by Dennis Zacharkow, PT
High heels inhibit the postural reflex mechanisms elongating one's standing posture in two ways:
Wearing heels on shoes results in a relaxation of important postural muscles of the foot. This causes a breakdown in the foot's postural reflex mechanism that is so critical for an elongated standing posture.
Stewart (1945) described the adverse effect of heels as follows:
"The insertion of a heel even as low as that of the average man's shoe causes a decrease in the tone of these postural muscles by about a half, and there develops a slight increase in the tension on the plantar fascia. The use of a two or three inch heel completely relieves the intrinsic postural muscles of the foot of their tone, and markedly increases tension in the plantar fascia; i.e., the postural reflex mechanism of the foot is negated by heels, and passive tension on non-contractile fascia is substituted for muscle tone."
With high heels, a forward displacement of the center of gravity when standing would lead to an increased demand on the back musculature to maintain an erect posture. Instead of this increased demand on the back musculature, Reynolds and Lovett (1910) found that with high heels, "the strain on the posterior musculature is relieved by motion of the center of gravity backward, through movement of the body backward as a whole, chiefly from the ankle joint."
In a study not involving high heels, Floyd and Silver (1955) also reported relaxation of the erector spinae with a backward displacement of the center of gravity of the body. This was observed with a slight backward swaying movement, occurring mainly at the ankle joints.
The tendency for the individual to lean backward when wearing high heels was also found in the classic Antioch College Studies (1931) on the effects of women's shoes on body mechanics. Compared to a group of women accustomed to wearing low-heeled shoes (heel height not exceeding one inch), the following standing postural faults were found to be two to three times more frequent among a group of women who habitually wore high-heeled shoes (heel height exceeding 1.5 inches): a sway back posture, an increased thoracic kyphosis, and an increased relaxation of the abdominal muscles (Antioch College, 1931).
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