The Result of Mid-High-Heeled Footwear on Young Adult Women
1 . Introduction
The perception of a woman ’ s physical appearance by other people ( both female and male ) is significantly dependent on the type of footwear she is wearing . Wearing high-heeled shoes belongs to women ’ s social behavior that increases the attractiveness , elegance , and even self-confidence of women [ 1 , 2 ] . Over 50 % of women wear highheeled shoes for 1 – 8 h per day , and at least one-third of women in western countries wear high-heeled shoes daily [ 3 ] . A common belief about the adverse impact of footwear on the body has attracted the attention of many researchers to the problem of the impact of wearing high-heeled shoes on various biomechanical aspects of the body . In particular , it has been reported that the habitual wearing of high heels may result in static and dynamic changes in posture and spinal curvatures [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 ] , as well as the lower extremities [ 13 ] . Studies also suggest that long-term wearing of high-heeled shoes may correlate with a higher rate of lower back pain [ 7 ] .
High-heeled shoes may lead to the development of postural disorders of the head , spine , pelvis , and knees [ 14 ] that are characterized by head protraction [ 8 ] , lumbar hyperlordosis [ 4 , 9 , 10 , 12 , 15 ] or decrease of the lordosis angle [ 6 ] , unnecessarily increase the forward inclination of the body and its asymmetry [ 11 ], and also pelvic anteversion
[ 4,5,9,15,16 ]
. Additionally , an elevated risk of foot and ankle injuries from high-heeled shoes is reported [ 17 ] . The postural changes like a compensatory increase in lumbar lordosis and pelvic tilt are suggested to provoke lumbar back pain in habitual wearers of high heels [ 10 , 15 , 18 ] . Decreased lumbar lordosis was usually described in habitual wearers [ 14 , 19 , 20 ] . Increased lumbar lordosis
[ 21 ] associated with high-heeled shoes has been reported for inexperienced wearers
[ 9,22 ]
, or adolescent experienced wearers [ 15 ] . Cowley et al . [ 23 ] concluded in their review that increased lumbar lordosis angles were found predominantly in inexperienced users . Some authors suggest that high-heeled shoes do not affect lumbar lordosis [ 12 ] . Research results until now have been inconclusive with respect to which effects and to what extent they are caused by wearing high-heeled shoes . The inconsistency of the literature findings may be due to high-heel habituation grade , age of the users , small samples , a variation of investigated heel-height used in the experiments , and the variety of assessment methods used .
The low , medium , and high heel shoe categories are mentioned in the literature
[ 24 ]
. Dai et al . [ 9 ] used heels in range 50.3 ± 13.9 . Drzał-Grabiec and Snela [ 11 ] conducted the study with two heel heights ( 4 cm and 8 cm ). De Oliveira Pezzan et al . [ 15 ] used wooden shoes with 10 cm heel and 2 cm elevation in the metatarsal region . Schroeder and Hollander
[ 4 ] used in their experiments different heel heights ranging from 7 to 11 cm .
Franklin et al . [ 14 ] conducted measurements with a three-dimensional electrogoniometer . Russell et al . [ 12 ] used a spinal mouse device to measure lumbar lordosis . Drzał-Grabiec and Snela [ 11 ] assessed the body posture parameters based on photogrammetry moiré pattern projection and fiducial markers attached to the skin . De Oliveira Pezzan et al . [ 15 ] also used fiducial markers but with single-camera photogrammetry . Dai et al . [ 9 ] analyzed standing left lateral radiographs , including that of the spine and pelvis , obtained in a standardized standing position barefoot and with high heels . Weitkunat et al . [ 8 ] used two standing lateral radiographs
12 Pedorthic Footcare Association | www . pedorthics . org