BALTIMORE—Angela Manning lost her left leg to diabetic vascular disease but it didn't stop her from wearing chunky, colorful, attention-grabbing high heels.
"I just ordered five pairs and they are gorgeous," the former corrections officer said. "I love my heels."
Manning, 52, wears heels only when sitting in her wheelchair because she isn't sure she could balance in one on her prosthetic. Plus, the prosthetics on the market now aren't made to fit the sky-high heels she favors.
Five engineering students at Johns Hopkins University may have a solution for women like Manning, who miss the joy of fashionable footwear after losing legs or feet. They have developed a prosthetic foot with an ankle that can adjust to accommodate many different heel heights.
"Women with prosthetics are now limited to what shoes they can wear," said Joey Tilson, one of the students. "This allows them to wear almost any type of shoe they decide."
Their design, which they call "Prominence," is not the first high-heeled prosthetic, but the current choices are limited and the Hopkins model could be the most versatile and advanced.
Currently, amputees can get custom-made prostheses for high heels. There are a few off-the-shelf models on the market, but none of them can adjust for heels beyond 2-inches, lower than many women who like high heels want.
The students tested their model on a pair of 4-inch gold strappy heels and said it has the potential to support even taller shoes.
Not being able to wear high heels may seem like a small inconvenience compared with the drastic life changes that amputees endure. But therapists and prosthetists say it is a common concern among female amputees, yet many insurance companies won't cover them because they are not considered a necessity.
Kim Cardosa, a physical therapist at University of Maryland Rehabilitation & Orthopaedic Institute, said she frequently hears from women who have lost limbs to diabetes or vascular diseases and other ailments. High heels were once an integral part of their outfits when they dressed up for church or dinner with friends and family. Others would like to wear nice heeled shoes with their business suits.
"They want to try to get back to as normal a life as possible and sometimes they get a little upset that their footwear is limited," Cardosa said.
Anne Mekalian's favorite shoe style is anything with a heel, but as a double amputee the 70-year-old's prosthetics don't allow her to wear footwear that is higher than a quarter inch.
She misses the days when she could dress up in fancy heels.
"I once wore them every day, all day," she said, dishearteningly. "I don't like practical-looking shoes. I don't like tennis shoes. They are for running and tennis."
There is a growing demand for more prosthetic options as amputees have become less embarrassed by their conditions, those in the field say. For example, some prosthetic feet are built with a slit in the toe so people can wear sandals.
"People aren't trying to hide their prosthetics like they once did," said Rebekah Spielman, global marketing manager for prosthetics manufacturer College Park Industries. "There is a sense of community, being proud of who you are and showing off your metal."
College Park Industries, based in Michigan, manufactures one of what they said are three models of high-heeled prosthetics on the market. Some men also buy the prosthetic to wear with cowboy boots or other shoes with a slight heel.
Spielman said it can take years to make, test and bring a prosthetic to market. A high-heeled prosthetic needs to be robust, but flexible and comfortable, she said.
"It has to be finely engineered and hold up to so much impact as well," she said.
Despite improvements in prosthetics design, the Hopkins students found that the options for women were few and that most are built for men's feet. Yet 46.6 percent of all amputations in 2013 were performed on women, according to The Amputation Coalition, based in Virginia.
The students, who made the prosthetic with the advice of prosthetists from Walter Reed National Military Medical Center in Bethesda, Md., say they just want to provide more options for amputees, particularly soldiers who lose limbs in combat. As more woman serve in active combat, the need for prosthetics that fit their needs is growing, the students said.
"We just want to make quality of life better for veterans," said Luke Brown, also part of the team.
More than 1,800 female veterans with amputations have received care and services from the U.S. Veterans Administration since 2000.
Enhancing mobility for injured soldiers is a top priority, said Dave Laufer, director of Orthotic and Prosthetic Service at Walter Reed.
"Basically, our prosthetics department is constantly looking to improve the function of all prosthetics in order to improve the quality of life for those service members, veterans and their families with amputations," he said.
Of course veterans aren't the only people who will benefit from these efforts.
Alexandra Capellini, a rising senior studying public health and pre-med at Johns Hopkins, lost her leg to bone cancer in 2003. She remembers eyeing girls wearing high heels in high school and feeling like she missed out on that rite of passage.
She tried the prosthetic her fellow students developed while wearing a flat shoe. She wasn't sure if her prosthetic, which has a computerized knee, would respond to the heel, but she hopes to be able to try it one day.
"I was completely ecstatic when the team first approached me about the initial design process," she said. "I think it is an exciting time in prosthetics and that we may soon be able to offer a woman a night on the town with her friends in high heels."
The Hopkins students now will assess whether the prosthetic has commercial appeal and would qualify for a patent.
The Amputee Coalition, a voluntary health organization that serves more than 2million people with limb loss and more than 28 million people at risk for amputation, also gets frequent inquiries about high-heeled prosthetics.