The use of orthotic heel lifts is proposed in many cases of Achilles tendon disorders as a first-line or conservative treatment. The use
of heeled shoes induces a plantar flexion of the ankle joint with a consequent decrease in the tension forces acting onto the triceps surae.
The question to address is how high must the heel be? Gait cycle using 1 cm- and 2 cm-high heel lifts was examined. Each measurement
included kinetic and kinematic data on angular variation and moments and power at the hip, knee and foot. The study included 14 healthy
subjects (5 males, 9 females) between 20 and 35 years of age. The data provided by the analysis of the force plate curve showed a statistically
significant change in some parameters (plate forces, knee moments) which were deemed useful in the analysis of load transfer modalities. A
very significant decrease (p = 0.0001) was found in the amplitude of the curve expressing the force produced by the whole limb in response
to ground reaction forces. This is expressed by a decrease in minimum values, suggesting a lower degree of energy absorption at heel strike,
as well as maximum values reflecting the amount of energy generated at push off. This might suggest that by reducing energy absorption by
the whole limb a 2-cm heel lift would have a protective effect for those muscles that are most significantly involved in this function, such as
the tibiotarsal complex (triceps surae) and the knee complex (rectus femoris).
