A 2001 survey conducted by researchers from Pennsylvania State University using 200 women found that 58% of women complained of lower back pain when wearing heels and 55% of women said they felt the worst overall back pain when wearing the highest heel. The researchers explained that as heel height increases, the body is forced to take on an unnatural posture to maintain its center of gravity. This changed position places more pressure and tension on the lower lumbar spine which explains why the women complained of severe back pain at a higher heel length.
Research shows that heels draw attention to long legs and small feet. Some argue that "high-heeled shoes, perhaps more than any other item of clothing, are seen as the ultimate symbol of being a woman." High heels often play a key role in emphasizing a wearer's, most commonly a woman's, arched back and extended buttocks. This "natural courting pose" sexualizes the wearer, and can turn them into objects subjected to the male gaze. This research highlights the emphasis heels place on the appearance of the wearer, instead of their arguably more valuable internal traits such as intelligence, creativity, or strength.
In a 2012 study, Kai-Yu Ho, Mark Blanchette and Christopher Powers, wanted to determine if heel height increased patellofemoral joint stress during walking. The patellofemoral joint refers to junction where the femur and patella meet. The study consisted of eleven participants wearing tracking and reflective markers as they walked across a 10 meter force plated walkway in low, medium and high heels. The study showed that as the height of the heel increased, the ball of the foot experienced an increase in pressure resulting in increased discomfort levels and peak patellofemoral joint stress. The researchers also mentioned that the long term usage of high heels would lead to repetitive overstress of the joint which would result in an increase in pain and eventually, patellofemoral joint osteoarthritis and Patellofemoral pain syndrome.
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Wearing high-heeled shoes is strongly associated with injury, including injury requiring hospital care. There is evidence that high-heel-wearers fall more often, especially with heels >2.5cm high, even if they were not wearing high heels at the time of the fall. Wearing high heels is also associated with musculoskeletal pain, specifically pain in the paraspinal muscles (muscles running up the back along the spine) and specifically with heel pain and plantar calluses (only women tested).
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