAS), Foot and Ankle Outcome Score (FAOS), and Thompson Test. Associations between footwear characteristics and Achilles tendinitis were analyzed using chi-square tests, correlation analysis, and multivariable logistic regression adjusting for potential confounders. Results: The prevalence of Achilles tendinitis was 76.1%, increasing from 53.1% in low-heel users to 90.0% in those wearing heels >3 inches (p=0.013). Daily heel use and wearing >3-inch heels were independent predictors (adjusted OR 3.62 and 5.44, respectively). Longer wearing hours correlated with higher pain scores (r=0.39, p=0.002) and lower FAOS scores. Functional limitations, particularly in prolonged standing and stair use, were most severe among daily high heel users. Conclusion: High heel height, daily frequency, and prolonged wear significantly increase the risk and functional impact of Achilles tendinitis in professional women, exacerbated by extended occupational standing. Preventive strategies should target footwear modifications, activity adjustments, and awareness initiatives.