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

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.