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Heels Dancing: Tips to look after your body

Heels Dancing: Tips to look after your body

Heels dancing has become increasingly popular from recreational dancers to professionals. Heels is not a style, culture or background in itself but is featured across many genres of dance with commercial heels being the most mainstream, influenced by artists in music videos, touring performances and award shows. Heels are commonly worn in other dance styles including vogueing, waacking, musical theatre, pole, salsa, or latin. However, heels can be worn in any style, even breaking or hip hop! This blog will focus on heels dancing for dancers currently or aiming towards commercial dancing.

It is important for dancers to understand the impact wearing and performing in heels can have on the body. When wearing heels, a person’s centre of mass is shifted forward causing a protruding head, increased arch in the lower back, increased pressure on the forefoot, plus an increased balance requirement due to the reduced base of support.1,2,3 Heels dancing can involve a lot of deep squat positions with weight on the toes rather than the heels. This can be challenging for the knees. It will also place the ankle in a more ‘open position,’ reducing stability and increasing the risk of ankle injury. 

This alteration in biomechanics explains why dancing in heels can be painful, despite Beyonce making it look so effortless. Whether you are a beginner heels dancer or heading towards performing professionally, we have some tips to help you train to become more comfortable dancing in heels and to look after your body.

1. Beginners: Advice to ease your transition into heels dancing

  • Dancing in heels has many similarities to dancing in pointe shoes, it requires adequate training, body awareness and maturity. For a beginner it is important to take classes with similar foundation like jazz or ballet as this will help strengthen your ankles and other muscle groups used when wearing a heel. 
  • Kiira Harper when giving advice for heels dancing admits ‘no heels dancer is a safe dancer’ but there are precautions you can take to ensure you look after your body. When starting out, you may find you need to change into a flat shoe like runners or dance barefoot as your feet will not be used to wearing heels for a whole class. As you build your confidence training in heels, it’s important to practice in your heels such as when rehearsing for a performance so you are training your muscle memory and the correct muscles to work during the routine.
  • Learn from different heels dancing teachers to become versatile, each teacher will teach their own style. Some of the first pioneers to teach heels dancing are Aisha Francis, Danielle Polanco, Anthony Garza, Yanis Marshall, Kiira Harper, Brinn Nicole, and Michelle Jersey Maniscalco. Searching these choreographers on YouTube is a great way to get to know heels dancing and how it differs between choreographers teaching their own style.
  • Train with dance teachers who teach correct heels dancing technique. This can be difficult to decipher but look at their credentials and experience and perhaps reach out to your local dance community via Facebook groups or on Instagram as they can point you in the right direction.

2. SHOES: Carefully select your shoes for heels dancing

  • For younger dancers doing cabaret, theatrical, tap or other types of dance in heels, start with a low, block heel and gradually work your way up as you gain strength and control. For pre-professional and experienced dancers the following guide will help when selecting a shoe for Heels Dancing.
  • Type of shoe - Boot heels are best for beginners as they provide the most ankle support while building up strength in the ankles. Good supportive heels may also have a lace up at front, buckle above the ankle, or a side zipper. These aspects all keep the ankle secure but are still flexible enough to move in. If your heels have laces, ensure they are durable and not touching the floor when tied up as this is a huge tripping hazard, the safest option is to tuck them into your shoe.
  • Width of the front of the shoe and thickness of the sole are important for allowing you to spread out your toes and feel the floor for greater stability. Ensure you have enough room in the front of your shoe and choose thinner soles that allow you to feel the floor better.  You could choose an open-toe shoe or a closed-toe shoe, as long as the toes aren’t cramped together. If your toes are cramped, you will get less feedback about your weight placement on the floor and less control around the foot and ankle.
  • Pumps - A pump may be suitable for more advanced heels dancing, depending on the choreography. A pump is the hardest type of heel to dance in as they require adequate strength to hold the foot within the shoe and it provides the least ankle support. Mishay Petronelli, with credits including The Greatest Showman and Janet Jackson, recommends pumps for pre-professional or professional dancers taking heels training as this will help prepare for any heel a dancer may be given and required to wear during a gig.
  • Avoid platforms if possible - This type of heel has an inflexible platform at the forefoot which can vary in height depending on the shoe. This can increase the risk of ankle injury due increased instability (heels are already unstable!) and less capacity for the dancer to “feel the floor”. Unless you are required to dance in a platform shoe as part of your professional costuming, please avoid them. 
  • Customised shoes – at the end of the day, dancing in heels is going to hurt regardless of what you do, especially if you are at rehearsals or performances for hours on end. You will need to break in new shoes. Gradually increase the time you train in new shoes, it will also take time for your feet to get used to them. To prolong your comfort you can try to get your heels customised to your feet at a shoe maker, they can add extra padding to reduce the pressure on your forefoot, or add rubber soles on bottom so you have a good grip on any surface. An alternative option for grip is to scratch the shoes on concrete to give them more texture, this creates more friction on the shoes while you’re dancing, applying hairspray to the bottoms will assist also. As a last minute option if you are already at class, most dancers will drop a small puddle of water on the floor and dip the bottom of their shoe into it for extra hold.

