
I found this image in a post on BoingBoing that linked to the Social Images blog. The poster does a pretty good job at describing (and illustrating) some of the common anatomical issues associated with prolonged wearing of high heels, and also giving the biomechanical reason for those problems.
It could be better written in some aspects. For example, why is the calf muscle and Achilles tendon tighter, when clearly in the illustration the muscle+tendon are shorter with high heels on? High heels cause the toes to point downward, shortening the calf muscles. What isn't explicitly stated is that high heels cause the wearer to constantly contract their calf muscles for balance. That contraction is probably what they mean by a "tightened" calf and Achilles. The toes are pointed downward because of the elevated heel, a motion normally caused by flexion of the calf muscles (called plantarflexion). The balance point is smaller and normal methods of balance are thrown off, so the calf muscles must work harder (= flex more) to maintain balance on the ball of the foot.
Perhaps worse, muscles are not equally powerful at all lengths they are weaker when stretched far or when scrunched short. Because the calf muscles are shorter than normal due to the elevated heel, they can't produce as much force. So not only are they called into action more often, they are less able to do that action when called upon.
All of what I just said doesn't even get into the problems associated with weight bearing caused by altering the geometry of the skeleton. The poster does a good job of describing these issues, including bunions and nerve pinching.
So, what's so attractive about high heels anyway? To me, the added height only half explains their appeal. The poster only looks at static issues, problems that are obvious on a woman who is standing still. But by altering the geometry of the skeleton, dynamic change is introduced. That is, a woman can't walk normally when wearing high heels. No shit, right? But how does her walk change? Well, by introducing a platform under the heel, a woman has to lift her heel higher in order for her heel to hit the ground properly when taking a step.
How is this done? Some women will raise up their thighs and flex their knees. But this is ungraceful it's what you see on Cops when the prostitutes are frantically running from the po-pos. More naturally, women will accomplish this (without thinking) by using abdominal and back muscles to lift their hip. Hip goes up, heel goes up, no tripping. Now, imagine step after step after step of this altered walk. Whoo boy, hips a swaying!
What I like about this poster is that it does a good job showing how many and varied changes take place when a simple change is made to the complex musculoskeletal system. One change at the bottom causes a cascade of effects, most of them problematic. It's this integration that I find interesting about biomechanics. Change one thing, and you could be changing everything. Sometimes for good, sometimes for bad.