# Postural Adaptations of the Spinopelvic Parameters in the Sagittal Plane Induced by the Use of High-Heeled Shoes in a Sample of Young Healthy Female Subjects: A Pilot Study

## TL;DR

This pilot study found that wearing high-heeled shoes for two hours did not cause significant postural changes or back pain in young women.

## Contribution

This is the first study to evaluate postural adaptations after sustained high-heel use rather than immediate effects.

## Key findings

- No significant postural changes were observed after two hours of high-heel use.
- No acute low back pain was reported among participants.
- Only a modest and likely non-clinically relevant change in thoracic kyphosis was noted.

## Abstract

This pilot study aimed to investigate postural adaptations in spinopelvic parameters on the sagittal plane following the use of high-heeled shoes over a prolonged period in a population of healthy young women. Thirty-four female participants were assessed using rasterstereography at three time points: standing barefoot (T1), immediately after wearing their own high-heeled shoes (T2), and after two consecutive hours of standing or walking while wearing the shoes (T3). The evaluation focused on trunk inclination, pelvic tilt, lumbar lordotic angle, and thoracic kyphotic angle. Participants were also stratified into two subgroups based on self-reported history of low back pain (LBP) during high-heel use: 13 symptomatic and 21 asymptomatic individuals.

The statistical analysis, conducted using both parametric and non-parametric tests due to the borderline normality of the data, revealed no significant postural changes between T2 and T3, nor any relevant differences between the two subgroups. Only a modest variation in the kyphotic angle was observed between T1 and T3, which may not be clinically relevant. Notably, none of the participants reported pain after the two-hour protocol.

These findings suggest that, in inexperienced users, high-heeled shoes do not induce significant spinopelvic compensations or acute lumbar discomfort following moderate-duration use. As this is the first study to evaluate postural outcomes after sustained use rather than immediate heel elevation, further research with larger and more diverse samples is warranted to better elucidate the potential role of heel-induced adaptations in the etiology of LBP.