Does every bone, muscle and joint from your toes to your neck hurt after a long day in heels at work? Love the way your favorite heels look on date night, but hate the way your body feels after having them on all night?

You’re not alone.

High heels have always been famous for the agonizing foot and ankle pain so many women experienced after wearing them. But now we know that heels are not only causing temporary foot pain that a sympathetic significant other can massage away, but instead, long term structural damage.

According to a recent review article wearing high heels is associated with a fundamental changes in the wearer’s posture and gait that the researchers found lead to “mostly negative consequences” long term.

Over time heels create strength imbalances in the muscles  that surround the ankle joint. This can lean to ankle instability which is associated with changes in gait and posture. Long term these changes are associated with injuries to muscles in the upper leg, hip and even the back.

“One condition known to compound the difficulty of walking is the use of high heeled shoes, which alter the natural position of the foot-ankle complex, and thereby produce a chain reaction of (mostly negative) effects that travels up the lower limb at least as far as the spine.”- Cronin, NJ

While the best defense against the damage high heels causes is to give up heels altogether, that’s probably not a realistic option and probably isn’t necessary at all as long as some preventive measures are taken to counteract the effects of heels on the ankle.

Spend Less Time In Heels

Keep in mind, you don’t have to give them up. But if you can find times in the day to slip them off and wear other shoes or simply go barefoot, even for short periods of time, you’re going to help minimize the negative effects the shoes are having on the mobility of your ankle. For example, in Gretchen Reynolds‘ article she states that: “Dr. Cronin also suggests slipping off heels while sitting at your desk, since wearing the shoes, even when not moving “can alter the resting length of the muscles and tendons around the ankle.”

So, give your feet a break during the day. If you’re going out to run errands, walking to get lunch and definitely once you’re home, give your feet a much needed break. Get into flatter shoes and out of the heels.

Strengthen Your Ankles

Calf raises and other exercises that strengthen your ankles are recommended to help counteract the effects of the heels. Specifically the researchers recommended heel raises and heel drops. An extra bonus is that your calves will look great too.

Heel raises are performed by simply rising up onto your toes from a flat footed position.

Heel drops are performed by standing on the edge of a stair and slowly lowering your heels as low as you can over the edge.

Leave the Heels in the Locker Room

Working out in heels has become a recent fad, with the Stiletto workout andHeel Hop, but those probably are not the best options for your foot, ankle and knee health.

Because heels are inherently unstable resulting in changes in posture and movement mechanics working out in them will only lead to greater impact forces across the already compromised muscles and joints and a greater chance for injury. According to Dr. Cronin, the impact forces created are: “… concentrated over a small region of the foot in high heels, creating regions of very high pressure,” leading to foot pain. Moreover, due to balance and biomechanics being compromised, running in heels is also “a very inefficient way to move.”

So lace up your cross trainers and leave the heels in the locker.

Go With Shorter,Thicker, Heels If Possible

Wearing heels for 40+ hours a week is already putting a lot of strain on the ankles and feet. Styles with taller and or thinner heels add to that strain. Taller heels lead to greater ankle inversion and thinner heels are more unstable. If you’re going to wear heels religiously, simply opting for shorter and/or thicker heels may help mitigate some of these negative effects.

While a shorter and/or thicker heel won’t help strengthen your ankle or improve your ankle mobility and are still damaging, shorter, thicker heels may lead to less severe changes in gait and posture. Therefore they would be less damaging to the structures of the lower body.

While they might not be the best choice for foot health and are probably keeping your podiatrist in business, heels aren’t going away any time soon. Despite all of the pain that they’ve caused women over the years, no one is giving up their “cute shoes”. The good news is, if you can make some of these simple changes to your routine, you can alleviate and maybe undo some of the damage that wearing heels has done to your body.