Walking in high-heel shoes induces redistribution of joint power and work

Walking in high-heel shoes (HHS) decreases the push-off power and little research has examined the specific muscle groups that compensate for it. The purpose was to examine the effects of walking in HHS compared to barefoot on lower extremity net joint work and power. Fourteen young women walked in HHS and barefoot at a fixed speed of 1.3 m·s^-1. Marker position and ground reaction force data were synchronously measured at 100 and 1000 Hz, respectively. Peak power and joint work variables were computed over the power phases of the gait cycle using an inverse dynamic approach. When walking in HHS was compared to barefoot, participants exerted a diminished push-off characterized by lesser peak power and lesser work by the ankle plantar flexors in late stance (A2 phase; p < 0.001). To compensate for the reduced ankle plantar flexor power, greater peak power was generated and work was performed in early stance by hip extensors (H1 phase; p ≤ 0.001), in mid-stance by knee extensors (K2 phase; p < 0.001) and in late stance and early swing phase by hip flexor muscles (H3 phase; p ≤ 0.001). Walking in HHS induces biomechanical plasticity and causes distal-to-proximal redistribution of net joint power and work during walking.