High risks from high heels

The study, published this month in the International Journal of Clinical Practice (IJCP), found that wearing high heels can strengthen the ankle initially, but leads to weakening and instability over time.

This is not surprising, said Tricia Turner, associate professor of kinesiology and athletic training coordinator in the College of Health and Human Services at UNC Charlotte.

"Initially when wearing heels the muscles that surround the ankles have to continuously contract to keep you upright and walking. Over time you need less muscle contraction as the lower leg muscles adapt to the changes in footwear. Once that occurs less muscle contraction occurs," she said.

"With prolonged use you get muscle shortening in the back of the leg and muscle lengthening in the front of the leg. These changes in muscle length then can change muscle strength. "

The IJCP report looked at ankle strength and balance in women training to be flight attendants, collecting data for each class year, freshman through senior, to consider the effects of high heels over time.

Turner said high heels can cause problems because they force the foot into a naturally unstable position. "In sneakers or flat shoes, the foot is positioned in neutral where the bones of the ankle are under the bones of the lower leg, creating a more stable joint and a decreased likelihood of injury."

"High-heeled shoes also change the normal walking or gait cycle, with the ultimate result being a less fluent gait cycle," Turner added.

She said ligament and nerve damage in the ankle could lead to issues in the legs and back.

"Changes at the ankle cause the muscles higher in the leg and back to lose efficiency and strength. It also changes the load the bones in and around the knee have to absorb which can ultimately lead to injury."

But Turner said there are ways to minimize the risk of injury. She recommends combination of stretching and strength and balance training.

Stretching

To stretch lower leg muscles, use a towel to pull your foot towards you for 30 seconds.

Strengthening

Use a theraband to strengthen the big muscles of the lower leg and ankle. Use the theraband to resist the ankle as it pushes up, out and in

Standing toe raises

To work the smaller muscles of the leg, put small objects on the floor and use your toes to pick them up.

Balance

Stand on one limb at a time, holding position for 30 seconds. This may be made more difficult by closing your eyes or standing on an unstable surface.