• D Casey Kerrigan, Jennifer L Johansson, Mary G Bryant, Jennifer A Boxer, Ugo Della Croce, and Patrick O Riley.
• Department of Physical Medicine and Rehabilitation, University of Virginia, Charlottesville, VA, USA. dck7b@virginia.edu
• Arch Phys Med Rehabil. 2005 May 1;86(5):871-5.

ObjectiveTo determine if women's dress shoes with heels of just 1.5 in (3.8 cm) in height increases knee joint torques, which are thought to be relevant to the development and/or progression of knee osteoarthritis (OA) in both the medial and patellofemoral compartments.DesignRandomized controlled trial.SettingA 3-dimensional motion analysis gait laboratory.ParticipantsTwenty-nine healthy young women (age, 26.7+/-5.0 y) and 20 healthy elderly adult women (age, 75.3+/-6.5 y).InterventionsNot applicable.Main Outcome MeasuresPeak external varus knee torque in early and late stance and prolongation of flexor knee torque in early stance. Three-dimensional data on lower-extremity torques and motion were collected during walking while (1) wearing shoes with 1.5-in high heels and (2) wearing control shoes without any additional heel. Data were plotted and qualitatively compared; major peak values and timing were statistically compared between the 2 conditions using paired t tests.ResultsPeak knee varus torque during late stance was statistically significantly greater with the heeled shoes than with the controls, with increases of 14% in the young women and 9% in the elderly women. With the heeled shoes, the early stance phase knee flexor torque was significantly prolonged, by 19% in the young women and by 14% in elderly women. Also, the peak flexor torque was 7% higher with the heeled shoe in the elderly women.ConclusionsEven shoes with moderately high heels (1.5 in) significantly increase knee torques thought to be relevant in the development and/or progression of knee OA. Women, particularly those who already have knee OA, should be advised against wearing these types of shoes.

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