title: The influence of high-heeled shoes on strain and tension force of the anterior talofibular ligament and plantar fascia during balanced standing and walking.
abstract: High-heeled shoes have the capability to alter the strain and tension of ligamentous structures between the foot and ankle, which may result in ankle instability. However, high-heeled shoes can also reduce the strain on plantar fascia, which may be beneficial for the treatment of plantar fasciitis. In this study, the influence of heel height on strain and tension force applied to the anterior talofibular ligament (ATL) and plantar fascia were investigated. A three-dimensional finite element model of coupled foot-ankle-shoe complex was constructed. Four heel heights were studied in balanced standing: 0 in. (0cm), 1 in. (2.54cm), 2 in. (5.08cm), and 3 in. (7.62cm). A walking analysis was performed using 2-in. (5.08cm) high-heeled shoes. During balanced standing, the tension force on the ATL increased from 14.8N to 97.0N, with a six-fold increase in strain from 0 in. to 3 in. (0-7.62cm). The tension force and the average strain on the plantar fascia decreased from 151.0N (strain: 0.74%) to 59.6N (strain: 0.28%) when the heel height increased from 0 in. to 2 in. (0-5.08cm). When heel height reached 3 in. (7.62cm), the force and average strain increased to 278.3N (strain: 1.33%). The walking simulation showed that the fascia stretched out while the ATL loading decreased during push off. The simulation outcome demonstrated the influence of heel height on ATL alteration and plantar fascia strain, which implies risks for ankle injury and suggests guidance for the treatment of plantar fasciitis.
authors: Orthopedic Institute, Medical College, Soochow University, 708 Renmin Rd, Suzhou, Jiangsu 215006, PR China; Department of Orthopedics, The First Affiliated Hospital of Soochow University, 708 Renmin Rd, Suzhou, Jiangsu 215006, PR China; Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China. Electronic address: jiayu@suda.edu.cn.
authors: Jia
authors: J
authors: Yu
authors: Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China.
authors: Duo Wai-Chi
authors: DW
authors: Wong
authors: Department of Orthopedics, The First Affiliated Hospital of Soochow University, 708 Renmin Rd, Suzhou, Jiangsu 215006, PR China.
authors: Hongtao
authors: H
authors: Zhang
authors: Orthopedic Institute, Medical College, Soochow University, 708 Renmin Rd, Suzhou, Jiangsu 215006, PR China; Department of Orthopedics, The First Affiliated Hospital of Soochow University, 708 Renmin Rd, Suzhou, Jiangsu 215006, PR China.
authors: Zong-Ping
authors: ZP
authors: Luo
authors: Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China. Electronic address: ming.zhang@polyu.edu.hk.
authors: Ming
authors: M
authors: Zhang
mesh_terms: D000842:Ankle; D001696:Biomechanical Phenomena; D005205:Fascia / Q000502:physiology*; D005528:Foot / Q000502:physiology*; D006801:Humans; D008022:Ligaments / Q000502:physiology*; D008954:Models, Biological; D011187:Posture / Q000502:physiology*; D012775:Shoes; D013314:Stress, Mechanical; D016138:Walking / Q000502:physiology*
keywords: Finite element analysis; Foot and ankle; Plantar fasciitis; Sprain ankle