Who gets a bunion deformity and the High Heel Myth?

Contrary to popular belief, high-heel shoes are actually not the main cause of ligament failure in bunion feet. Studies have indeed shown that more than 90% of bunion sufferers are female and that societies changing from barefoot to wearing ordinary shoes (not high-heels) increased in their incidence of bunion condition.

However, there have been no subsequent studies to show how much high-heel shoes make feet more susceptible to bunion formation than the original findings by ordinary shoes. The reason for female being more susceptible to bunion development is due actually to their female hormones (estrogen) which tend to loosen ligaments, including the ones supporting the displaced bones in bunion feet. Genes plays also a much more important role than high-heel shoes.

A woman' s body is more flexible due 

to the female hormone estrogen.

Studies have shown more than 80% of bunion sufferers have positive family history and most of them never wore much high heels at all. Only a small proportion ( <5%) of bunion patients can only blame on their high-heel shoes for they have no family history of bunions. One study showed that positive family history is probably 25 times more important as a cause of bunions than high-heel shoes.


The strong evidence of female hormone being possibly the most important causative factor in bunion development is because bunion is a soft tissue problem of ligament loosening and female hormones is responsible for looser female joints than male's and loosening of pelvic ring for easier delivering of babies. Interestingly, some women did notice their bunion deformity had become worse during and after their pregnancies.

In summary, bunions are mainly a female condition relating to their female hormone and often compounded by heredity. Although high-heel shoes are not the main cause of ligament failure in bunion feet, they can probably precipitate earlier onset and accelerate progression of a bunion prone foot due to genetic factor. Avoiding high heels may help prevent unnecessary aggravation but not necessarily its progressive nature. If a woman has no family history of bunion deformity, there is probably still increased risk after wearing high heels for a significant number of years.

Total 1056 surveyed	395 (36.5%) had bunions	High heels (+)	High heels (-)
395 (36.5%) had bunions	100%	17%	83%
Family History (+)	88%	14%	74%
Family History (-)	12%	3%	9%
Survey results initiated by Center for Dr. Wu's bunion surgery with the co-operation of Hong Kong Baptist University

Reference information: www.bunioncenter.com

It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your Orthopedist for diagnosis and treatment.