Introduction

INTRODUCTION

High heels are considered to be a wardrobe staple for women across multiple settings, despite their impracticality. While they are commonly worn by women for aesthetic reasons, they have been known to contribute to significant injuries, such as ankle joint sprains and excessive plantar bending (Lee, 2014). Wearing high heels can affect many aspects of walking, including balance, pattern, and efficiency of walking. Additionally, high heels influence neuromuscular control, the length-tension muscle contraction relationship, joint angles, cadence, and stride and stance phases (Weon & Cha, 2018). Heel-wearing experience may also play a role in gait variability, though some argue that age and heel height may be more influential factors (Cronin, 2014). While heel heights have been defined differently, high heels are commonly considered ~6cm, with low heels being ~3cm, and medium heels somewhere in between (Cha, 2020). Overall, studies have shown that the higher the heel height, the greater these gait effects may be (Barkema, et al., 2012).

The impact of wearing high heels is a prominent topic to investigate considering the prevalence of high heel wearing in women. A survey from the American Podiatric Medical Association (APMA) revealed that nearly half of women (49%) wear high heels (APMA, 2014). A different report from The Spine Health Institute found that 72% of women will wear high heels in their lifetime, with 42% of young women (ages 20-49) claiming to wear them daily, compared to 34% of middle-aged/older women (ages 50+) (Hutson, 2016). Nevertheless, it has been found that the more frequently one wears heels, and the higher they are, the greater the effects are on the body and gait pattern.

The purpose of this study was to determine the effects of various heel heights on gait (through the use of different shoes), specifically in terms of changes in joint angles of the ankle and knee, in addition to step length, stride length, and stride rate. Studies have found high heels to have significant effects on ankle angles and increased plantar flexion of the foot (​​Wiedemeijer & Otten, 2018). Similarly, knee angles are also affected, with the amount of knee flexion increasing with heel height, and with the range of motion being greatly reduced compared to barefoot walking (Cronin, 2014). Research has also found participants to have shorter stride lengths (Opila-Correia, 1990) and step lengths with heels, as well as increased stride rates (Barkema et al., 2012).

With this in mind, we hypothesize that if heel height is increased, then stride and step length will decrease, while stride rate will increase. We also hypothesize that with increased heel height, plantar flexion at the ankle and flexion at the knee will increase.