A

decreased lumbar lordosis and a decreased

angle of pelvic inclination
have also been shown to occur in
women standing and wearing high
heels (X = 6.4 cm) (18) and standing
on a 4.5-cm wooden heel block
(3) when compared with women
standing and wearing no heels.

Significant differences ( p < .01)

were found between zero and positive
heel inclination postures for sagittal
lumbar angle [F (1,14) = 5.11
(~~ 5), sagittal pelvic tilt [F (1,42) =
9.41 (Figure 6), and sacral base angle
[F (1,14) = 11.91 (Figure 7). These
results suggest that standing with pos
itive heel inclination decreased lumbar
lordosis, sacral base angle, and
sagittal anterior pelvic tilt when compared
to standing with zero heel inclination.

DISCUSSION
Significant differences in skeletal
alignment were found when positive
heel inclination was compared with
zero heel inclination using the
Meuecom Skeletal Analysis System.
With a 5.1 cm inclination, there was
a decrease in the anterior pelvic tilt,
sacral base angle, and lumbar lordosis.
Other investigations have also
found that as heel height increased,
there was a decrease in lumbar lordosis
and pelvic inclination (3.18). Although
a change in pelvic tilt of only
lo was found in this study, the total
pelvic tilt range of motion that occurs
in walking has been found to be

Although total body center of

gravity (COG) was not measured in
this study, the decrease in the anterior
pelvic tilt, sacral base angle, and
lumbar lordosis may be the result of
the body's compensation to the forward
shift of COG of the lower extremities
caused by the plantar flexed
position of the foot. To compensate,
the body may adjust the upper body
COG to a more posterior position by
reducing the lumbar lordosis through
posteriorly tilting the pelvis. In sup
port of this, Opila et al (18) found
that the head and thoracic spine
moved to a more posterior position
relative to the line of gravity when
wearing high heels was compared
with barefeet. In this study, the knee
flexion angle did not change with
increased heel height.
Opila et a1 (18) suggested that
the flexing of the knees was an initial
compensation to the plantar flexed
position of the foot but that, over
time, fatigue of the thigh muscles
occurred and other compensations
were made in the pelvis and upper
trunk.