Heel-lovers everywhere, it's time to confirm what you may have long suspected: heels aren't great for your health.
This revelation may not really be that surprising considering high heels essentially force you to teeter around on your tip-toes all day, but what may come as a shock is exactly how much damage they are capable of doing.
Put it this way, it's not just your feet that suffer.
Let's start at the bottom and work our way up. What do high heels do to your feet? Short answer: nothing good.
"There's some good evidence that when ladies walk in a high heel shoe, there is increased pressure on the front part of the foot," Associate Professor Lloyd Reed from the QUT School of Clinical Sciences in podiatry told The Huffington Post Australia. "Particularly under the big toe joint, the first metatarsal.
"A lot of weight gets shifted over to the front there, and there is less pressure out near the little toe.
"The types of problems that we see [as a result of this] is something like a bunion on the big toe joint, or hallux valgus.
"Other problems can include corns and calluses on the feet, especially under the ball of the foot and then on the tops of the toes. The pain under the ball of the foot is called metatarsalgia. There is also something called Plantar fasciitis which some people would refer to as 'heel spur syndrome' which is pain directly under the heel."
If these aren't gnarly enough to make you reconsider your high heel addiction, take into account what Reed refers to as Haglund's Deformity (mmmm. Sexy).
"That's a bump on the back of the heel which can be quite painful when ladies are wearing their dress heels or court shoes," Reed said. "It may be associated with using high heels for prolonged period."
Not that pain is going to stop women from wearing heels any time soon. As Reed points out, one American study found 42 percent of women wore high heels in spite of pain for aesthetic reasons.
"There's even some evidence to suggest women more likely to have inappropriately fitting shoes than blokes, even into older age," Reed said. "And of course, people who have the worst fit in shoes are more likely to have problems with calluses and bunions and so on.
"Some of that also has to do with the style of high heel. For instance I know the fit of the shoe often has a tapered toe and narrow upper section, and that in itself can be a problem for the feet."
"What happens when you wear high heels is that your heel is raised off the ground, which in turn makes your body start to push forward," Associate Professor Kevin Netto and Director of Research at the School of Physiotherapy and Exercise Science at Curtin University told The Huffington Post Australia.
"So you set up what is known as sheer force in your knee. Basically, the front part of your body is trying to fall forward and you are trying to pull it backwards by keeping yourself upright. It's a constant battle.
"That's why most people who wear really high heels will find their knees hurt rather than their ankles. Basically because of the sheer force you set up in your knee."
Knee osteoarthritis is much more common in females than males in all ages. In fact the prevalence is about 30 percent higher in females.
In terms of the actual damage caused to a regular high heel wearer, Netto has this to say:
"If you cut their knees open, it would be a pretty disgusting mess. Cartilage in your knee helps cushion forces, and if you are wearing heels every day you keep tearing on it and pulling on it and pulling on it. As such, it tends to become quite worn, and that's not something you can regenerate. It's not regenerative material."
Adds Reed: "There is evidence that when person walks [in high heels] they do a couple of things, and one of these is to increase the bending of the knee in order to improve their walking and adjust to the fact their ankle is not going to move as much.
"The consequences of this is it produces much more pressure, or more load, in the inside edge of the knee, in the medial compartment of the knee joint.
"Now, the medial compartment of the knee joint is the most common place for knee arthritis, and it has been shown knee osteoarthritis is much more common in females than males in all ages. In fact the prevalence is about 30 percent higher in females."
One of the things people tend to like about high heel shoes is the fact they make their legs look toned (and it's little wonder, considering the muscles are actually flexed).
"The leg muscles are more active in walking in high heel shoes, especially down the front of the leg," Reed said. "The muscle at the back of the leg, the calf muscle, actually tends to shorten.
"As such, it can actually become uncomfortable [to wear flat shoes] if someone has been wearing high heels for long time. They might experience leg pain and discomfort, and that has to do with the shortening of the muscle belly of the calf.
