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Manolo Blahnik stiletto.

Fred Lum/Fred Lum/The Globe and Mail

Consider the stilettoed, Saturday night club reveller: She's generally slow, with short, teetering strides.

But beyond walking funny, women who regularly wear high heels are at greater risk of developing knee osteoarthritis and joint degeneration - and the higher the heel, the greater the risk, according to a new Iowa State University study.

While previous studies examined the way high heels affect joints, the Iowa researchers looked at heel height specifically.

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Study author and kinesiology masters student Danielle Barkema had 15 women walk in flats, two inch and 3.5 inch heels. Using sensors, cameras and other lab equipment, Ms. Barkema measured the forces acting on their knee joints and the shock wave travelling up their bodies from the heel strike.

As heels got higher, compression grew on the inside of the knee. Aside from the knee, heels two inches and higher also changed joint positions at the ankle, hip and trunk. These changes alter posture, which can in turn put strain on the lower back.

The idea for the thesis came from Ms. Barkema's twin sister Ashley, who managed a Chicago department store and witnessed the physical toll regular high-heel wear was having on her co-workers. The older women in particular were suffering from problems with their knees and hips."I tell my friends to try to wear high heels in moderation," Ms. Barkema said in a release, "and, if possible, to wear lower heels."

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