The Impact of Load Carriage and High-heeled Shoes on Gait During Incline Walking

Main Article Content

Chan Siow Cheng
Tan Ying
Chong Yu Zheng
Tan Yin Qing

Abstract

Introduction: High-heeled footwear lacks sufficient cushioning at the heel, leading to direct transmission of impact forces to the body, which may contribute to musculoskeletal strain. While previous studies have examined the effects of high heels on gait and posture, limited research has investigated the combined impact of high-heeled walking, load carriage, and surface incline on lower limb biomechanics. This study seeks to address this gap by analyzing the forces exerted on the ankle joint and Achilles tendon under these conditions. Materials and Methods: Fifteen young healthy local university female undergraduates were assessed in biomechanics lab for the kinetic impact of walking under various conditions, comparing barefoot and high-heeled shoe conditions with and without load carriage. The analysis encompassed walking on both level and inclined surfaces at participants' preferred walking speeds. Utilizing the inverse dynamic method, the forces exerted on the ankle joint and Achilles tendon were calculated. Results: Variations in VGRF can indicate potential stress on joints and tissues; however, the results showed no statistically significant differences in maximum VGRF between conditions. Nevertheless, the study observed a consistent increase in both ankle joint and tendon forces with the steepening of slope across all heel height and load carriage conditions. Conclusion: The results of this research enhance our understanding of the interactions between humans and high-heels, providing insights to enhance the performance of the musculoskeletal system. This knowledge is valuable for prioritizing women's safety and health in terms of gait and posture while wearing high-heeled footwear.

Downloads

Download data is not yet available.

Article Details

How to Cite
Chan Siow Cheng, Tan Ying, Chong Yu Zheng, & Tan Yin Qing. (2025). The Impact of Load Carriage and High-heeled Shoes on Gait During Incline Walking. Malaysian Journal of Medicine and Health Sciences, 21(6), 1398.1 –1398.8. https://doi.org/10.47836/mjmhs.v21.i6.1398
Section
Original Articles

References

Barkema DD, Derrick TR, Martin PE. Heel height affects lower extremity frontal plane joint moments during walking. Gait Posture. 2012;35(3):483-8. doi:10.1016/j.gaitpost.2011.11.013.

Speksnijder CM, vd Munckhof RJ, Moonen SA, Walenkamp GH. The higher the heel the higher the forefoot-pressure in ten healthy women. The foot. 2005;15(1):17-21. doi:10.1016/j.foot.2004.10.001.

Di Sipio E, Piccinini G, Pecchioli C, Germanotta M, Iacovelli C, Simbolotti C, et al. Walking variations in healthy women wearing high-heeled shoes: Shoe size and heel height effects. Gait Posture. 2018;63:195-201. doi:10.1016/j.gaitpost.2018.04.048.

Dames KD, Smith JD. Effects of load carriage and footwear on lower extremity kinetics and kinematics during overground walking. Gait Posture. 2016;50:207-11. doi:10.1016/j.gaitpost.2016.09.012.

Wang J, Gillette JC. Carrying asymmetric loads during stair negotiation: Loaded limb stance vs. unloaded limb stance. Gait Posture. 2018;64:213-9. doi:10.1016/j.gaitpost.2018.06.113.

Chow DH, Kwok ML, Au-Yang AC, Holmes AD, Cheng JC, Yao FY, et al. The effect of backpack load on the gait of normal adolescent girls. Ergonomics. 2005;48(6):642-56. doi:10.1080/00140130500070921.

Lee S, Li JX. Effects of high-heeled shoes and asymmetrical load carrying on lower-extremity kinematics during walking in young women. J Am Podiatr Med Assoc. 2014;104(1):58-65. doi:10.7547/0003-0538-104.1.58.

Nguyen LY, Harris KD, Morelli KM, Tsai L-C. Increased knee flexion and varus moments during gait with high-heeled shoes: a systematic review and meta-analysis. Gait Posture. 2021;85:117-25. doi:10.1016/j.gaitpost.2021.01.017.

Lee J, Yoon Y-J, Shin CS. The effect of backpack load carriage on the kinetics and kinematics of ankle and knee joints during uphill walking. J Appl Biomech. 2017;33(6):397-405. doi:10.1123/jab.2016-0221.

