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International Urogynecology Journal

, Volume 30, Issue 12, pp 2049–2054 | Cite as

Can wearing high heels influence anal canal pressure and the severity of fecal incontinence?

  • Veronique Vitton
  • Laure LucianoEmail author
  • Sandra Ortiz
  • Karine Baumstarck
  • Michel Bouvier
Original Article

Abstract

Introduction and hypothesis

Wearing high heels may not only produce deleterious effects on the musculoskeletal system and on the general posture, but also on the activity of pelvic floor muscles. However, no data are currently available concerning the link between fecal incontinence and wearing high heels. Our aim was to determine whether wearing high-heeled shoes could influence anal canal pressure values in patients suffering from fecal incontinence.

Methods

In this retrospective monocentric study, 338 female patients were included. Clinical data, including the Wexner score, and manometric data were recorded (using 3D high-resolution anorectal manometry). Wearing high heels was defined by the use of high-heeled shoes at least four times a week for 4 consecutive hours with at least 1 year of usage time and heels ≥3 cm. Two sub-groups were defined: “high heels” vs “no high heels.”

Results

The two subgroups were comparable for clinical data, including Wexner score, except for a higher age, menopause and hormone replacement therapy, and urinary incontinence in the group with “high heels.” No statistical difference was observed concerning the anal canal pressure. Using analysis by logistic regression, only age was related to a significantly lower resting pressure.

Conclusions

In this retrospective cohort of women with fecal incontinence, no clinical or manometric differences were observed between women who wore high heels versus those who did not. Because there is limited knowledge on this potential link and because the pelvic tilt may vary according to age and the habit of walking with high heels, further studies are necessary.

Keywords

High-heeled shoes Fecal incontinence 3D high-resolution anorectal manometry 

Notes

Compliance with ethical standards

Conflicts of interest

None.

