Abstract
High-heeled shoes have the capability to alter the strain and tension of ligamentous structure between the foot and ankle, which may result in ankle instability. Contrarily, high-heeled shoes can also reduce the strain on plantar fascia, which may be beneficial to the treatment of plantar fasciitis. In this study, the influence of heel h eight on the strain and tension force of the anterior talofibular ligament (ATL) and plantar fascia were investigated. A three-dimensional finite element model of coupled foot-ankle-shoe complex was constructed. Four heel heights were studied in balanced standing: (0-inch, 1-inch, 2-inch, and 3-inch). A 2 inch high-heeled shoe was used for the study during walking stance. During balanced standing, the tension force on the ATL increased from 14.8N to 97.0N, with a six-fold increase of strain from 0 inches to 3 inches. Conversely, at 3 inches, the tension force and average strain on the fascia reduced from 151.0N (strain: 0.74%) to 59.6N (strain: 0.28%), and increased sharply to 278.3N (strain: 1.33%) despite it being less relative to standing. The walking simulation showed that the fascia tensed while the loading of ATL decreased during push off. The simulation outcome demonstrated the influence of heel height on the alteration of the ATL and plantar fascia strain, which has risk implications for ankle injury and also guidance for the treatment for plantar fasciitis.
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