Every month, XSENSOR's Sports Performance Science Contributor, Antonio Robustelli, MSc, CSCS (Sports Performance Scientist & Technologist with OmniAthlete Performance Concept), will offer his take on essential and recommended reading, research, and review for plantar pressure applications using gait analysis for athletes.
Be sure to tune in to get the abstracts, summaries, and key takeaways or read the full studies at your own pace.
Research Title: Plantar Pressure Distribution in Female Olympic-Style Weightlifters
Authors: Hawrylak A., Gronowska H.
Journal: International Journal of Environmental Research & Public Health
Publication Year: 2020
Abstract
Background: The aim of this study was to investigate differences in static and dynamic plantar pressure and other foot geometry variables between female Olympic-style weightlifters and an age- and sex-matched control group.
Methods: The study involved 24 national-level competitive weightlifters and 24 physical education students. Leg dominance was determined and baropodometry was used to assess plantar pressure and foot posture during quiet standing and walking. For all variables basic descriptive statistics were calculated (mean ± standard deviation). Students 't' test was used to compare the between-group differences. Spearman's rank correlation coefficients were calculated to determine the association between BMI (Body Mass Index) and average and peak plantar pressure.
Results: No significant differences were observed in plantar pressure distribution between the two groups. A moderate correlation was found between BMI and non-dominant limb peak and average plantar pressure in the group of weightlifters in the static condition and in the control group in the dynamic condition.
Conclusions: Olympic-style weightlifting may affect plantar pressure distribution and foot posture in female weightlifters. BMI may also correlate with peak and average plantar pressure in this population. Further research is needed to determine if Olympic-style weightlifting may affect plantar pressure distribution and foot posture in female weightlifters.
Why the Study Is Relevant
This study aims to investigate whether Olympic female weightlifters shows differences in plantar pressure distribution and plantar loading respect to untrained females.
The research question seems to not really be focused as plantar pressure distribution can be influenced by several factors, including training and recovery status as well as anatomical structure, joint mobility, and neuromuscular properties in other regions of the body: in fact we don’t know anything about the training done in the hours prior to the measurement as well as range of motion and mobility test in ankle, knee, and hip joint.
Also, a larger sample size would have been necessary as well as testing foot dynamics and plantar loading during the lifts.
Summary
Foot structure and plantar pressure distribution are important in Olympic weightlifting as they can influence stability, balance, and maximal force production.
The authors of this study tried to answer the question if a specific type of foot structure and shape (neutral, pronation, supination) prevail among female weightlifters and if significant difference exists in plantar pressure distribution between weightlifters and untrained females.
Key Takeaways
- Olympic style weightlifting may affect plantar pressure distribution in female weightlifters.
- BMI may correlate with average and peak plantar pressure in female weightlifters.
Research Title: The Effect of Foot Orthoses with Forefoot Cushioning or Metatarsal Pad on Forefoot Peak Plantar Pressure in Running
Authors: Hahni M., Hirschmuller A., Baur H.
Journal: Journal of Foot & Ankle Research
Publication Year: 2016
Abstract
Background: Foot orthoses are frequently used in sports for the treatment of overuse complaints with sufficient evidence available for certain foot-related overuse pathologies like plantar fasciitis, rheumatoid arthritis, and foot pain (e.g., metatarsalgia). One important aim is to reduce plantar pressure under prominent areas like metatarsal heads. For the forefoot region, mainly two common strategies exist: metatarsal pad (MP) and forefoot cushioning (FC). The aim of this study was to evaluate which of these orthosis concepts is superior in reducing plantar pressure in the forefoot during running.
Methods: Twenty-three (13 female, 10 male) asymptomatic runners participated in this cross-sectional experimental trial. Participants ran in a randomised order under the two experimental (MP, FC) conditions and a control (C) condition on a treadmill (2.78 ms-1) for 2 minutes, respectively. Plantar pressure was measured with the in-shoe plantar pressure measurement device pedar-x®-System and mean peak pressure averaged from ten steps in the forefoot (primary outcome) and total foot was analysed. Insole comfort was measured with the Insole Comfort Index (ICI, sum score 0-100) after each running trial. The primary outcome was tested using the Friedman test (α = 0.05). Secondary outcomes were analysed descriptively (mean ± SD, lower & upper 95%-CI, median and interquartile-range (IQR)).
Results: Peak pressure [kPa] in the forefoot was significantly lower wearing FC (281 ± 80, 95%-CI: 246-315) compared to both C (313 ± 69, 95%-CI: 283-343; p = .003) and MP (315 ± 80, 95%-CI: 280-350; p = .001). No significant difference was found between C and MP (p = .858). Peak pressures under the total foot were: C: 364 ± 82, 95%-CI: 328-399; MP: 357 ± 80, 95%-CI: 326-387; FC: 333 ± 81 95%-CI: 298-368. Median ICI sum scores were: C 50, MP 49, FC 64.
