Gender and somatotype differences in postural alignment: Response to high-heeled shoes and simulated weight gain

Postural alignment was analysed in 77 subjects grouped for gender and somatotype under four conditions: barefoot, in low-heeled shoes, in low-heeled shoes with a simulated abdominal weight gain, and in high-heeled shoes. Significant gender differences were found in the distances between the line of gravity of the whole body and the thoracic spine (P<0.001) and greater trochanter (P<0.001) during barefoot stance. The centre of gravity of the body was measured to pass anterior to the greater trochanter in males and posterior in females. In response to the external stresses of a simulated weight gain and high-heeled shoes, subjects consistently had significant anterior displacements of the head and posterior displacements of the upper trunk, with only 2 out of 16 groups having changes at the greater trochanter. The combination of these compensations must cause a flattened lumbar lordosis, opposite to the increased lumbar lordosis observed clinically in habitual wearers of high-heeled shoes and overweight individuals.