Postural alignment in barefoot and high-heeled stance.

The posture of nineteen subjects under two conditions of footwear was analyzed for differences in the location of the line of gravity of the body with respect to anatomical landmarks. Intrasubject comparison of barefoot and high-heeled stance showed that the wearing of high heels caused lumbar flattening, a backward tilting pelvis, a reduction of the distance of the knee and ankle from the line of gravity, and a posterior displacement of the head and thoracic spine. The alignment at the greater trochanter did not vary with heel height, perhaps indicating a need to maintain a constant extending moment loading at the hip joint. The change in lumbar lordosis measured in high-heeled stance is inconsistent with clinical findings of hyperlordosis in habitual wearers of high-heeled shoes. It is possible, however, that changes in postural muscle tone due to the altered pelvic inclination may, in the long term, result in hyperlordosis of the lumbar spine.