Pelvic Floor Muscles Tense Up Before the Uterus
On the subway stairs during the morning commute, the rhythmic click-clack of high heels fills the station.
Women in tight business suits and high heels climb stairs, cross crosswalks, and move between offices and conference rooms all day long. When they finally take off their shoes in the evening, the first thing they usually say is almost always the same.
“My back feels like it’s about to break.”
Most people assume it’s because their feet hurt. However, the perspective of orthopedic, rehabilitation, and obstetrics/gynecology specialists is slightly different. While the pain starts in the feet, the most significant changes unexpectedly occur in the pelvis.
The moment you put on high heels, the body’s center of gravity shifts forward. To avoid falling, the lower back arches more, the pelvis tilts forward, and the muscles in the hips and thighs remain in a state of tension all day. On the outside, it looks like a graceful walk, but inside the body, an “invisible muscle war” continues to maintain balance.
These changes don’t end in a day or two. If repeated, they can lead to chronic lower back, pelvic, and hip pain. This musculoskeletal burden is particularly severe for occupational groups who spend long hours standing, such as flight attendants, retail staff in department stores, and hotel employees.
Recently, interest has expanded to the pelvic floor muscles. The pelvic floor is a ‘hammock’-like muscle structure that supports the uterus, bladder, and rectum from below. It plays a crucial role not only in urination, bowel movements, and sexual function but also in pregnancy and childbirth.
According to research, high heels change the body’s posture, which can increase tension in the pelvic floor muscles. If repeated over long periods, this can lead to muscle fatigue and dysfunction, and some women have reported correlations with chronic pelvic pain, dyspareunia (painful intercourse), and urinary urgency.
Not Infertility, But the Pelvis Remembers
So, are high heels a cause of infertility? Currently, the medical consensus leans toward ‘no.’
There is no direct evidence that high heels diminish ovarian function, interfere with ovulation, or make pregnancy itself impossible. While rumors circulate on the internet that “high heels cause the uterus to shift” or “high heels lead to infertility,” there is a lack of reliable research to support these claims.
However, this is not a matter to be simply dismissed.
A significant number of women receiving infertility treatment already suffer from chronic pelvic conditions such as endometriosis, pelvic inflammatory disease, or adenomyosis. For them, the continuous tension of pelvic muscles and lower back/pelvic pain can further degrade their quality of life. This is why managing body balance, blood circulation, and muscle health is so important during the process of preparing for pregnancy.
The situation changes slightly once pregnancy occurs. During pregnancy, ligaments become loose due to the influence of the hormone relaxin, and the center of gravity shifts forward. At this time, high heels can exacerbate back pain and increase the risk of falls, so most obstetricians recommend low heels or sneakers.
Fertility specialists do not say, “Never wear high heels.” Instead, they advise that reducing the time spent in heels, choosing low heels on days when standing for long periods is necessary, and performing calf stretches and ankle exercises intermittently can help maintain pelvic health.
High heels may make women look more beautiful. But the place that pays the highest price for that beauty may not be the feet, but the pelvis. Behind every click-clack of those footsteps, our pelvis is working tirelessly, balancing itself invisibly all day long.
※ This article was written to help general readers understand the topic based on clinical experience in obstetrics/gynecology and reproductive medicine, as well as the latest research data. It does not replace a specific individual’s diagnosis or treatment, and actual medical judgment must be made through consultation with a specialist.
※ The images used in this article were created using generative AI (ChatGPT, OpenAI) and depict fictional individuals, not real people.