Search Results (257)

Runners have a high probability of sports injuries due to improper landing patterns. This study aimed to investigate the effects of three different foot strike patterns on lower limb muscle activation in healthy young male university students without specialized sports training experience. Methods: Sixteen healthy male college students (age: 21 ± 1 years) participated in this study. They performed running with three different foot strike patterns: forefoot strike (FFS), midfoot strike (MFS), and rearfoot strike (RFS) at controlled speeds of 1.4–1.6 m/s. EMG signals from six lower limb muscles (vastus lateralis, vastus medialis, rectus femoris, tibialis anterior, lateral gastrocnemius, and medial gastrocnemius) during the stance phase were collected using a wireless EMG system (1000 Hz). Ensemble Empirical Mode Decomposition (EEMD) was employed to analyze the time–frequency characteristics of lower limb EMG signals and ankle joint co-activation patterns to investigate the corresponding neuromuscular control mechanisms. Statistical analyses were performed using repeated-measures ANOVA, and significance was set at p < 0.05. Results: The timing of maximum energy in lower limb muscles during the stance phase occurred earlier in RFS compared to FFS and MFS. At initial ground contact, the low-frequency component energy (below 60 Hz) of the medial gastrocnemius was significantly higher in MFS and RFS compared to FFS, while FFS exhibited significantly higher high-frequency component energy (61–200 Hz). The co-activation of ankle dorsiflexors and plantar flexors (TA/GM) was also significantly higher in MFS and RFS compared to FFS. During the 100 ms before foot contact, the low-frequency component energy (below 60 Hz) of the lateral gastrocnemius was significantly higher in MFS compared to FFS, and the degree of TA/GM co-activation was significantly higher in both MFS and RFS compared to FFS. Conclusions: The maximum frequency in lower limb muscles appeared earliest during the mid-stance phase in the rearfoot strike (RFS) pattern. Moreover, during the pre-activation and early stance phases, frequency differences were observed only in the medial gastrocnemius, with RFS showing significantly higher low-frequency power. Full article

Background: Plantar plate injuries represent a common yet frequently underdiagnosed etiology of forefoot pain and metatarsophalangeal joint instability. Diagnostic accuracy is often compromised by nonspecific clinical presentations and significant symptom overlap with other forefoot pathologies, including Morton’s neuroma and synovitis. Early and accurate identification is essential to prevent progression to irreversible deformity. Methods: This narrative review synthesizes recent literature on the clinical evaluation, imaging modalities, and differential diagnosis of plantar plate injuries. A comprehensive literature search in a narrative review format of key databases and relevant journals was performed to critically appraise the diagnostic accuracy, advantages, limitations, and clinical implications of various diagnostic techniques. Results: Physical examination maneuvers—including the drawer test, toe purchase test, and Kelikian push-up test—provide important diagnostic insights but are constrained by operator dependency and lack of standardization. Among imaging modalities, MRI and dynamic ultrasound offer high diagnostic utility, with MRI providing superior specificity and ultrasound enabling functional, real-time assessment. Emerging techniques such as dorsiflexion-stress MRI and dual-energy CT show promising diagnostic potential, though broader clinical validation is lacking. Differential diagnosis remains a major challenge, given the clinical and radiological similarities shared with other forefoot conditions. Conclusions: Accurate diagnosis of plantar plate injuries necessitates a multimodal strategy that combines clinical suspicion, structured physical examination, and advanced imaging. Acknowledging the limitations of each diagnostic modality and integrating findings within the broader clinical context are essential for timely and accurate diagnosis. Future research should prioritize validation of diagnostic criteria, enhanced access to dynamic imaging, and the development of consensus-based grading systems to improve diagnostic precision and patient outcomes. Full article

Plantar pressure and foot load distribution are essential parameters in evaluating postural alignment, neuromuscular balance, and the risk of musculoskeletal disorders. This cross-sectional study analyzed static plantar pressure in 113 healthy young adults (18–35 years) using the Spine 3D Sensor Medica platform. Contact area, load, average pressure, and maximum peak pressure were measured bilaterally in forefoot and hindfoot regions. Strong correlations were found between body weight, BMI, and plantar load, particularly in the hindfoot, while peak pressures were influenced more by individual biomechanical factors than anthropometry. Women demonstrated greater inter-limb asymmetries compared to men. These findings provide reference values for static plantar pressure and highlight their importance for clinical musculoskeletal rehabilitation. By identifying early postural imbalances and abnormal load distributions, baropodometric assessments can guide targeted interventions, improve pain management, and optimize functional recovery. The study supports incorporating advanced plantar pressure analysis in personalized rehabilitation programs for preventing and managing musculoskeletal dysfunctions. Full article

Treadmill running gait differs to overland running and is commonly used to evaluate interventions. One challenge is accurately defining strike pattern and related impact kinetics. This study aimed to characterise foot-strike patterns during treadmill running using the spatial distribution of in-shoe plantar forces and to identify differences in impact kinetics through spectral analysis. Low- and high-frequency power components were analysed in heel, midfoot and forefoot strike patterns. No distinct impact peaks were identified in the force traces; however, significant spatial differences were found. Forefoot strikes exhibited lower peak impact force, average loading rate, and high-frequency power spectral density (PSD) components compared to heel and midfoot strikes, with heel also lower than midfoot. Strike pattern classification was derived from spatial force distribution, where >70% posterior and >50% anterior denote heel and forefoot strikes, while midfoot strikes demonstrate a more balanced distribution with >25% in the central zone. These findings support the integration of spatial, force-based classification with frequency-domain analysis to enhance the evaluation of impact attenuation in treadmill-based running interventions. Full article

