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. 2024 Jun 29;11(7):667.
doi: 10.3390/bioengineering11070667.

Suitable Heel Height, a Potential Method for Musculoskeletal Problems during the Third Trimester: A Pilot Study

Linjuan Wei  1 , Yan Wang  1   2   3 , Yinghu Peng  4 , Guoxin Zhang  1 , Qitao Tan  1   2   3 , Yaodong Gu  5 , Ming Zhang  1   2   3
Affiliations

Suitable Heel Height, a Potential Method for Musculoskeletal Problems during the Third Trimester: A Pilot Study

Linjuan Wei et al. Bioengineering (Basel). .

Abstract

Background: The treatment options for third-trimester musculoskeletal issues are limited. This study aims to examine how heel height affects gait biomechanics and provides heel height recommendations for various musculoskeletal problems.

Methods: Five third-trimester gravidas were recruited wearing uniform footwear with four heel heights (0 mm, 15 mm, 30 mm, and 45 mm). Lower-limb muscle forces, joint angles, joint torques, joint contact forces, and ground reaction forces (GRF) at specific moments (the first peak, valley, and second peak of GRF) were collected for one-way analysis of variance with repeated measures.

Results: The soleus, gastrocnemius, tibialis posterior, plantaris, obturator externus, gluteus maximus, gemellus superior, and obturator internus were the smallest at heel heights of 45 mm and 15 mm at the valley of GRF. Hip extension and knee flexion displayed the smallest joint angle and joint torques at a height of 15 mm. Ankle joint contact force decreased with increased heel height.

Conclusions: The height of the heel significantly impacts muscle force, joint angles, joint torques, and joint contact force. A heel of 15 mm might be the most suitable heel height to potentially avoid or alleviate musculoskeletal problems during the third trimester.

Keywords: gait biomechanics; heel height; third trimester.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Schematic diagram of the shoe (A) and heel pads (B).
Figure 2
Figure 2
Location and names of the reflective markers. The black arrows direct to the marker labels. The arrows of other colors represent the direction of movement of the markers. Abbreviation: LASI/RASI = left/right anterior superior iliac crest; LPSI/RPSI = left/right posterior superior iliac crest; SACR = medial of the LPSI and RPSI; RFTC = right greater trochanter; RTT1—4 = four markers at the lateral side of 1/2 of the right thigh; RFLE = lateral epicondyle of the right femur; RFME = medial epicondyle of the right femur; RST1—4 = four markers at the lateral side of 1/2 of the right shank; RLA = right lateral ankle; RMA = right medial ankle; RHT1—3 = three markers located at the right heel; RD5M = distal lateral of the right fifth metatarsal; RD1M = distal medial of the right first metatarsal; RTOE = right head of the second metatarsal.
Figure 3
Figure 3
Illustration of peak 1, peak 2, the valley, and the change range.
Figure 4
Figure 4
Comparisons of lower-limb muscle force and GRF during the stance phase under different shoe conditions. Sol: soleus muscle force; Gas: gastrocnemius muscle force; TP: tibialis posterior muscle force; Gmi: gluteus minimus muscle force; Gma: gluteus maximus muscle force; GS: gemellus superior muscle force; OE: obturator externus muscle force; OI: obturator internus muscle force; Pla: plantaris muscle force; GRF: vertical ground reaction force.
Figure 5
Figure 5
Comparisons of lower-limb joint angles during the stance phase under different shoe conditions. Hip Fle (+): hip flexion (+); Knee Fle (+): knee flexion (+); Ankle Eve (+): ankle eversion (+).
Figure 6
Figure 6
Comparisons of lower-limb joint torque during the stance phase under different shoe conditions. Hip Fle (+): hip flexion torque (+); Knee Fle (+): knee flexion torque (+); Knee Exr (+): knee external rotation torque (+); Ankle Dor (+): ankle dorsiflexion torque (+).
Figure 7
Figure 7
Ankle joint contact force.
See this image and copyright information in PMC

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References

    1. Forczek W., Ivanenko Y., Salamaga M., Sylos-Labini F., Frączek B., Masłoń A., Curyło M., Suder A. Pelvic movements during walking throughout gestation—The relationship between morphology and kinematic parameters. Clin. Biomech. 2020;71:146–151. doi: 10.1016/j.clinbiomech.2019.11.001. - DOI - PubMed
    1. Abbassi-Ghanavati M., Greer L.G., Cunningham F.G. Pregnancy and laboratory studies: A reference table for clinicians. Obstet. Gynecol. 2009;114:1326–1331. doi: 10.1097/AOG.0b013e3181c2bde8. - DOI - PubMed
    1. Alexander S.E., Pollock A.C., Lamon S. The effect of sex hormones on skeletal muscle adaptation in females. Eur. J. Sport Sci. 2022;22:1035–1045. doi: 10.1080/17461391.2021.1921854. - DOI - PubMed
    1. Chu S.R., Boyer E.H., Beynnon B., Segal N.A. Pregnancy results in lasting changes in knee joint laxity. PM R. 2019;11:117–124. doi: 10.1016/j.pmrj.2018.06.012. - DOI - PMC - PubMed
    1. Letompa S., Khanyile L., Mathivha T., Purbhoo M. Foot health status in pregnant women. Foot. 2023;55:101938. doi: 10.1016/j.foot.2022.101938. - DOI - PubMed

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