Could High-Heels Be Affecting My Incontinence?

Could wearing high heels affect my ability to use by pelvic floor? This article below makes the suggestion that ankle position (in particular plantarflexion – the high heel position) can hamper the activation of pelvic floor muscles and hence lead to incontinence! So should we really give those high heels a miss after having children?

Priya Kannan, Stanley Winser, Ravindra Goonetilleke & Gladys Cheing (2018) Ankle positions potentially facilitating greater maximal contraction of pelvic floor muscles: a systematic review and meta-analysis, Disability and Rehabilitation, DOI: 10.1080/09638288.2018.1468934

Kannan et al. (2018) is an interesting systematic review that is well worth a read. This review assessed the effect of various ankle positions on pelvic floor muscles in women. This review analysed four studies which compared the resting muscle activity and maximal voluntary contraction in women’s pelvic floor muscles to three ankle positions: neutral, 15 degrees dorsiflexion and 15 degrees plantarflexion.

This review revealed that the resting activity of pelvic floor muscles was significantly greater in both neutral and 15 degrees dorsiflexion of the ankle compared to 15 degrees plantarflexion (the position our feet are in when we wear heels). In addition, the maximal voluntary contraction of pelvic floor muscles was found to be significantly greater in 15 degrees dorsiflexion compared to 15 degrees plantarflexion. There was found to be no significant difference between neutral and 15 degrees dorsiflexion of the ankle for both resting activity and maximal voluntary contraction of pelvic floor muscles.

What does this mean for my incontinence?

– When re-training pelvic floor muscles in women with urinary incontinence, these exercises should be performed in standing with the ankles in either neutral or dorsiflexion of the ankles rather than plantarflexion to enable better pelvic floor muscle activation…in other words, take the heels off!

– Women suffering from urinary incontinence who wear high heels are more likely to experience leakage during exertion due to the reduced resting activity found in pelvic floor muscles in ankle plantarflexion.

– Women suffering from urinary incontinence should be encouraged to avoid wearing high heels and instead wear flat shoes to enable better pelvic floor muscle activation. In addition, women should also be aware of the effects of body posture and ankle positions in their day-to-day activities and when they exercise.

If you are suffering from incontinence and want help with understanding more about this condition and how to treat and manage it then come and see Bonnie, our Women’s Health Physiotherapist at Bend + Mend Physiotherapy in Sydney’s CBD.

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