References

  1. 1.
    De Oliveira Pezzan PA, João SM, Ribeiro AP, Manfio EF. Postural assessment of lumbar lordosis and pelvic alignment angles in adolescent users and nonusers of high-heeled shoes. J Manip Physiol Ther. 2011;34(9):614–21.CrossRefGoogle Scholar
  2. 2.
    Yu J, Cheung JT, Fan Y, Zhang Y, Leung AK, Zhang M. Development of a finite element model of female foot for high-heeled shoe design. Clin Biomech (Bristol, Avon). 2008;23(Suppl 1):S31–8.CrossRefGoogle Scholar
  3. 3.
    Mika A, Oleksy L, Mika P, Marchewka A, Clark BC. The effect of walking in high- and low-heeled shoes on erector spinae activity and pelvis kinematics during gait. Am J Phys Med Rehabil. 2012;91(5):425–34.CrossRefGoogle Scholar
  4. 4.
    Ebbeling CJ, Hamill J, Crussemeyer JA. Lower extremity mechanics and energy cost of walking in high-heeled shoes. J Orthop Sports Phys Ther. 1994;19(4):190–6.CrossRefGoogle Scholar
  5. 5.
    Russell BS, Muhlenkamp KA, Hoiriis KT, Desimone CM. Measurement of lumbar lordosis in static standing posture with and without high-heeled shoes. J Chiropr Med. 2012;11(3):145–53.CrossRefGoogle Scholar
  6. 6.
    Chen CH, Huang MH, Chen TW, Weng MC, Lee CL, Wang GJ. Relationship between ankle position and pelvic floor muscle activity in female stress urinary incontinence. Urology. 2005;66(2):288–92.CrossRefGoogle Scholar
  7. 7.
    Vitton V, Baumstarck-Barrau K, Brardjanian S, Caballe I, Bouvier M, Grimaud JC. Impact of high-level sport practice on anal incontinence in a healthy young female population. J Women’s Health (Larchmt). 2011;20(5):757–63.CrossRefGoogle Scholar
  8. 8.
    Jorge JM, Wexner SD. Etiology and management of fecal incontinence. Dis Colon Rectum. 1993;36(1):77–97.CrossRefGoogle Scholar
  9. 9.
    Cheeney G, Remes-Troche JM, Attaluri A, Rao SS. Investigation of anal motor characteristics of the sensorimotor response (SMR) using 3-D anorectal pressure topography. Am J Physiol Gastrointest Liver Physiol. 2011;300(2):G236–40.CrossRefGoogle Scholar
  10. 10.
    Barthet M, Bellon P, Abou E, et al. Anal endosonography for assessment of anal incontinence with a linear probe: relationships with clinical and manometric features. Int J Color Dis. 2002;17(2):123–8.CrossRefGoogle Scholar
  11. 11.
    Vitton V, Vignally P, Barthet M, et al. Dynamic anal endosonography and MRI defecography in diagnosis of pelvic floor disorders: comparison with conventional defecography. Dis Colon Rectum. 2011;54(11):1398–404.CrossRefGoogle Scholar
  12. 12.
    Barthet M, Portier F, Heyries L, et al. Dynamic anal endosonography may challenge defecography for assessing dynamic anorectal disorders: results of a prospective pilot study. Endoscopy. 2000;32(4):300–5.CrossRefGoogle Scholar
  13. 13.
    Benezech A, Bouvier M, Vitton V. Faecal incontinence: current knowledges and perspectives. World J Gastrointest Pathophysiol. 2016;7(1):59–71.CrossRefGoogle Scholar
  14. 14.
    Russell BS. The effect of high-heeled shoes on lumbar lordosis: a narrative review and discussion of the disconnect between internet content and peer-reviewed literature. J Chiropr Med. 2010;9(4):166–73.CrossRefGoogle Scholar
  15. 15.
    Grimmer K, Dansie B, Milanese S, Pirunsan U, Trott P. Adolescent standing postural response to backpack loads: a randomised controlled experimental study. BMC Musculoskelet Disord. 2002;3:10.CrossRefGoogle Scholar
  16. 16.
    Capson AC, Nashed J, McLean L. The role of lumbopelvic posture in pelvic floor muscle activation in continent women. J Electromyogr Kinesiol. 2011;21(1):166–77.CrossRefGoogle Scholar
  17. 17.
    Chen HL, Lin YC, Chien WJ, Huang WC, Lin HY, Chen PL. The effect of ankle position on pelvic floor muscle contraction activity in women. J Urol. 2009;181(3):1217–23.CrossRefGoogle Scholar
  18. 18.
    Sapsford RR, Hodges PW, Richardson CA, Cooper DH, Markwell SJ, Jull GA. Co-activation of the abdominal and pelvic floor muscles during voluntary exercises. Neurourol Urodyn. 2001;20(1):31–42.CrossRefGoogle Scholar
  19. 19.
    Bo K. Pelvic floor muscle training is effective in treatment of female stress urinary incontinence, but how does it work? Int Urogynecol J Pelvic Floor Dysfunct. 2004;15(2):76–84.CrossRefGoogle Scholar
  20. 20.
    Neumann P, Gill V. Pelvic floor and abdominal muscle interaction: EMG activity and intra-abdominal pressure. Int Urogynecol J Pelvic Floor Dysfunct. 2002;13(2):125–32.CrossRefGoogle Scholar
  21. 21.
    Makol A, Grover M, Whitehead WE. Fecal incontinence in women: causes and treatment. Womens Health (Lond). 2008;4(5):517–28.CrossRefGoogle Scholar
  22. 22.
    Macmillan AK, Merrie AE, Marshall RJ, Parry BR. The prevalence of fecal incontinence in community-dwelling adults: a systematic review of the literature. Dis Colon Rectum. 2004;47(8):1341–9.CrossRefGoogle Scholar
  23. 23.
    Snow RE, Williams KR. High heeled shoes: their effect on center of mass position, posture, three-dimensional kinematics, rearfoot motion, and ground reaction forces. Arch Phys Med Rehabil. 1994;75(5):568–76.PubMedGoogle Scholar
  24. 24.
    Bo K, Finckenhagen HB. Is there any difference in measurement of pelvic floor muscle strength in supine and standing position? Acta Obstet Gynecol Scand. 2003;82(12):1120–4.CrossRefGoogle Scholar
  25. 25.
    Morgan DM, Kaur G, Hsu Y, et al. Does vaginal closure force differ in the supine and standing positions? Am J Obstet Gynecol. 2005;192(5):1722–8.CrossRefGoogle Scholar
  26. 26.
    Thekkinkattil DK, Lim MK, Nicholls MJ, Sagar PM, Finan PJ, Burke DA. Contribution of posture to anorectal manometric measurements: are the measurements in left-lateral position physiologic? Dis Colon Rectum. 2007;50(12):2112–9.CrossRefGoogle Scholar

Copyright information

© The International Urogynecological Association 2019

Authors and Affiliations

  • Veronique Vitton
    • 1
  • Laure Luciano
    • 2
    • 3
    Email author
  • Sandra Ortiz
    • 1
  • Karine Baumstarck
    • 4
  • Michel Bouvier
    • 1
  1. 1.Service de Gastroentérologie, CHU Nord, Aix-Marseille UniversitéMarseilleFrance
  2. 2.Department of GastroenterologyInstruction Hospital of French Army LaveranMarseilleFrance
  3. 3.Department of GastroenterologyFrench Military Hospital LaveranMarseille CedexFrance
  4. 4.EA3279 Self-perceived Health Assessment Research Unit, University HospitalAix-Marseille Université, APHMMarseilleFrance

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