In a 2012 study, Kai-Yu Ho, Mark Blanchette and Christopher Powers, wanted to determine if heel height increased patellofemoral joint stress during walking. The patellofemoral joint refers to junction where the femur and patella meet. The study consisted of eleven participants wearing tracking and reflective markers as they walked across a 10 meter force plated walkway in low, medium and high heels. The study showed that as the height of the heel increased, the ball of the foot experienced an increase in pressure resulting in increased discomfort levels and peak patellofemoral joint stress. The researchers also mentioned that the long term usage of high heels would lead to repetitive overstress of the joint which would result in an increase in pain and eventually, patellofemoral joint osteoarthritis and Patellofemoral pain syndrome.
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If you have flatter feet then running shoes with more cushioning is the way to go. Having extra material to absorb impact on ground strike will translate into more distance and less fatigue. Runners with a more neutral foot type can make selections that are considered more “middle of the road”. Make sure you also check the way that your old shoes wear on the outsole, this can tell you a lot about the way you step.