Analysis of foot kinematics wearing high heels using the Oxford foot model

Abstract

Wearing high heels is thought to lead to various foot disorders and injuries such as metatarsal pain, Achilles tendon tension, plantar fasciitis and Haglund malformation. However, there is little available information explaining the specific mechanisms and reasons why wearing high heels causes foot deformity. Therefore, the purpose of this study was to investigate the foot kinematics of high heel wearers and compare any differences with barefoot individuals using the Oxford Foot Model (OFM). Fifteen healthy women aged 20–25 years were measured while walking barefoot and when wearing high heels. The peak value of angular motion for the hallux with respect to the forefoot, the forefoot with respect to the hind foot, and the hind foot with respect to the tibia were all analyzed. Compared to the barefoot, participants wearing high heels demonstrated larger hallux dorsiflexion (22.55 ${}^{\circ }$ $\pm$ 1.62 ${}^{\circ }$ VS 26.6 ${}^{\circ }$ $\pm$ 2.33 ${}^{\circ }$ for the barefoot; $P=$ 0.001), and less hallux plantarflexion during the initial stance phase ( $-$ 4.86 ${}^{\circ }$ $\pm$ 2.32 ${}^{\circ }$ VS $-$ 8.68 ${}^{\circ }$ $\pm$ 1.13 ${}^{\circ }$ ; $P<$ 0.001). There were also greater forefoot adduction (16.15 ${}^{\circ }$ $\pm$ 1.37 ${}^{\circ }$ VS 13.18 ${}^{\circ }$ $\pm$ 0.79 ${}^{\circ }$ ; $P<$ 0.001), but no significant differences were found in forefoot abduction between the two conditions. The hind foot demonstrated a larger dorsiflexion in the horizontal plane (16.59 ${}^{\circ }$ $\pm$ 1.69 ${}^{\circ }$ VS 12.08 ${}^{\circ }$ $\pm$ 0.9 ${}^{\circ }$ ; $P<$ 0.001), greater internal rotation (16.72 ${}^{\circ }$ $\pm$ 0.48 ${}^{\circ }$ VS 7.97 ${}^{\circ }$ $\pm$ 0.55 ${}^{\circ }$ ; $P<$ 0.001), and decreased peak hind foot extension rotation ( $-$ 5.49 ${}^{\circ }$ $\pm$ 0.69 ${}^{\circ }$ VS $-$ 10.73 ${}^{\circ }$ $\pm$ 0.42 ${}^{\circ }$ ; $P=$ 0.001). These findings complement existing kinematic evidence that wearing high heels can lead to foot deformities and injuries.