Effect of Heel Lift Insoles on Lower Extremity Muscle Activation and Joint Work during Barbell Squats

The effect of heel elevation on the barbell squat remains controversial, and further exploration of muscle activity might help find additional evidence. Therefore, 20 healthy adult participants (10 males and 10 females) were recruited for this study to analyze the effects of heel height on lower extremity kinematics, kinetics, and muscle activity using the OpenSim individualized musculoskeletal model. One-way repeated measures ANOVA was used for statistical analysis. The results showed that when the heel was raised, the participant’s ankle dorsiflexion angle significantly decreased, and the percentage of ankle work was increased (p < 0.05). In addition, there was a significant increase in activation of the vastus lateralis, biceps femoris, and gastrocnemius muscles and a decrease in muscle activation of the anterior tibialis muscle (p < 0.05). An increase in knee moments and work done and a reduction in hip work were observed in male subjects (p < 0.05). In conclusion, heel raises affect lower extremity kinematics and kinetics during the barbell squat and alter the distribution of muscle activation and biomechanical loading of the joints in the lower extremity of participants to some extent, and there were gender differences in the results.