In a 2016 study from the Sahmyook University in Korea, researchers wanted to investigate the effects of high heels on the activation of muscles in the cervical and lumbar portions of the spine which refers to the neck and lower back.[29] Thirteen women were recruited to walk down a walkway in three different testing conditions: barefoot, in 4 cm heels and in 10 cm heels. Surface electrodes were placed on the muscle mass of the women’s spines as well as their feet to measure the electrical activity of muscles at different points of movement. The results of the study indicated an increase in both cervical and lumbar muscle activation as heel height increased. The cervical spine, the neck, assists in maintaining head stability and postural control in the body. The usage of high heels shifts the body’s center of mass which forces the spine to adjust itself in order to maintain balance. The researchers mentioned that over time these results would increase local muscle fatigue that could lead to muscle swelling, decreased muscle movement and even tissue deformation.

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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.[23] 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.
In the UK in 2016 temporary receptionist Nicola Thorp was sent home unpaid after she refused to follow the dress code of firm Portico. Thorp launched an online petition calling for the UK government to "make it illegal for a company to require women to wear high heels at work".[37] Two parliamentary committees in January 2017 decided that Portico had broken the law; by this time the company had already changed its terms of employment.[38][39] The petition was rejected by the government in April 2017 as they stated that existing legislation was "adequate".[40] Existing legislation allows women to be required to wear high heels, but only if it is considered a job requirement and men in the same job are required to dress to an "equivalent level of smartness".[41]
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