High heels can lead to ankle injuries

Wearing high heels can strengthen the ankle initially, but leads to weakening and instability over time, a new study has warned.
The findings are not surprising, said Tricia Turner, associate professor of kinesiology and athletic training coordinator in the College of Health and Human Services at University of North Carolina at Charlotte.
"Initially when wearing heels the muscles that surround the ankles have to continuously contract to keep you upright and walking," Turner said.
"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," she added.
The study 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," Turner said.

"High-heeled shoes also change the normal walking or gait cycle, with the ultimate result being a less fluent gait cycle," she 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," she said.
Turner said there are ways to minimise the risk of injury. She recommends combination of stretching and strength and balance training.

The study is published in the International Journal of Clinical Practice (IJCP).