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Title: The influence of high-heeled shoes on strain and tension force of the anterior talofibular ligament and plantar fascia during balanced standing and walking
Authors: Yu, J 
Wong, DWC 
Zhang, H
Luo, ZP
Zhang, M 
Issue Date: Oct-2016
Source: Medical engineering & physics, Oct. 2016, v. 38, no. 10, p. 1152-1156
Abstract: High-heeled shoes have the capability to alter the strain and tension of ligamentous structures between the foot and ankle, which may result in ankle instability. However, high-heeled shoes can also reduce the strain on plantar fascia, which may be beneficial for the treatment of plantar fasciitis. In this study, the influence of heel height on strain and tension force applied to 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 in. (0 cm), 1 in. (2.54 cm), 2 in. (5.08 cm), and 3 in. (7.62 cm). A walking analysis was performed using 2-in. (5.08 cm) high-heeled shoes. During balanced standing, the tension force on the ATL increased from 14.8 N to 97.0 N, with a six-fold increase in strain from 0 in. to 3 in. (0-7.62 cm). The tension force and the average strain on the plantar fascia decreased from 151.0 N (strain: 0.74%) to 59.6 N (strain: 0.28%) when the heel height increased from 0 in. to 2 in. (0-5.08 cm). When heel height reached 3 in. (7.62 cm), the force and average strain increased to 278.3 N (strain: 1.33%). The walking simulation showed that the fascia stretched out while the ATL loading decreased during push off. The simulation outcome demonstrated the influence of heel height on ATL alteration and plantar fascia strain, which implies risks for ankle injury and suggests guidance for the treatment of plantar fasciitis.
Keywords: Finite element analysis
Foot and ankle
Sprain ankle
Plantar fasciitis
Publisher: Elsevier
Journal: Medical engineering & physics 
ISSN: 1350-4533
DOI: 10.1016/j.medengphy.2016.07.009
Rights: © 2016 IPEM. Published by Elsevier Ltd. All rights reserved.
©2016. This manuscript version is made available under the CC-BY-NC-ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/
The following publication Yu, J., Wong, D. W. C., Zhang, H., Luo, Z. P., & Zhang, M. (2016). The influence of high-heeled shoes on strain and tension force of the anterior talofibular ligament and plantar fascia during balanced standing and walking. Medical Engineering & Physics, 38(10), 1152-1156 is available at https://doi.org/10.1016/j.medengphy.2016.07.009
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