Lower back pain and neck pain can be exacerbated by altering the gait cycle. Improper heel heights in shoes and ill fitting shoes are common causes impairing the gait cycle.
In the normal gait cycle, the foot rolls over from the heel to the forefoot. Increased effort of the muscles involved in walking occurs when this gait is impaired.
Walking on the toes as is in wearing high heels or when there are tight heel cords increases the muscular effort. The muscles controlling the foot and ankle, knees, hips and trunk have to work harder. There is also diminished the leg venous pressure compared with walking barefooted.
Shoes therefore may increase loads on the lower extremity joints causing muscle and joint pain. Patients who already have pain can exacerbate the back and neck pain secondary to wearing improper shoes.
Even those who have no pain can experience back and neck discomfort or pain depending on the type of shoes that they wear.
In wearing high heels, the plantar pressure in the heel and midfoot shifts to the inner (medial) forefoot, and the vertical and forefoot ground reaction forces increase.
Muscles have to contract with greater force on wearing high heeled shoes since the person is walking on his/her forefoot.
Normal gait consisting of shifting the body weight to gradually roll over from the heel to the forefoot is greatly impaired. The over active contraction of the muscles will lead to pain and cramps in the calves, thigh, back and can exacerbate low back pain and neck pain.
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