Wear High Heels Research Articles

WHY WALKING FLAT-FOOTED HURTS AFTER HIGH HEELS

When it comes to shoes, some women will go through hell for a pair of Jimmy Choos. But what effect does wearing high heels have on our bodies? Clinicians have known for a long time that if you hold a limb in a shortened position over an extended period, the muscles shorten. High-heeled shoes push our heels up, which made Marco Narici from Manchester Metropolitan University wonder whether wearing heels on a regular basis could shorten our calf muscles. According to Narici, there was some anecdotal evidence that something changed because secretaries in the 1950s complained about discomfort when they took their heels off and walked flat-footed. ‘I thought it was an experiment which was inadvertently being done by women. What we could do was test high heel wearers to see if we could find some changes in the calf muscle,’ says Narici (p. 2582).At that time, Robert Csapo, from the University of Vienna, Austria, was visiting Narici's Active Lifespan Lab, so Narici and Costis Maganaris asked Csapo to test the theory. Placing an advert in the Manchester Evening News asking for volunteers ranging in age from 20 to 50 years who had regularly worn 5cm high heels for 2 years or more, Csapo attracted 80 recruits, which he whittled down to a final group of 11 who felt uncomfortable walking without their heels. Then he recruited a second group of women who did not wear high heels and teamed up with Olivier Seynnes to look at the internal workings of both groups' calf muscles.Measuring the size of the women's calf muscles with MRI, the team found that the calf muscles of the high heel wearers were the same size as those of the women who preferred flat shoes; they hadn't shrunk. ‘We were expecting slightly smaller muscle volumes in the high heel wearers because we thought that if the muscle is in a shortened position then you are loading it less and the muscle volume should be smaller,’ explains Narici.Next Csapo and Seynnes used ultrasound to measure the muscle fibre length in the women's calf muscles, and this time they did see a difference. The high heel wearers' muscle fibres were 13% shorter than those of the women who wore flat shoes. ‘This confirmed the hypothesis,’ says Narici, ‘because when you place the muscle in a shorter position, the fibres become shorter.’ However, by shortening the fibres, the muscles would have to contract more to shorten by the same length, and if this was the case the high heel fans' calf muscles could no longer function optimally and thus would produce less force than the flat shoe wearer's calf muscles. Had the shortened muscle fibres made it more difficult for high heel addicts to walk efficiently?The team turned their attention to the tendons that attach the calf muscle to the heel. Scanning with MRI, the team could see that the Achilles' tendon was the same length in the two groups of women. The tendon had not lengthened to compensate for the shorter calf muscle. However, the high heel fans' tendons were much thicker and stiffer than the flat shoe wearers'. Narici and his team realised that by thickening and stiffening, the Achilles' tendon compensates for the shortened muscle fibres in the calf muscle, allowing the fashion addicts' calf muscles to function optimally as they walk, but causing discomfort when walking on flat feet because the tendon cannot stretch sufficiently.So should women give up wearing high heels? Narici doesn't think so, but suggests that fashion addicts may want to try stretching exercises to avoid soreness when they kick off their heels at the end of the day.

