Wearing high heels
is associated with chronic pain of the neck, lower back and knees. A lot of whiplash Clients complain that the most significant impact is not to be able to go out with their high heels. The
mechanisms behind this have not been fully understood. The purpose of a study by Weitkunat was to investigate the influence of high-heeled shoes on the
sagittal balance of the spine and the whole body in non-habitual wearers
of high heels.
Methods
Lateral standing
whole body low-dose radiographs were obtained from 23 female
participants (age 29 ± 6 years) with and without high heels and
radiological parameters describing the sagittal balance were quantified.
These were analyzed for differences between both conditions in the
total sample and in subgroups.
Results
Standing in high heels was associated with an increased femoral obliquity angle [difference (Δ) 3.0° ± 1.7°, p < 0.0001], and increased knee (Δ 2.4° ± 2.9°, p = 0.0009) and ankle flexion (Δ 38.7° ± 3.4°, p < 0.0001).
The differences in C7 and meatus vertical axis, cervical and lumbar
lordosis, thoracic kyphosis, spino-sacral angle, pelvic tilt, sacral
slope, and spinal tilt were not significant. Individuals adapting with
less-than-average knee flexion responded to high heels by an additional
increase in cervical lordosis (Δ 5.8° ± 10.7° vs. 1.8° ± 5.3°).
Conclusions
In all participants,
wearing high heels led to increased flexion of the knees and to more
ankle flexion. While some participants responded to high heels primarily
through the lower extremities, others used increased cervical lordosis
to adapt to the shift of the body’s center of gravity. This could
explain the different patterns of pain in the neck, lower back and knees
seen in individuals wearing high heels frequently.
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