How do high heels affect coronal pelvis and hip movements during walking?

Effects of High Heels on Coronal Pelvis and Hip Movements During Walking

High heels significantly increase non-sagittal hip and pelvis motion during walking, specifically causing higher peak hip internal rotation and adduction compared to flat footwear. 1

Biomechanical Changes in Coronal Plane

• Women wearing high heels demonstrate greater non-sagittal hip and pelvis motion, particularly increased hip internal rotation and adduction in the coronal plane 1
• These alterations in biomechanics are accompanied by increased gluteus maximus and gluteus medius muscle activity during walking 1
• The degree of biomechanical alteration appears to increase with heel height, with more pronounced effects seen in heels higher than 5.08 cm 2

Neuromuscular Adaptations

• Women use different neuromuscular strategies when walking in high heels, with increased activation of hip stabilizing muscles 1
• Gluteus medius activity increases significantly with heel height to maintain pelvic stability in the coronal plane 1
• These compensatory muscle activation patterns are necessary to maintain balance and stability while walking on an elevated, narrowed base of support 3

Gait Pattern Alterations

• High heels cause a higher stride frequency and shorter stride length compared to barefoot walking 1
• Walking in high heels results in asynchronous subtalar and knee joint action, disrupting normal gait mechanics 2
• Rearfoot motion is significantly altered, with greater supination at footstrike and reduced maximum pronation angle during stance phase 4
• These changes affect the entire kinetic chain, including pelvic motion in the coronal plane 5, 3

Potential Clinical Implications

• The altered coronal plane mechanics and increased muscle activity may contribute to musculoskeletal complaints in regular high heel wearers 5, 3
• Increased hip adduction during walking in high heels may place additional stress on hip joint structures 6
• The biomechanical changes in the coronal plane could potentially contribute to altered load distribution across the pelvis and lower extremities 3, 4
• Contrary to common belief, high heels actually decrease lumbar lordosis during walking rather than increasing it 5

Factors Affecting Biomechanical Response

• The magnitude of coronal plane alterations appears to be related to heel height, with more pronounced effects at heights above 5 cm 2
• Experience in wearing high heels does not significantly alter these biomechanical patterns, suggesting these are inherent adaptations to the footwear design 6, 5
• The observed biomechanical differences between men and women in walking patterns disappear when corrected for height or body mass, suggesting that sex-related morphology differences primarily account for these variations 1

Practical Considerations

• Properly fitting footwear that accommodates foot structure and provides adequate support is essential for maintaining proper biomechanical alignment 7
• Regular high heel use may require compensatory physical therapy interventions to address altered muscle activation patterns and potential imbalances 8
• The energy cost of walking increases with heel height, indicating greater physiological demands when walking in high heels 2