하이힐 굽 높이에 따른 보행 시 족저압 변화 비교 분석

본 연구는 구두 굽 높이 변화에 따른 보행 시 족저압력을 비교, 분석함으로써 구체적인 데이터를 정량화하여 높은 굽을 착용함으로 인한 전족부의 압력 증가가 발에 미치는 영향을 알아보고자 한다. 본 연구에 사용된 구두는 선행연구를 바탕으로 여대생이 선호하는 구두 굽 높이 3cm, 7cm를 선택하였으며 여대생 10명을 대상으로 발을 전족부와 후족부로 나누어 수직힘, 최대압력, 평균압력을 측정하였다. 그 결과 전족부에서의 평균압력은 7cm 높이 구두가 높게 나타났으며, 후족부에서는 7cm 높이 구두가 낮게 나타났다. 통계처리 결과 전족부위에서는 3cm 굽 높이와 7cm 굽 높이의 최대압력 비교에서 유의한 차이가 나타났으며(p<.05), 후족부위에서는 수직힘, 최대압력, 평균압력 모두 유의한 차이가 나타났다(p<.05). 이상과 같이 구두를 착용함으로서 전족부의 최대압력이 높아지는 것은 물론이고 후족부위의 수직힘, 최대압력, 평균압력도 높아지는 것을 알 수 있었다. 이러한 현상은 전족부위에 높은 압력분포로 구속압이 증가하여 발가락의 변형을 유발할 수 있으며 후족부위에 압력증가는 장시간 착용 시 뒤꿈치의 통증을 유발할 수 있다. 따라서 굽이 있는 구두를 착용할 때 굽 높이가 7cm일 때 보다는 3cm일 때, 굽 높이가 낮을수록 전족부의 변형 예방과 후족부의 통증을 줄일 수 있을 것으로 기대된다. We aimed to determine the effect of heel height on foot pressure by comparing and analyzing data on foot pressure in shoes with different heel heights. Qn the basis of a previous study, we selected 3cm and 7cm as the shoe heel heights preferred by female college students. We divided 10 female students into forefoot and hindfoot to measure vertical force, maximum pressure, and average pressure. The average pressure on the forefoot was higher and that on the hindfoot was lower in the case of 7cm high-heeled shoes. The maximum pressure on the forefoot was significantly higher in the case of the 7cm heel height (p<.05). The vertical force, maximum pressure, and average pressure on the hindfoot were also significantly higher in the case of the 7cm heel height (p<.05). The results showed that wearing 7cm high-heeled shoes exerted greater maximum pressure on the forefoot and greater vertical force, maximum pressure, and average pressure on the Hndfoot. This leads to increase in confining pressure caused by high pressure distribution over the forefoot and increase in the pressure on the hindfoot, which may cause deformation of toes and heel pain over a long period. Therefore, female college students who wish to wear high heels are recommended to wear 3cm high-heeled shoes rather than 7cm high-heeled shoes.

Postura do pé e classificação do arco plantar de adolescentes usuárias e não usuárias de calçados de salto alto

OBJECTIVES: To investigate the relationship between foot posture and plantar arch among adolescent wearers and non-wearers of high-heeled shoes. METHODS: Thirty-six female adolescents aged 13 to 20 years were selected and grouped as 16 high-heel non-wearers and 20 high-heel wearers. Foot posture was analyzed using photos, firstly barefoot and, secondly, after wearing previously standardized high-heeled platform shoes for an hour. The analysis was performed using the software SAPo. Barefoot impressions were taken, and the Chipaux-Smirak Index was calculated to classify the plantar arch of the foot. For statistical analyses, the paired t test was used to investigate equality between the right and left sides. The Shapiro-Wilk adherence test was performed, followed by inferential analysis using the non-parametric Wilcoxon test, the Mann-Whitney test and Spearman's correlation coefficient. The significance level used was 0.05. RESULTS: There was no correlation between the type of plantar arch and foot posture among the female adolescents studied. However, the rearfoot angle was significantly different, with rearfoot varus after wearing the shoes in both groups. The plantar arch in the wearers group presented smaller values for the Chipaux-Smirak Index. CONCLUSIONS: There is no correlation between foot posture and the type of plantar arch, although these variables are influenced by high-heeled shoes. Article registered in the Australian New Zealand Clinical Trials Registry (ANZCTR) under the number ACTRN12608000300370.

Calf-Contouring Surgery of Gastrocnemius Hypertrophy: Selective Neurectomy of the Sural Nerve

Generally, Asians tend to have obese calves that are shorter and thicker than those of Caucasians. The cause of the enlarged calves is either an excess of subcutaneous fat or calf muscular hypertrophy, but some patients have both conditions. These features are accentuated by the contraction of the calf muscles when patients stand in tiptoe position or wear high heels. In the case of calf muscular hypertrophy without excessive subcutaneous fat, manipulation of the calf muscle is an effective method for reducing calf circumference. From January 2005 to December 2006, the authors performed selective sural neurectomy for 20 patients who complained of obese calves. Using a popliteal incision, the sural nerve branches to the medial and/or lateral gastrocnemius muscles were dissected from the posterior tibial nerve. Using a nerve stimulator, the branches with the most contractile portions were resected in 1 cm lengths at the distal ends. One medial branch was resected in 15 patients, and two branches were resected in 5 patients. In the case of a lateral neurectomy, only one branch was resected. Ultrasound-assisted liposuction was combined for five patients who also showed excessive subcutaneous fat. The patients ranged in age from 19 to 29 years (mean, 23 years). The follow-up period varied from 6 to 18 months. The circumferential change was checked 6 months postoperatively 15 cm below the medial condyle and 15 cm above the medial malleolus. These average circumferences were reduced, respectively, from 36.6 and 32.5 cm to 35.5 and 32.2 cm. In gait analysis performed at 6 months postoperatively, the calf muscle power was slightly reduced to 95% of the preoperative state, but still remained above the normal range. Subjectively, no patient complained of muscle weakness or gait disturbance. One patient showed lower leg edema after mountain climbing that subsided after 1 day of rest. The authors believe a selective neurectomy technique can be an effective method for treating obese calves.

