The Effect of High Heel Shoes on Tibiofemoral and Patellofemoral joint Contact Forces and Muscle Forces

Abstract

Abstract
Introduction: High heel shoes affect the
knee joint and can cause arthritis in the
tibiofemoral (TFJ) and patellofemoral joints
(PFJ). There is a dearth of research
investigating the contact forces of TFJ and
PFJ. Therefore, the purpose of this study
was to assess the effect of high heel shoes
on muscle forces as well as TFJ, and PFJ
contact forces during walking.
Materials & Methods: A total of nine
young females with mean age, height, and
body mass of 21.34±3.83 years, 1.49±0.14
m, and 60.54±1.76 kg, respectively, were
randomly included in this study. The
walking variables in each case were
measured while walking with 6-cm-heels,
3-cm-heels, and without shoes. All
measurements were conducted on the right
legs. The Qualisys motion analyzer and
Kistler Force Plate were utilized to record
data. The data were collected using
OpenSim software to obtain muscular and
joint contact forces. In addition, the data
were analyzed in SPSS software. P-value
less than 0.05 was considered statistically
significant.
Findings: The internal and external TFJ
contact force during walking with 6-cmheels was 3.66±4.07 N/BW, which was
significantly higher than that during
walking without shoes (P=0.05). The
anterior-posterior PFJ contact force was
obtained at 1.71±0.27N/BW, which was
significantly greater than that during
walking without shoes by 0.61 N/BW
(P=0.001). Moreover, the vertical force of
PFJ contact forces during walking with 6-
cm-heels (6 cm) was significantly greater
than that during walking without shoes
(P=0.025). However, there were no
significant differences between walking
with 6- and 3-cm-heels regarding anteriorposterior, internal-external, and vertical TFJ
and PFJ forces (P>0.05).
Discussion & Conclusions: Walking with
high heel shoes increased joint contact force
in the medial compartment

of TFJ and PFJ
during the stance phase of the gait cycle.
This increase in forces as cumulative forces
can put the joint at the high risk of
degeneration and arthritis. The TFJ and PFJ
pain are warning signs of walking with high
heel shoes. Given the harmful effect of high
heels on TFJ and PFJ, it is recommended to
use low heel shoes or flat ones.