Association between high-heeled shoes of varied heel height and bladder neck elevation in women: an exploratory study

Priya Kannan, Brigitte Fung, Regina W.C. Leung, Ravindra Goonetilleke, Stanley J. Winser (Corresponding Author)

Research output: Journal article publicationJournal articleAcademic researchpeer-review

1 Citation (Scopus)


Objectives: To evaluate the relationship between high-heeled shoes of varied heel height and bladder neck elevation in women. Methods: A cross-sectional, exploratory design was applied. Twenty-three continent 18–49-year-old women performed pelvic floor muscle (PFM) contractions while standing in high-heeled shoes of varied heel height. Transabdominal ultrasound was used to evaluate bladder neck elevation in ventral-cranial direction from the resting position during maximum voluntary contraction (MVC) of pelvic floor muscles. Results: Significantly greater bladder neck elevation was demonstrated in neutral ankle position compared to the two- (0.27 [95% CI 0.14–0.39] p < 0.001) and three-inch high-heeled conditions (0.37 [95% CI 0.21–0.53]) p < 0.001). A non-significant association was found between lumbopelvic angle and bladder neck elevation in the ankle dorsiflexion and the two- and three-inch high-heeled conditions. Conclusion: Significantly lower bladder neck elevation in high-heeled conditions indicates that pelvic floor muscle contraction to elevate bladder neck might not be as strong while wearing high-heel shoes as it is while standing bare feet. Further studies with larger sample size are required to evaluate the possible relationship between varied heel height, bladder neck elevation, and urinary incontinence in women.

Original languageEnglish
Pages (from-to)85-92
Number of pages8
JournalFootwear Science
Issue number2
Publication statusPublished - 4 May 2019


  • ankle position
  • Australian New Zealand Clinical Trials Registry (ACTRN12617001463369)
  • high heels
  • lumbar lordosis
  • pelvic floor muscle
  • pelvic tilt
  • Trial Registration:

ASJC Scopus subject areas

  • Human Factors and Ergonomics
  • Biophysics
  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Biomedical Engineering

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