3. Warm-up: The best exercises to get your body ready for heels dancing

  • Exercises to warm-up when heels dancing don’t differ greatly from those that are conducted in a pointe class. Your warm-up should be done without the heels on so you can work through your feet properly first.
  • Calf rises – aim to achieve 25 single leg calf rises. The principal physiotherapist of the Australian Ballet Sue Mayes has some pointers for the perfect calf rises based on her research in 2003 including: The speed of movement should be slow, take 1 second to rise up, and 1 second to lower down. Your foot should be parallel, with your knee neutral so it is not bent or hyperextended, move through your full pain free range of motion with optimal control, ensure your toes remain long and flat, aim for a smooth motion, movement should be vertical so avoid any rocking forwards, you should see the gastrocnemius muscle active throughout range, for good alignment ensure the mid tibia (shin bone) is aligned with the 2nd metatarsal (2nd toe).4
  • Foot intrinsics – try a long toe push with a light theraband, for this exercise you will place the band around one toe at a time and slowly lift the toe, then lower back to the floor (easiest to perform in sitting), you can also try piano toes where you lower one toe to the floor at a time from smallest to biggest, and for a challenge try lowering in order of the biggest to smallest toe.
  • Balance – stand with your feet together on demi pointe, slowly lower your body to a full knee bend with control then slowly rise back up, this will require engagement of your core to hold you steady. This exercise takes you into a deep squat on the toes a common position in heels choreography. As mentioned earlier this increases the load on the knees and requires very good strength and control. It should only be performed if the action is pain free. If you experience knee pain please seek advice from your physiotherapist.
  • Core – try a tabletop exercise, lying on your back with both legs in a tabletop position with 90 degrees flexion of hips and knees, slowly extend one leg straight at a time. It is important to activate your core as you need to hold it when balancing to keep your centre, especially during turns
  • Bridges – you will need your glute max to help push you up from kneeling to standing when dancing in heels rather than requiring your quads and hamstrings to do all the work, ensure your feet are close to the bottom, then push through your heels to lift the bottom up, you can also try this on one leg for increased difficulty.

4. Cool-down: Take time to recover properly with these tips so your body aches a little less the day after heels dancing

  • Calf stretching can assist in allowing the muscle to relax in a lengthened position again, after working hard in a shortened position while dancing in heels. Other alternatives to release tension include massage or using a foam roller.
  • Lower back – in heels dancing a lot of time is spent with the lower back in a forced arch so it is essential to open up the lower back in the opposite direction. Try a child’s pose stretch with a 30 second hold, a cat-cow stretch on your hands and knees for 10 repetitions, knee rocks side to side to rotate through the lumbar spine, knee hugs into chest for 30 seconds, and slow controlled roll downs from standing for 10 repetitions.
  • Drink lots of water and try to get a good night’s sleep after a heels class, in particular for those classes that go for 3 or more hours or for all day long rehearsals.

Due to the increased demand on the body while heels dancing, it is important to ensure you are incorporating these safe dance practices so you can enjoy all the fun heels dancing provides while looking after your body. Our dance physiotherapists Rhianna and Jo are available for dance assessments if you are wanting to improve your heels dancing technique or have been experiencing pain associated with your dancing.


This blog was written by Physiotec Dance Physiotherapist, Rhianna Tunks

If you would like to book with one of our dance physio's, Rhianna or Jo, please call, email or book online below:

Phone: (07) 3342 4284

Email: [email protected]



  1. Chien HL, Lu TW and Liu MW. Effects of long-term wearing of high-heeled shoes on the control of the body’s center of mass motion in relation to the center of pressure during walking. Gait Posture 2014; 39: 1045–1050.
  2. Silva AM, de Siqueira GR, da Silva GA: Implications of high-heeled shoes on body posture of adolescents. Rev Paul Pediatr 2013; 31(2): 265–71
  3. Yung-Hui L and Wei-Hsien H. Effects of shoe inserts and heel height on foot pressure, impact force, and perceived comfort during walking. Appl Ergon 2005; 36: 355–362.
  4. Mulready R – How To Get Strong Calves. The Australian Ballet 2020. Retrieved from: https://australianballet.com.au/behind-ballet/how-to-get-strong-calves
Heels are not always good for the sole

Heels are not always good for the sole

As physio's we often see a link between high heels and pain, but so many people are attached to their heels and these fashion items have been worn for many centuries. Did you know that men used to wear high heels? According to historians, way before the famous high heel was part of the female wardrobe, they were used by soldiers in the 16th century to give them stability in stirrups while riding on a horse so they could shoot their bows while standing up. High heeled shoes have evolved over the centuries with Christian Dior making them popular after World War II and today they are a part of most women’s wardrobe. But apart from being a fashion statement, what do heels do for you?

The HIGH behind the high heels

A recent study by Morris and colleagues studied female gait patterns in flat and high heeled shoes. They found when females wore heels, their perception of attractiveness was increased. They started to walk in a more feminine way with greater pelvic rotation and increased lateral pelvic tilt. Smith in 1999 reported that wearing high heels indicated status for women. No wonder researchers also found that the number of pairs of high heeled shoes owned by study participants was a minimum of 4 and maximum of 25. These may be the good reasons to own a few pairs! How many pairs of heels do you own?

