Foot Pain in Relation to the Foot Biomechanical Measures in the Framingham Foot Study

Purpose: Population-based studies approximate that 25% of US adults experience foot pain. Some clinical studies suggest that pain is related to areas of high loading in the foot, whereas others suggest pain and plantar loading are not related. The purpose of this study was to evaluate the biomechanical measures of foot function in a large population study. Methods: A community-based subset of the Framingham Foot study population had dynamic pressure scan data analyzed (N=913). There was one gait trial, and only right foot data were analyzed. Plantar pressures were masked by anatomical regions: toes, forefoot, arch, and rearfoot. Peak pressure (PP; N/cm2) and pressure-time (PTI; Ns/cm2) were calculated within each region. ANOVA adjusted for age, gender, and BMI assessed differences between regional pain groups to the referent (no pain) group. Results: Rearfoot maximum and average PP was significantly higher in the “Forefoot Pain Only” group. PTI was similar at all locations in participants with and without regional foot pain. Conclusion: Differences in rearfoot maximum and average PP for the “Forefoot Pain Only” group relative to the “No Regional Pain” group suggests that either rearfoot pressure changes because of forefoot pain or abnormal rearfoot pressure leads to pain. Knowledge in compensatory mechanisms in gait will help uncover ways in which treatment may be guided to prevent foot pain and disability from occurring. Strategies for alleviating forefoot pain may reside in correcting or stabilizing the rearfoot.