As far as your legs are concerned, you're going to stretch out the muscles in the front, tighten and shorten the muscles in the back and you're going to cause the legs and the ankles to swell.
"There have also been a couple of studies done which look at swelling in the ankles and feet and the legs, and they have found there is an increase in swelling as a result of standing in high heel shoes compared to standing in low heel shoes," Reed continued.
"That's because there's a reduction in the efficiency of the calf muscle pump which should pump the blood and the fluid back toward toward the heart. But because it doesn't work as well in high heels, it creates pressure in the veins.
"So as far as your legs are concerned, you're going to stretch out the muscles in the front, tighten and shorten the muscles in the back and you're going to cause the legs and the ankles to swell."
"There is a common thinking that when it comes to the back, what's called the lumbar lordosis or the curve at the lower back will increase with higher heeled shoes," Reed told HuffPost Australia.
"Scientific research is not conclusive with that. It's very common on the internet but the scientific research is mixed on that front.
"What there is lots of evidence for is the increase in muscle activity in the lower back. Also there's some increase in the abdominal muscles and, for some people, there's an increase in muscle activity in the thoracic region of the spine and the neck.
"So effectively the increase in muscle demand can go right up through the body, from foot to leg to the lower back, to the middle back, up to the neck."
"I challenge anybody to say they walk normally in really high heels. You don't need a PhD in bio-mechanics to explain that one. Just look at someone's gait.
Put simply, those who wear high heels are at risk of doing themselves an injury. (Yes, even if you're super talented at walking in the highest of stilettos, this means you.)
"Wearing high heels effects your centre of mass, which is basically the balance point in the body," Netto said.
"Everyone has a balance point in their body, and to maintain your balance, you have to keep this little balance point over your base of support, which is your feet, basically. If you lose your balance then your balance point moves outside where it's supposed to be.
"When you wear heels, you bring the balance point in your body higher, so you become less stable and much more prone to falling etc.
"The higher the heel, the more you are going to raise your centre of mass, and the more unstable you are going to become, which means you have a higher potential of falling."
For those who are reading this thinking, 'yeah... but I'm great at walking in heels, so this doesn't apply to me', Netto has this to say:
"I challenge anybody to say they walk normally in really high heels. You don't need a PhD in bio-mechanics to explain that one. Just look at someone's gait."
According to Reed, a study over a ten-year period (from 2002-2012) in the United States revealed the rate of injuries suffered by ladies wearing high heels doubled within the decade (though they're not sure why).
The highest rate of those injured were within the age bracket of 20 - 29, followed closely by 30-39.
"The most common injury was a sprain or a strain in the foot or the ankle," Reed said.
"There was also a similar study done in Victoria, conducted from 2006 - 2010, which looked at the number of injuries presenting to emergency departments which were directly attributed to a high heel shoe.
"All of the people injured were less than 55 years of age, and the most common injury was an ankle injury, which doesn't really come as a surprise, as when ankle is flexed, it's more prone to ankle sprains."
Interestingly, most ladies presented with their injuries on Sunday mornings between 8am and 12pm.
"So perhaps due to a Saturday night injury," Reed said. "We don't know this for sure, but that's what we may infer."
More injuries were also reported in the summer months.
"Obviously we would recommend people don't spend a lot of time in high heels," Reed told HuffPost Australia. "And even if they have to wear a high heel, try and get the shape of the shoe to be slightly rounder or broader toe box to fit the foot. if possible.
"Sometimes we suggest that even if there's a bit of heel height, a larger width of heel might be advantageous, particularly with the slip risk."
Netto was more to the point.
"Don't wear them. It's pretty bloody simple," he said. "It's a bit like smoking, if you don't want to get lung cancer, don't smoke. If you don't want a bad back and bad knees, don't wear heels.
"Even if you feel you have to wear them, you don't have to wear stilettos. They just aren't called for. If you are going to have to wear something, wear something light and stay on your feet as little as possible.
"Look, in terms of recommendations, I'm not going to say very much. I don't want to be an advocate for them."