Dr. Mandy Messinger is a respected Doctor of Physical Therapy in NYC with a background in competitive dance, yoga and pilates. It is through the integration of these practices that she helps restore patients and clients to their best possible condition. Here she shares with us how to stay safe and injury free while working your best high-heeled look!

-Dr. Laura Miranda, DOWNTOWN’S Fitness Editorial Director

High heels are beautiful, fun and stylish, but can they also be damaging to your body or even dangerous?

As a physical therapist, my patients often ask “Can I wear heels?” The true answer is always no. However, I find it important to be a practical clinician, so I give the following answer: Wear high heels, but first let’s discuss why high heels are detrimental to our health and then explore ways to modify the heels you already own, making them safer and more comfortable.

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Why heels are bad for you: The Simple Story

High heels place the body in an altered position. The higher the actual heel, the more these changes will be amplified. Feet are they key component to proper body alignment, especially during movement. The feet are also crucial to skeletal stabilization. High heels place the feet and ankles in a state of instability, predisposing the feet and the rest of the body to injury.

Possible short term injuries that can occur while wearing high heels include ankle sprains, strains and fractures of the foot or ankle.

While barefoot, the heel bone (calcaneus), the bone that sits directly on top of the calcaneus (talus), and the lower leg bones (tibia and fibula) fit into a well-stacked, locked bone structure, which naturally prevents the ankle from twisting and damaging the surrounding supportive ligaments.

High heels unhinge this structure, placing the onus of stability on the ligaments and tendons of the ankle. Ligaments are not as stable as bone, so when you are in high heels and you walk on uneven terrain, the possibility of “rolling” your ankle greatly increases. If the force of a twist is great enough, it may even cause a fracture.

Potential long-term injuries after wearing heels year after year include bunions, hallux rigidus (stiff 1st toe joint), patellofemoral pain syndrome (pain under the kneecaps), lower back pain and neck pain.

If you must wear heels, here are my recommendations:

1. Buy heels with ankle support: buckles or straps that tie are the strongest. No pumps without a strap – support your ankle!

2. Modify your heels: If you already own pumps and don’t want to get rid of them, you can modify them using my DIY method:

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a) Cut off the sleeves of a long-sleeved shirt.

b) Place your foot in the shoe and place the tie underneath the arch of the sole. Then cross the tails in an “X” over your ankle and cross behind, tying a bow at the Achilles tendon.

c) Feel free to experiment with how you wrap them, just make sure your ankle is secured in the shoe.

3. When purchasing new shoes, be sure to buy high heels that fit your foot size: Prevent your foot from sliding around in shoes. Note: Suede and leather can stretch, so consider buying a ½ size smaller.

4. Get extra wear out of older boots:
When you find your foot sliding around, slide sneaker insoles into the boot. This not only takes up extra space and allows the shoe to fit snugly again, but it helps provide extra cushioning and additional support.

5. Find a good shoemaker: Worn-out soles or missing heel caps can cause increased impact on the joints or uneven pressure on the whole foot when walking. Take care of your shoes!

4. Bring a pair of flats with you for walking: Carry your heels in a plastic bag or a little shopping bag that you can throw out or stash away somewhere after you change into them.

5. Do preventative ankle strengthening & stretching exercises 2-3 times a week. This will increase your foot’s natural stability, helping to prevent injuries. Stretching will help counteract the shortened position that the calf muscles are in when the foot is in high heels.

-Dr. Mandy Messinger*

*Dr. Mandy Messinger is a licensed, outpatient orthopedic physical therapist with certifications in Ashtanga-based Vinyasa Yoga and mat-based Pilates, and a personal background in competitive figure skating and dance. She specializes in manual and therapeutic exercise-based treatment for a variety of injuries and illnesses, including post-surgical rehabilitation, injury treatment and prevention, work-related pain and ergonomic assessment, return-to-sport therapy and specialized rehabilitation. She can be reached for treatment or training inquiries via email at ThePhysicalWarrior@gmail.com