Kellis E, Arampatzi F. Effects of sex and mode of carrying schoolbags on ground reaction forces and temporal characteristics of gait. Journal of Pediatric Orthopaedics B. 2009;18(5):275-82. doi:10.1097/BPB.0b013e32832d5d3b.

Chew KY, Tan YQ, Chan SC, editors. The effects of different high heeled shoes during gait at the kinetic and kinematic impact. IEEE 15th Student Conference on Research and Development (SCOReD); 2017: IEEE. doi:10.1109/SCOReD.2017.8305435.

Sharifmoradi K. The Effect of High Heel Shoes on Tibiofemoral and Patellofemoral joint Contact Forces and Muscle Forces. Journal of Ilam University of Medical Sciences 2019;27(2):159-68. doi:10.29252/sjimu.27.2.159.

Hong Y, Li J-X, Fong DT-P. Effect of prolonged walking with backpack loads on trunk muscle activity and fatigue in children. J Electromyogr Kinesiol. 2008;18(6):990-6. doi:10.1016/j.jelekin.2007.06.013.

Chan SC, Ang KW, Tan YQ, editors. The Effect of Load Carriage While Wearing High Heeled Shoes on Ankle Joint Kinetics During Walking. IEEE Student Conference on Research and Development (SCOReD); 2020: IEEE. doi:10.1109/SCOReD50371.2020.9250996.

Sarvestan J, Ataabadi PA, Yazdanbakhsh F, Abbasi S, Abbasi A, Svoboda Z. Lower limb joint angles and their variability during uphill walking. Gait Posture. 2021;90:434-40. doi:10.1016/j.gaitpost.2021.09.195.

Strutzenberger G, Leutgeb L, Claußen L, Schwameder H. Gait on slopes: Differences in temporo-spatial, kinematic and kinetic gait parameters between walking on a ramp and on a treadmill. Gait Posture. 2022;91:73-8. doi:10.1016/j.gaitpost.2021.09.196.

Franz JR, Lyddon NE, Kram R. Mechanical work performed by the individual legs during uphill and downhill walking. The Journal of Strength & Conditioning Research. 2012;45(2):257-62. doi:10.1016/j.jbiomech.2011.10.034.

Montgomery JR, Grabowski AM. The contributions of ankle, knee and hip joint work to individual leg work change during uphill and downhill walking over a range of speeds. Royal Society open science 2018;5(8):180550. doi:10.1098/rsos.180550.

Hong Y, Li JX. Influence of load and carrying methods on gait phase and ground reactions in children’s stair walking. Gait Posture. 2005;22(1):63-8. doi:10.1016/j.gaitpost.2004.07.001.

Zeng Z, Liu Y, Hu X, Li P, Wang LJBPH. Effects of high-heeled shoes on lower extremity biomechanics and balance in females: a systematic review and meta-analysis. BMC Public Health. 2023;23(1):726. doi:10.1186/s12889-023-15641-8.

Bigouette J, Simon J, Liu K, Docherty CLJJoat. Altered vertical ground reaction forces in participants with chronic ankle instability while running. Journal of athletic training. 2016;51(9):682-7. doi:10.4085/1062-6050-51.11.11.

Rabusin CL, Menz HB, McClelland JA, Evans AM, Landorf KB, Malliaras P, et al. Efficacy of heel lifts versus calf muscle eccentric exercise for mid-portion Achilles tendinopathy (the HEALTHY trial): study protocol for a randomised trial. Journal of foot and ankle research. 2019;12:1-12. doi:10.1186/s13047-019-0325-2.

Cronin NJ, Barrett RS, Carty CP. Long-term use of high-heeled shoes alters the neuromechanics of human walking. J Appl Physiol. 2012;112(6):1054-8. doi:10.1152/japplphysiol.01402.2011.

Ferley DD, Osborn RW, Vukovich MD. The Effects of Uphill Vs. Level-Grade High-Intensity Interval Training on VO2max, Vmax, VLT, and Tmax in Well-Trained Distance Runners. The Journal of Strength & Conditioning Research. 2013;27(6):1549-59. doi:10.1519/JSC.0b013e3182736923.

