Dedication Simple Solutions Experience

A formula for ideal heel height

If you visit me, I may well have reason to tell you your ideal shoe heel height. I've used a simple and extremely reliable measuring technique for this which I devised in 1980. I've been teaching it to my students for over 20 years. I can tell you the highest your shoe heels should be, and the lowest. Don't be afraid, it might not be as low as you fear. Sometimes I tell people to wear high heels and that's their treatment!

This comes in very handy when I'm deciding whether orthotics will work, or when a bride with a foot problem is deciding on her wedding shoes, or when someone has plantar fasciitis, or arthritis in the foot or ankle, and in countless other situations.

I can give you an interesting example. I have a long-time patient who's done movies, Broadway and TV. He came to me once with an unstable bone in his arch, which I was able to stabilize simply by telling him not to go below a certain heel height in his show shoes. He stayed pain-free with those shoes for a long time, until the wardrobe people decided to fix the heels.

Eventually he came back to me, after having seen two other doctors and a physical therapist. He'd been in pain for three months, and was about to quit the show because he couldn't take it anymore. He was in distress because somehow he'd developed Achilles tendinitis, or so he thought, immediately after the shoes were re-heeled.

I measured the new heels versus my original prescription. They were 3/8-inch higher. It was strange, because it's rare to cause Achilles tendinitis by raising the heel. Usually it would follow abrupt lowering of the heel. So I examined him, and found, despite the pain in the back of his ankle and the diagnoses of the three previous health professionals, that he did not have an Achilles tendinitis.

I discovered on my X-ray that he had an extra bone, about the size of a marble, lodged in the back of his ankle, which was getting jammed between his foot and leg bones by the raised heel. This is a common injury in dancers, called "posterior impingement syndrome of the ankle". You can Google it. His treatment? You're getting good at this, that's right, lower his heels back to the original prescription. Pain gone.

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