Effects of high-heeled footwear on static and dynamic pelvis position and lumbar lordosis in experienced younger and middle-aged women.

There is still conflicting evidence about the effect of high-heeled footwear on posture, especially if methodological confounders are taken into account. The purpose of this study was to investigate the effect of high-heeled footwear on lumbopelvic parameters in experienced younger and middle-aged women while standing and walking. Thirty-seven experienced younger (n=19:18-25 years) and middle-aged (n=18:26-56 years) women were included in this randomized crossover study. Using a non-invasive back shape reconstruction device (rasterstereography), static (pelvic tilt and lumbar lordosis angle) and dynamic (pelvic rotation, median lumbar lordosis angle and range of motion) parameters representing pelvis position and lumbar curvature were measured. In order to analyse standing and walking on a treadmill (0.83m/s), the effects of high-heels (7-11cm) were compared to standard control shoes. There were no effects on the lumbar lordosis angle or range of motion under static or dynamic conditions (p>0.05, d≤0.06). But there was a small effect for a reduced pelvic tilt (p=0.003, d=0.24) and a moderate effect for an increased transversal pelvic rotation (p=0.001, d=0.63) due to high heel shoed standing or walking, respectively. There were no significant age-group or interaction effects (p>0.05). Altered pelvic parameters may be interpreted as compensatory adaptations to high-heeled footwear rather than lumbar lordosis adaptations in experienced wearers. The impact of these findings on back complaints should be revisited carefully, because muscular overuse as well as postural load relieving may contribute to chronic consequences. Further research is necessary to examine clinically relevant outcomes corresponding to postural alterations.