• Anna Mika, Brian C Clark, and Łukasz Oleksy.
• Department of Clinical Rehabilitation, University School of Physical Education in Krakow, Al. Jana Pawla II 78, 31-571 Krakow, Poland. Electronic address: anna.mika@awf.krakow.pl.
• Man Ther. 2013 Dec 1;18(6):506-11.

BackgroundRecent studies suggest that wearing high-heel shoes increases the risk of developing certain musculoskeletal pain conditions. In this study we sought to examine whether heel height alters lumbar and hip extensor muscle timing characteristics during a standardized trunk flexion task.MethodsThirty-one young, healthy women (22-27 years; 168.6 ± 5.1 cm; 57.1 ± 11.8 kg) participated in this study. Lumbar erector spinae (ES), gluteus maximus (GM), and biceps femoris (BF) electromyographic (EMG) signals were recorded during a trunk flexion task where subjects were instructed to flex their trunk in the sagittal plane and then return to a neutral posture. The task was repeated under three footwear conditions: while wearing no footwear, while wearing shoes with 4-cm heels, and while wearing shoes with 10-cm heels. EMG onset and offset times, as well as EMG duration, were calculated for each muscle and compared across conditions.ResultsWe observed a significantly earlier onset of the ES EMG activity (1.36 ± 0.61 vs. 1.56 ± 0.67 s), and significantly delayed onset of the GM EMG activity (1.72 ± 0.66 vs. 1.28 ± 0.58 s) during the flexion phase of movement in the 10-cm heeled compared to the no footwear condition. The GM muscle also exhibited an earlier offset time in the 10-cm heel condition compared to the no footwear condition during the flexion movement (2.57 ± 0.67 vs. 3.30 ± 0.61 s) as well as during the return from flexion movement phase (10.87 ± 0.58 vs. 11.69 ± 0.65 s). These alterations in timing characteristic resulted in an overall decrease in the EMG duration for the GM muscle during the flexion movement.ConclusionThe results of this study suggest that high-heels alter trunk and hip extensor muscle coordination patterns. These findings, when considered in combination with other recent findings on the biomechanical effects of wearing high-heels, raise concern about whether wearing high heels results in abnormal spine loading patterns and increases the risk for developing musculoskeletal injuries.Copyright © 2013 Elsevier Ltd. All rights reserved.

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