hazardous heels: the effects of high heeled shoes on gait and posture

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Investigating Alterations and Adaptations in Running Mechanics to Minimize Injuries and Increase Performance in Ultramarathon Runners Leegan Boudreau and Jami Anderson

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Page 1: HAZARDOUS HEELS: The Effects of High Heeled Shoes on Gait and Posture

Investigating Alterations and Adaptations in Running Mechanics to Minimize Injuries and

Increase Performance in Ultramarathon RunnersLeegan Boudreau and Jami Anderson

Page 2: HAZARDOUS HEELS: The Effects of High Heeled Shoes on Gait and Posture

Goals• Identify changes in kinematics during

ultramarathon running • Study which kinematic changes are harmful vs

helpful • Propose adaptive training • Gain insight on health benefits and risks of

extreme exercise

Page 3: HAZARDOUS HEELS: The Effects of High Heeled Shoes on Gait and Posture

What is an Ultramarathon?● Categorized as any race longer

than a typical 26.2 mile marathon○ Divided into races that are

either distance specified or time specified.

● Can be held on roadways or trails (Mountain Ultramarathon or MUM)

Page 4: HAZARDOUS HEELS: The Effects of High Heeled Shoes on Gait and Posture

Injuries • Common injury:

• Knee• Stress fractures in foot

• Women are more at risk• Compared to shorter distance runners, ultra

runners have higher risk of stress fracture• Injuries more prevalent in younger, less

experienced runners

Page 5: HAZARDOUS HEELS: The Effects of High Heeled Shoes on Gait and Posture

Why is this study important?• Ultramarathon running has increased

exponentially in the past few years• Number of races increased 1000% over the

last 10 years• American ultramarathon runners increased

from 18,000 in 2003 to 105,000 last year• Little is know about how the body adapts to

extreme exercise• Understanding how to efficiently compete at this

level can have other applications

Page 6: HAZARDOUS HEELS: The Effects of High Heeled Shoes on Gait and Posture

Previous Studies• Most studies compared sub-elite vs elite

groups• Kinematic trends observed in elite runners:

• Higher oscillating frequency• Reduced aerial time• Reduced vertical GRF• Reduced COM oscillating amplitude

• Increased step frequency reduces GRFs• Increase stiffness in the leg, which

corresponds to a smaller knee flexion angles, which together reduces GRFs

Page 7: HAZARDOUS HEELS: The Effects of High Heeled Shoes on Gait and Posture

Contact Time

Aerial Time

Step Frequency*

Maximal GRF*

COM Downward Displacement

Leg Length Change*

Page 8: HAZARDOUS HEELS: The Effects of High Heeled Shoes on Gait and Posture

Limitations of Previous Studies

● Lack of diversity in gender

● Most studies conducted on treadmills

● Neglect harsh gradients associated with MUMs

● Research conducted outside of racing conditions

● Research conducted over short distance and not reflective

of typical “ultra” distances

Page 9: HAZARDOUS HEELS: The Effects of High Heeled Shoes on Gait and Posture

Proposed ResearchLorem 3

● Initial Testing ○ Evaluate

biomechanics○ Mimic Ultra

Environment● Evaluation Phase

○ Create training protocol

● Final Testing○ Reevaluate using

same methods as initial testing

Lorem 1

● Diverse participant pool● Divide into 3 groups

○ Novice○ Moderate○ Elite

Lorem 2

● Force Plate○ GRF

● Motion Capture○ Knee flexion

angle○ Aerial Time○ Contact Time

Lorem 3Lorem 2 Research ApproachParticipants Equipment/Variables

Page 10: HAZARDOUS HEELS: The Effects of High Heeled Shoes on Gait and Posture

Conclusion• Study effectiveness of training protocol on sub-elite runners

performance• By increasing sub-elite runners performance we are decreasing their

likeliness of injury• Release successful aspects of training protocol for applications such

as:• Ultramarathon running• Marathon running• Extreme Mountain Trekking

Page 11: HAZARDOUS HEELS: The Effects of High Heeled Shoes on Gait and Posture

References1. Balducci, P., Clémençon, M., Trama, R., Blache, Y., Hautier, C., 2017. Performance Factors in a Mountain Ultramarathon.