Effect of Positive Heel Inclination on Posture

Millions of women wear high heels on a daily basis; however, few studies have analyzed the changes high heels (positive heel inclination) have on posture. The purpose of this study was to determine whether positive heel inclination changed the postural alignment of the head, spine, pelvis, and knees. Fifteen female college students ((mean age = 22.7, SD = 3.7 years) had sagittal plane angles measured for the cervical spine, thoracic spine, lumbar spine, sacral spine, and knee joints in addition to anterior/posterior displacements of the head and pelvis. All variables were assessed by a Metrecom Skeletal Analysis System, a three-dimensional electrogoniometer. Six randomized trials, three at zero heel inclination and three at 5 cm positive heel inclination, were measured. Analysis of variance results indicated positive heel inclination of subjects brought about significantly lower anterior pelvic tilt, lumbar lordosis, and sacral base angles when compared with zero heel inclination (p < .01). Clinically, patients with low back pain may be affected by high heel usage because of the reduction of the normal lumbar lordosis.

Lower extremity mechanics and energy cost of walking in high-heeled shoes.

In today's society, many women wear high-heeled shoes. However, the effect that shoes of different heel heights have on the biomechanics and energy cost of gait has not been fully investigated. In the present study, the energy cost and the lower extremity mechanics in shoes of different heel heights (1.25 cm, 3.81 cm, 5.08 cm, and 7.62 cm) were examined in 15 female subjects, seven of whom could be considered experienced high-heel wearers. Kinematic data from high-speed video and kinetic data from a force platform were collected to describe lower extremity mechanics while subjects walked overground at a speed of 4.2 km/hour. Heart rate and oxygen consumption were monitored while subjects walked on a treadmill, also at 4.2 km/hour. There were no significant differences in any of the parameters as a function of experience in wearing high heels; therefore, the data were pooled for further analysis. Analysis of the biomechanical data revealed that ankle plantar flexion, knee flexion, vertical ground reaction force, and the maximum anteroposterior braking force increased as a function of heel height. In addition, the timing of the subtalar and knee joint action was asynchronous with the increase in heel height. Metabolically, heart rate and oxygen consumption also increased with heel height. There were many significant differences between the 5.08-cm and the 7.62-cm heel conditions. Therefore, to maintain comfort and decrease the risk of injury, women may be advised not to wear shoes with a heel height greater than 5.08 cm.

Indications for Fusion of the Ankle

Summary Arthrodesis of the ankle is usually indicated for painful posttraumatic lesions of the ankle joint. Any malalignment of the ankle in varus, valgus, or equinus should be corrected at the time of fusion. The operation is contraindicated unless the patient believes that his pain is severe enough to justify surgery. In lesions of a non-traumatic nature, fusion is indicated as a curative measure, as in tuberculosis of the ankle, or to correct deformity. Unless the patient will wear high heels indefinitely, the ankle should be fused at 90 degrees or in 5 degrees of calcaneus. An ankle fused in the neutral position will produce a good gait; fusion in the equinus will accentuate the postoperative limp.

Foot Instability during Walking in Shoes with High Heels

Abstract The walking patterns of eleven women, who were occasional wearers of high-heeled shoes, were compared during walking barefoot and in shoes with high heels. Results showed that the wearing of high heels decreased the pronation of the foot during the support phase of walking. The heels caused a significant decrease in step length, in out-toeing, and in the total range of movement at the talocalcaneal joint. Although these changes were statistically significant, not every subject showed all these changes or the same degree of change. Half of the group showed instability during the support phase of walking. The assumption can be made that some occasional high heel wearers do not adequately adjust to the high-heeled shoe.