Millions of women wear high heels on a daily basis; however, few studi
es have analyzed the changes high heels (positive heel inclination) ha
ve on posture. The purpose of this study was to determine whether posi
tive heel inclination changed the postural alignment of the head, spin
e, pelvis, and knees. Fifteen female college studies (((X) over bar ag
e = 22.7, SD = 3.7 years) had sagittal plane angles measured or the ce
rvical spine, thoraic spine, lumbar spine, sacral spine, and knee join
ts in addition to anterior/posterior displacements of the head and pel
vis. All variables were assessed by a Metrecom Skeletal Analysis Syste
m, a three-dimensional electrogoniometer. Six randomized trials, three
at zero heel inclination and three at 5 cm positive heel inclination,
were measured. Analysis of variance results indicated positive heel i
nclination of subjects brought about significantly lower anterior pelv
ic tilt, lumbar lordosis, and sacral base angles when compared with ze
ro heel inclination (p < .01). Clinically, patients with low back pain
may be affected by high heel usage because of the reduction of the no
rmal lumbar lordosis.