Effects of high heeled shoes on gait. A review

Highlights

• Walking in high heeled shoes influences gait in its pattern.

• Gait changes in terms of movements and forces throughout the whole body.

• From the heels up, consequences are noticeable up to the head.

Abstract

Background

Walking in high heels (HH) may alter gait in various ways, which may be of importance to designers and physicians.

Research question

How does walking in high heels alter gait and how can this be explained from a biomechanical and control point of view.

Methods

Relevant literature has been collected in which high heeled walking was studied, after which the results were bundled and interpreted in a framework of biomechanics and control.

Results

Major changes were found in the rollover function of the feet, the ankle and knee joints and the lower back, while step length and balance were compromised. An increase in heel height forces the foot in an increased plantar flexion, which in its turn increases knee flexion and lordosis of the lower back. All changes can be related with each other in a plausible pattern of movement and control.

Introduction

Presently it is mostly women who wear high heels and claim their purpose is for aesthetic reasons only. On top of that Guéguen [7] studied the effect of men's behavior on women wearing HH shoes. He found that men's helping behavior increases as heel height increases. Although there seem to be some advantages, there are many more disadvantages in walking in HH shoes. For instance, apart from the discomfort during walking in HH shoes, the long term effects have been linked to many medical problems. Many studies in HH gait are done from a medical point of view, and with specific parts of the body (e.g. knee, ankle, foot) as their main focus. However, in order to fully understand how different parts of the body are affected by HH gait, we need to bundle the different findings and find the underlying mechanism. That is the purpose of this review: to increase our understanding of high heeled gait. In this way, we can more thoroughly understand the separate changes in gait since they are part of the whole pattern of gait itself. This can be relevant information for the users of HH shoes, shoe designers and physicians. For instance, they could address complaints of pain that may not seem logically linked to HH gait at first sight. Next to that, designers could adjust a shoe to make it more comfortable to wear.