International Journal of Sports Medicine 38, 819–826. doi:10.1055/s-0043-1123422. Degache, F., Morin, J.-B., Oehen, L., Guex, K., Giardini, G., Schena, F., Millet, G.Y., Millet, G.P., 2016. Running Mechanics

during the World’s Most Challenging Mountain Ultramarathon. International Journal of Sports Physiology and Performance 11, 608–614. doi:10.1123/ijspp.2015-0238

3. Giandolini, M., Gimenez, P., Temesi, J., Arnal, P.J., Martin, V., Rupp, T., Morin, J.-B., Samozino, P., Millet, G.Y., 2016. Effect of the Fatigue Induced by a 110-km Ultramarathon on Tibial Impact Acceleration and Lower Leg Kinematics. Plos One 11. doi:10.1371/journal.pone.0151687

4. Giandolini, M., Vernillo, G., Samozino, P., Horvais, N., Edwards, W.B., Morin, J.-B., Millet, G.Y., 2016. Fatigue associated with prolonged graded running. European Journal of Applied Physiology 116, 1859–1873. doi:10.1007/s00421-016-3437-4

5. Hoffman MD, Krishnan E (2014) Health and Exercise-Related Medical Issues among 1,212 Ultramarathon Runners: Baseline Findings from the Ultrarunners Longitudinal TRAcking (ULTRA) Study. PLOS ONE 9(1): e83867. https://doi.org/10.1371/journal.pone.0083867

6. Kasmer, M.E., Ketchum, N.C., Liu, X.-C., 2014. The effect of shoe type on gait in forefoot strike runners during a 50-km run. Journal of Sport and Health Science 3, 122–130. doi:10.1016/j.jshs.2014.03.005

7. Lin, S., Sung, W., Kuo, F., Kuo, T..J., & Chen, J. (2014). Impact of Center-of-Mass Acceleration on the Performance of Ultramarathon Runners, Journal of Human Kinetics, 44(1), 41-52. doi: https://doi.org/10.2478/hukin-2014-0109

8. Millet, G.Y., Morin, J.-B., Degache, F., Edouard, P., Feasson, L., Verney, J., Oullion, R., 2009. Running from Paris to Beijing: biomechanical and physiological consequences. European Journal of Applied Physiology 107, 731–738. doi:10.1007/s00421-009-1194-3

9. Millet, G.Y., 2011. Can Neuromuscular Fatigue Explain Running Strategies and Performance in Ultra-Marathons? Sports Medicine 41, 489–506. doi:10.2165/11588760-000000000-00000

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References Continued9. Morin, J., Tomazin, K., Edouard, P., Millet, G., 2011. Changes in running mechanics and spring–mass behavior induced by a

mountain ultra-marathon race. Journal of Biomechanics 44, 1104–1107. doi:10.1016/j.jbiomech.2011.01.02810. Morin, J.-B., Samozino, P., Millet, G.Y., 2011. Changes in Running Kinematics, Kinetics, and Spring-Mass Behavior over a

24-h Run. Medicine & Science in Sports & Exercise 43, 829–836. doi:10.1249/mss.0b013e3181fec51811. Vernillo, G., Savoldelli, A., Zignoli, A., Skafidas, S., Fornasiero, A., Torre, A.L., Bortolan, L., Pellegrini, B., Schena, F., 2015.

Energy cost and kinematics of level, uphill and downhill running: fatigue-induced changes after a mountain ultramarathon. Journal of Sports Sciences 33, 1998–2005. doi:10.1080/02640414.2015.1022870

12. Vernillo, G., Savoldelli, A., Zignoli, A., Trabucchi, P., Pellegrini, B., Millet, G.P., Schena, F., 2014. Influence of the world’s most challenging mountain ultra-marathon on energy cost and running mechanics. European Journal of Applied Physiology 114, 929–939. doi:10.1007/s00421-014-2824-y

13. Berkowitz B. What happens to your body during an ultramarathon [Internet]. The Washington Post. WP Company; 2015 [cited 2018Nov15]. Available from: https://www.washingtonpost.com/graphics/health/ultramarathon/?noredirect=on

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