The DOWNSIDE of wearing high heels

Wearing this type of footwear does have its ups, however long term they do take a toll on the body. Several studies have shown that long term high heel use impacts on the whole lower body, from the lower back all the way down to the feet.

High heels and lower back pain

Researchers  have reported that in a survey they conducted with 200 females who had been wearing high heels regularly for 1 year, 58% of them were complaining of low back pain (Lee et al 2001). This is not surprising considering standing and walking in heels has been shown to result in changes in the curvature of the lower back and increased levels of activity in the back muscles, both potentially amplifying loads on the joints of the lower back and fatigue in the back muscles.

High heels and hip pain

When wearing heels, weight is transferred forward towards the forefeet. This forward shift of the bodyweight at the feet means that the trunk and head need to shift relatively backwards to balance the body weight. This changes where the weight is transmitted through the hip and potentially places larger loads particularly through the front of the hip. The increased in rotation and tilting of the pelvis that occur while walking in heels can also place adverse loads across the hips joints and tendons. Even when sitting, high heels push the knees up higher than normal which can result in higher compressive loads across the hip joint. All of these factors may explain why wearing high heels often aggravates hip pain.

High heels and knee pain

The knee joint is also affected with increased compressive forces around the patellofemoral joint (kneecap) (Kerrigan et al 1998) and the inner compartment of the knee joint with forces increased by 23% (Kerrigan et al 1998, Stephanyshyn et al. 2000, Simonsen et al 2012). Landing on those heels while walking also means your quadriceps have to work harder as the foot tends to accelerate more quickly to its impact with the ground (Stefanyshyn et al 2000). Too much activity of your quadriceps can contribute to the higher compressive forces around the knee. Some researchers suggest that the wearing of high heels may make females more vulnerable to developing knee osteoarthritis (Kerrigan et al 1998, Simonsen et al 2012).

High heels and calf & ankle pain

The forward shift in bodyweight can lead to unstable postures (Lee et al 2001) and an increased rate of falls and ankle sprains. In the lower leg, calf muscles shorten while the Achilles tendon, the tendon at the back of the heel, stiffens up resulting in decreased active range of motion of the ankle (Csapo et al 2010). This can explain why regular heel users have discomfort when walking in flats.

High heels and forefoot pain

The biggest impact however occurs at the forefoot. Wearing high heels creates a doubling of pressure under the balls of the feet compared to walking barefoot (McBride et all 1991, Speknijder et al 2005). Bunions and callouses under the feet have also been associated with wearing narrow and shorter shoes (Menz 2005).

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Physiotherapy recommendations around high heels

From a health perspective, high heels are not the greatest footwear. As physiotherapists, we commonly see lower back, hip, knee and foot problems aggravated with the use of heels.

Our recommendations for wearing high heels:

  1. Avoid or minimise use of high heels
  2. Save those heels for special occasions rather than wearing them on a daily basis
  3. Don’t walk to/from work in heels – change into sports/walking shoes
  4. Keep the heels to < 2 cm heel height (Ko et al 2009)
  5. When sitting, if you can slip those heels off and place your feet flat on the ground, do so.
  6. Take some ballet flats with you when going out so you can easily slip them on to dance

So, here’s your excuse to go out and buy some new shoes ladies!

Do your body a favour and choose the flats or the lower heels.

Do you experience pain when wearing heels?

Our physiotherapists can assist you with your pain and get you standing more comfortably again.


Csapo et al (2010)On Muscle Tendon and High Heels. Journal of Experimental Biology, 213,2582-2588

Kerrigan, Todd, O Riley (1998)Knee Osteoarthritis and high-heeled Shoes. Lancet, 351:1399-1401

Ko et al (2009) Relationship Between Plantar Pressure and Soft Tissue Strain Under Metatarsal Heads with Different Heel Heights . Foot and Ankle International , 3,11

Lee, Jeong,Freivalds (2001) Biomechanical Effects of wearing High Heeled Shoes. International Journal of Industrial Ergonomics, 28,321-326

McBride et al (1991) First Metatarsophalangeal Joint Reaction Forces during High- Heel Gait. Foot and Ankle International

Menz, Morris (2005) Foot Characteristics and Foot Problems in Older People. Gerontology, 51(5): 346-351

Simonsen et al (2012)Walking on High Heels Changes Muscle Activity and the Dynamics of Human Walking Significantly. Journal of Applied Biomechanics,28,20-28

Smith (1999) High Heels and Evolution. Psychology, Evolution and Gender ,1.3,245-277

Speksnijder et al (2005) The Higher the heel, the igher the forefoot –pressure in ten healthy women. The Foot,15, 17-21

Stefanyshyn et al( 2000)The Influence of High Heeled Shoes on Kinematics, Kinetics and Muscle EMG of Normal Female Gait. Journal of Applied Biomechanics, 16, 309-319

Thompson, Coughlin (1994) The High Price of High- Fashion Footwear, The Journal of Bone and Joint Surgery 76A,1586-1593