title: Effect of shoe heel height and total-contact insert on muscle loading and foot stability while walking.
abstract: BACKGROUND
  Women wearing high-heeled shoes often complain of foot instability and low-back pain. Previous studies have demonstrated that using total-contact inserts (TCIs) in running shoes reduces impact on leg muscles and alters rearfoot motion. This study investigated how shoe heel height and use of TCIs in high-heeled shoes affect the wearer's rearfoot complex, muscle loading, and subjective comfort.
  
  
  METHODS
  Fifteen inexperienced high heel wearers walked under 6 test conditions formed by the cross-matching of shoe insert (with and without TCI) and heel height (1.0, 5.1, and 7.6 cm) at a speed of 1.3 m/s. The measures of interest were rearfoot kinematics; muscle activities by electromyography (EMG) of the tibialis anterior (TA), medial gastrocnemius (MG), quadriceps (QUA), hamstrings (HAM), and erector spinae (ES); and subjective comfort rating by visual analogue scale for each test condition.
  
  
  RESULTS
  The statistical results showed that elevated heel height significantly increased plantar flexion (P < .001) and inversion (P < .01) at heel strike, prolonged TA-MG co-contraction (P < .001) and QUA activation period (P < .001), and increased root mean square (RMS) EMG in all measured muscles (TA, MG, QUA, ES: P < .001; HAM: P < .01). The use of TCIs reduced the rearfoot inversion angle (P < .01) and RMS EMG in both QUA and ES muscles (P < .01) and increased comfort rating (P < .001).
  
  
  CONCLUSIONS
  These findings suggest that wearing high-heeled shoes adversely affects muscle control and reduces loads in QUA and ES muscles.
  
  
  CONCLUSIONS
  The use of a TCI may improve comfort rating and foot stability.
authors: China Medical University, Department of Sports Medicine, Taichung, Taiwan.
authors: Wei-Hsien
authors: WH
authors: Hong
authors: Yung-Hui
authors: YH
authors: Lee
authors: Yen-Hui
authors: YH
authors: Lin
authors: Simon F T
authors: SF
authors: Tang
authors: Hsieh-Ching
authors: HC
authors: Chen
mesh_terms: D000328:Adult; D004576:Electromyography; D005260:Female; D005528:Foot / Q000502:physiology*; D005684:Gait / Q000502:physiology; D006801:Humans; D018482:Muscle, Skeletal / Q000502:physiology*; D010147:Pain Measurement; D012775:Shoes; D016138:Walking / Q000502:physiology*; D055815:Young Adult