Yan S-h, Zhang K, Tan G-q, Yang J, Liu Z-c. Effects of obesity on dynamic plantar pressure distribution in Chinese prepubescent children during walking. Gait Posture. 2013;37(1):37-42. doi:10.1016/j.gaitpost.2012.05.018.

Hof AL. Scaling gait data to body size. Gait Posture. 1996;3(4):222-3. doi:10.1016/0966-6362(95)01057-2.

Field A. Discovering statistics using IBM SPSS statistics: sage; 2013.

Hyun S-H, Kim Y-P, Ryew C-C. Effect on the parameters of the high-heel shoe and transfer time of ground reaction force during level walking. Journal of exercise rehabilitation. 2016;12(5):451. doi:10.12965/jer.1632592.296.

Moore JX, Lambert B, Jenkins GP, McGwin Jr G. Epidemiology of high-heel shoe injuries in US women: 2002 to 2012. The Journal of Foot and Ankle Surgery. 2015;54(4):615-9. doi:10.1053/j.jfas.2015.04.008.

Diniz P, Pacheco J, Guerra‐Pinto F, Pereira H, Ferreira FC, Kerkhoffs GJKS. Sports Traumatology, Arthroscopy. Achilles tendon elongation after acute rupture: is it a problem? A systematic review. Knee Surg Sports Traumatol Arthrosc. 2020;28(12):4011-30. doi:10.1007/s00167-020-06010-8.

Shang J, Chen L, Zhang S, Zhang C, Huang J, Wang X, et al. Influence of high-heeled shoe parameters on biomechanical performance of young female adults during stair ascent motion. Gait Posture. 2020;81:159-65. doi:10.1016/j.gaitpost.2020.07.065.

Stefanyshyn DJ, Nigg BM, Fisher V, O'Flynn B, Liu W. The influence of high heeled shoes on kinematics, kinetics, and muscle EMG of normal female gait. J Appl Biomech. 2000;16(3):309-19. doi:10.1123/jab.16.3.309.

Luximon Y, Cong Y, Luximon A, Zhang M. Effects of heel base size, walking speed, and slope angle on center of pressure trajectory and plantar pressure when wearing high-heeled shoes. Human movement science. 2015;41:307-19. doi:10.1016/j.humov.2015.04.003.

Wan FK, Yick K-L, Winnie W. Effects of heel height and high-heel experience on foot stability during quiet standing. Gait Posture. 2019;68:252-7. doi:10.1016/j.gaitpost.2018.12.004.

Harman E, Hoon K, Frykman P, Pandorf C. The effects of backpack weight on the biomechanics of load carriage. Army Research Inst Of Environmental Medicine Natick Ma Military Performancediv; 2000. doi:10.21236/ADA377886.

Jones BH, Perrotta DM, Canham-Chervak ML, Nee MA, Brundage JF. Injuries in the military: a review and commentary focused on prevention. Am J Prev Med. 2000;18(3):71-84. doi:10.1016/S0749-3797(99)00169-5.

Chan SC, Chia JW, Tan YQ, editors. Kinetic and kinematic impacts during level walking, uphill walking, level running and uphill running. IEEE Student Conference on Research and Development (SCOReD); 2018: IEEE. doi: 10.1109/SCORED.2018.8710809.

Alexander N, Strutzenberger G, Ameshofer LM, Schwameder H. Lower limb joint work and joint work contribution during downhill and uphill walking at different inclinations. J Biomech. 2017;61:75-80. doi:10.1016/j.jbiomech.2017.07.001.

Neves KA, Johnson AW, Hunter I, Myrer JW. Does Achilles tendon cross sectional area differ after downhill, level and uphill running in trained runners? J Sports Sci Med. 2014;13(4):823. https://pmc.ncbi.nlm.nih.gov/articles/PMC4234952/.

Walsh GS, Harrison IJEjoss. Gait and neuromuscular dynamics during level and uphill walking carrying military loads. European journal of sport science. 2022;22(9):1364-73. doi:10.1080/17461391.2021.1953154.