The Effect of Heel Height on Gait and Posture

This study explores relevant full-text literature to reveal the effects of heel height on gait and posture and the kinetics and kinematics of the foot, ankle, knee, hip, and spine.

The risk of ankle inversion injury has been shown to relate to increased heel height, which may contraindicate the use of heel raises in patients with a history of lateral ankle sprains.

In high-heeled shoes, the ankle joint has greater freedom of frontal plane motion (and is therefore less mechanically stable) because of the reduced articular congruence between the talus and tibiofibular mortice.

This reduced articular congruence can be attributed to the plantarflexed position of the foot.

Payne et al. found that feet with laterally deviated subtalar joint axes, especially when combined with a plantarflexed ankle joint, are at risk of inversion ankle injury.

Numerous studies have demonstrated that high-heeled shoes increase the maximum peak pressure, total pressure, and duration of pressure under the medial forefoot during gait.

Snow et al. indicated that wearing high heels results in higher overall pressures across the metatarsal heads.

Studies have also found that the knee does not achieve the same amount of flexion in high-heeled shoes when compared to low-heeled shoes.

Opila-Correia found that wearing high heels increased hip and knee flexion and increased spinal lumbar lordosis.

The postural changes caused by high heels is an overall increase in stiffness of the kinetic chain, which renders tissues more prone to injury from shock and aberrant force vectors over time.

The risk of injury increases further with a higher magnitude of vertical ground reaction forces in high heels.


  1. Emma E. Cowley, Thierry L. Chevalier, Nachiappan Chockalingam (2009) The Effect of Heel Height on Gait and Posture. Journal of the American Podiatric Medical Association: November/December 2009, Vol. 99, No. 6, pp. 512-518

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