Arch-support foot-orthoses normalize dynamic in-shoe foot pressure distribution in medial tibial stress syndrome

This systematic review evaluates the existing literature about medial tibial stress syndrome (MTSS) in novice and recreational runners. PubMed/MEDLINE, EMBASE, Web of Science, Scopus, SPORTDiscus and CINAHL databases were searched until July 2020. Studies covering risk factors, diagnostic procedures, treatment methods and time to recovery of MTSS in novice and recreational runners were selected. Eleven studies met the inclusion criteria and were included. The risk factors of MTSS are mainly intrinsic and include higher pelvic tilt in the frontal plane, peak internal rotation of the hip, navicular drop and foot pronation, among others. Computed tomography (CT) and pressure algometry may be valid instruments to corroborate the presence of this injury and confirm the diagnosis. Regarding treatment procedures, arch-support foot orthoses are able to increase contact time, normalize foot pressure distribution and similarly to shockwave therapy, reduce pain. However, it is important to take into account the biases and poor methodological quality of the included studies, more research is needed to confirm these results.

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Changes in Plantar Foot Pressure with In-Shoe Varus or Valgus Wedging

Journal of the American Podiatric Medical Association ◽

10.7547/87507315-94-1-1 ◽

2004 ◽

Vol 94 (1) ◽

pp. 1-11 ◽

Cited By ~ 27

Author(s):

Bart Van Gheluwe ◽

Howard J. Dananberg

Keyword(s):

Pressure Distribution ◽

Loading Rate ◽

Peak Pressure ◽

Center Of Pressure ◽

Scientific Evidence ◽

Peak Load ◽

Foot Orthoses ◽

Foot Pressure ◽

Custom Made

Varus and valgus wedging are commonly used by podiatric physicians in therapy with custom-made foot orthoses. This study aimed to provide scientific evidence of the effects on plantar foot pressure of applying in-shoe forefoot or rearfoot wedging. The plantar foot pressure distribution of 23 subjects walking on a treadmill was recorded using a pressure insole system for seven different wedging conditions, ranging from 3° valgus to 6° varus for the forefoot and from 4° valgus to 8° varus for the rearfoot. The results demonstrate that increasing varus wedging magnifies peak pressure and maximal loading rate at the medial forefoot and rearfoot, whereas increasing valgus wedging magnifies peak pressure and maximal loading rate at the lateral forefoot and rearfoot. As expected, the location of the center of pressure shifts medially with varus wedging and laterally with valgus wedging. However, these shifts are less significant than those in peak load and maximal loading rate. Timing variables such as interval from initial impact to peak load do not seem to be affected by forefoot or rearfoot wedging. Finally, rearfoot wedging does not significantly influence pressure variables of the forefoot; similarly, rearfoot pressure remains unaffected by forefoot wedging. (J Am Podiatr Med Assoc 94(1): 1-11, 2004)

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Effect of medial arch support foot orthosis on plantar pressure distribution in females with mild-to-moderate hallux valgus after one month of follow-up

Prosthetics and Orthotics International ◽

10.1177/0309364613518229 ◽

2014 ◽

Vol 39 (2) ◽

pp. 134-139 ◽

Cited By ~ 14

Author(s):

Maede Farzadi ◽

Zahra Safaeepour ◽

Mohammad E Mousavi ◽

Hassan Saeedi

Keyword(s):

Pressure Distribution ◽

Hallux Valgus ◽

Plantar Pressure ◽

Peak Pressure ◽

Foot Orthoses ◽

First Metatarsal ◽

Plantar Pressure Distribution ◽

Before And After ◽

Arch Support ◽

Foot Orthosis

Background:Higher plantar pressures at the medial forefoot are reported in hallux valgus. Foot orthoses with medial arch support are considered as an intervention in this pathology. However, little is known about the effect of foot orthoses on plantar pressure distribution in hallux valgus.Objectives:To investigate the effect of a foot orthosis with medial arch support on pressure distribution in females with mild-to-moderate hallux valgus.Study design:Quasi-experimental.Methods:Sixteen female volunteers with mild-to-moderate hallux valgus participated in this study and used a medial arch support foot orthosis for 4 weeks. Plantar pressure for each participant was assessed using the Pedar-X®in-shoe system in four conditions including shoe-only and foot orthosis before and after the intervention.Results:The use of the foot orthosis for 1 month led to a decrease in peak pressure and maximum force under the hallux, first metatarsal, and metatarsals 3–5 ( p < 0.05). In the medial midfoot region, peak pressure, maximum force, and contact area were significantly higher with the foot orthosis than shoe-only before and after the intervention ( p = 0.00).Conclusion:A foot orthosis with medial arch support could reduce pressure beneath the hallux and the first metatarsal head by transferring the load to the other regions. It would appear that this type of foot orthosis can be an effective method of intervention in this pathology.Clinical relevanceFindings of this study will improve the clinical knowledge about the effect of the medial arch support foot orthosis used on plantar pressure distribution in hallux valgus pathology.

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