Conclusion: In contrast to the metatarsal pad orthosis, the forefoot cushioning orthosis achieved a significant reduction of peak pressure in the forefoot of recreational runners. Consequently, the use of a prefabricated forefoot cushioning orthosis should be favoured over a prefabricated orthosis with an incorporated metatarsal pad in recreational runners with normal height arches.
Why the Study Is Relevant
This study aimed to investigate which orthosis strategy works best to reduce plantar pressure in the forefoot of runners: the authors evaluated the effect of forefoot cushioning and metatarsal pad on peak pressure in the forefoot during treadmill running.
The paper introduces an interesting research question trying to address the popular topic of overuse injuries (i.e. plantar fasciitis, metatarsalgia) in distance runners. The research design is cross-sectional.
The cons if this study are the relatively small sample size and the fact that runners have been asked to run on a specific footstrike pattern (rearfoot and not forefoot strike) thus not allowing a natural movement to occur.
Summary
Overuse is one of the most common running-related injuries and the ankle/foot area has been shown to be the second most common overuse injury location after the knee.
The overuse injuries in the ankle/foot area includes stress fractures, plantar fasciitis, and metatarsalgia: increase plantar pressure in the forefoot in distance runners has been found to be a red flag in the risk of developing an overuse injury.
The authors found that forefoot cushioning is more effective than metatarsal pad in reducing forefoot peak pressure.
Key Takeaways
- Forefoot cushioning orthosis can significantly reduce peak pressure in the forefoot of recreational runners.
- Forefoot cushioning can be used as a treatment where pressure reduction is the goal in recreational runners with normal arch height.
Research Title: Dynamic Patterns of Forces & Loading Rate in Runners with Unilateral Plantar Fasciitis: A Cross-Sectional Study
Authors: Ribeiro AP., Joao SMA., Casanova Dinato R., Tessutti VD., Camargo Neves Sacco I.
Journal: Plos One
Publication Year: 2015
Abstract
Aim/Hypothesis: The etiology of plantar fasciitis (PF) has been related to several risk factors, but the magnitude of the plantar load is the most commonly described factor. Although PF is the third most-common injury in runners, only two studies have investigated this factor in runners, and their results are still inconclusive regarding the injury stage.
Objective: Analyze and compare the plantar loads and vertical loading rate during running of runners in the acute stage of PF to those in the chronic stage of the injury in relation to healthy runners.
Methods: Forty-five runners with unilateral PF (30 acute and 15 chronic) and 30 healthy control runners were evaluated while running at 12 km/h for 40 meters wearing standardized running shoes and Pedar-X insoles. The contact area and time, maximum force, and force-time integral over the rearfoot, midfoot, and forefoot were recorded and the loading rate (20–80% of the first vertical peak) was calculated. Groups were compared by ANOVAs (p<0.05).
Results: Maximum force and force-time integral over the rearfoot and the loading rate was higher in runners with PF (acute and chronic) compared with controls (p<0.01). Runners with PF in the acute stage showed lower loading rate and maximum force over the rearfoot compared to runners in the chronic stage (p<0.01).
Conclusions: Runners with PF showed different dynamic patterns of plantar loads during running over the rearfoot area depending on the injury stage (acute or chronic). In the acute stage of PF, runners presented lower loading rate and forces over the rearfoot, possibly due to dynamic mechanisms related to pain protection of the calcaneal area.
Why the Study Is Relevant
This study aims to investigate the patterns of plantar loading during running in runners suffering from both acute and chronic plantar fasciitis.
The research is a descriptive study with a very good sample size (45 runners with PF and 30 healthy runners in the control group) that tried to investigate the patterns of plantar loads and loading rate in runners with chronic and acute PF by using a very applied approach: in fact data collection has not been performed in a treadmill and lab controlled environment but rather on a regular asphalt surface to allow a natural running movement to occur.
Summary
Plantar fasciitis is one of the most prevalent musculoskeletal disorders in running athletes.
Plantar loads over the calcaneal area has been found to be one of the primary risk factors for developing plantar fasciitis as excessive loads can stimulate microtraumas formation and the start of an acute inflammatory response. Then the repetitive impact of the heel can lead to a chronic process, involving degeneration and fragmentation of plantar fascia.
The authors of the study found that runners with PF exhibits different patterns of plantar loads on the rearfoot area depending if they are in the chronic or acute stage.
Key Takeaways
- Plantar load in PF runners is higher than in healthy runners.
- Runners in the acute stage of PF presents a lower loading rate and forces over the rearfoot area.