Background and Clinical Significance: Angioleiomyoma (ALM) is a benign tumor that generally presents as a single lesion and, according to the updated WHO classification, includes the following three histological subtypes: solid (or capillary), cavernous, and venous. Typically, ALMs are described as well-defined nodules in the lower extremities but are unusually located in the acral locations and toes. We summarize two cases of ALM and perform a systematic review to provide foot surgeons with the most up-to-date and useful information on the epidemiological aspects, anatomical distribution, and specific histological subtypes of ALM in the foot. Materials and Methods: A systematic review was carried out according to the criteria of a PICO framework, and a systematic search and data processing were carried out according to the PRISMA guidelines. We analyzed patient demographics, clinical characteristics, diagnostic workup, treatment, and clinical outcomes. Each one of the included articles was independently assessed for methodological quality and risk of bias by an independent evaluator. The risk of bias of the included studies was assessed based on their characteristics. Results: This systematic review included 14 case series with 172 reported cases of ALM. One hundred and seventy-two (18.57%) were cases of ALM located on foot, excluding the ankle region. The female-to-male ratio was 1.48. The most common location was the hindfoot (41.5%), followed by the forefoot (20.2%) and the midfoot (8.9%). In 29.4% of cases, the location of the lesions could not be determined. The most frequent location of the lesions was subcutaneous (69%), followed by subaponeurotic (16.5%) and skin (14.5%) locations. The most frequent histological presentation was the solid histologic subtype (65%), followed by the venous subtype (21%) and the cavernous subtype (14%), respectively. Of the total reported cases of ALM located in foot, 63.1% presented as solid painful lesions. Calcified presentations occurred in 7% of cases, with more than half of the cases located in the hindfoot. Surgical excision was the treatment of choice in the two herein reported cases of solid ALM located in the hindfoot, one of them with a calcified presentation. No recurrence was observed in either case after two and five years of follow-up, respectively. All cases reviewed after surgical excision showed a low recurrence rate with a favorable prognosis regardless of the histological subtype and a very rare tendency toward malignancy. Conclusions: ALMs of the foot present as well-defined, painful nodules in the subcutaneous tissue of middle-aged women. Solid histological subtypes are the most prevalent. Histopathological analysis is usually essential for confirmation. Treatment consists primarily of direct excision, with remarkably low recurrence rates. Full article

Introduction: The optimal management of hallux sesamoid fracture nonunions remains a subject of ongoing debate, particularly in the context of personalized medicine. This systematic review aimed to synthesize current evidence regarding surgical strategies for this rare but disabling condition. Methods: A comprehensive literature search was conducted in accordance with the PRISMA guidelines. Results: Six studies met the inclusion criteria, encompassing a total of 80 patients. Surgical techniques varied and included open and arthroscopic sesamoidectomy, autologous bone grafting (alone or combined with screw fixation), and percutaneous screw fixation. When reported, outcomes were generally favorable, with union rates ranging from 90.5% to 100% and with consistent postoperative improvements in clinical function. Complication and reoperation rates were both 6.5%. The most frequent reoperation was sesamoidectomy for persistent pain or nonunion, followed by hardware removal. Conclusions: Despite the limited and low-quality evidence, available data suggest that individualized surgical planning can lead to favorable outcomes with low complication rates. Sesamoidectomy remains the most reliable salvage procedure in refractory cases. These findings support a personalized, stepwise approach to treatment—prioritizing sesamoid preservation, when feasible, while reserving excision for symptomatic nonunions. Further studies are needed to validate tailored algorithms and refine patient-specific decision-making in this challenging clinical scenario. Full article

Hallux valgus is one of the common causes of forefoot pain in the field of foot and ankle surgery. This condition is characterized by valgus and pronation deformities of the first ray, leading to bunion pain, metatarsalgia, callus formation, and gait disturbances. Conventional open osteotomy of the first metatarsal and proximal phalanx of the first toe has been widely performed. Recently, with increasing reports of favorable radiologic and clinical outcomes of minimally invasive surgery, this technique has been performed by many surgeons. Despite the various surgical methods available, there is still no consensus on the optimal treatment of hallux valgus, and the advantages and disadvantages of open versus minimally invasive techniques remain a topic of debate. This narrative review aims to provide a comprehensive overview of the latest radiographic evaluation and surgical treatment for hallux valgus. Full article

Background: Pes planus is a condition where the arch of the foot collapses, resulting in the entire sole contacting the ground. The biomechanical implications of pes planus on gait have been widely studied; however, research specific to Black African populations, particularly recreational runners, is scarce. Aim: This study aimed to describe the forefoot centre of pressure (CoP) trajectory during the barefoot gait cycle among Black African recreational runners with pes planus. Methods: A prospective explorative and quantitative study design was employed. Participants included Black African male recreational runners aged 18 to 45 years diagnosed with pes planus. A Freemed™ 6050 force plate was used to collect gait data. Statistical analysis included cross-tabulations to identify patterns. Results: This study included 104 male participants across seven weight categories, with the majority in the 70-to-79 kg range (34.6%, n = 36). Most participants with pes planus showed a neutral foot posture (74.0%, n = 77) on the foot posture index 6 (FPI-6) scale. Flexible pes planus (94.2%, n = 98) was much more common than rigid pes planus (5.8%, n = 6). Lateral displacement of the CoP was observed in the right forefoot (90.4%, n = 94) and left forefoot (57.7%, n = 60). Load distribution patterns differed between feet, with the right foot favouring the medial heel, arch, and metatarsal heads, while the left foot favoured the lateral heel, medial heel, and lateral arch. No statistical significance was found in the cross-tabulations, but notable lateral CoP displacement in the forefoot was observed. Conclusions: The findings challenge the traditional view of pes planus causing overpronation and highlight the need for clinicians to reconsider standard diagnostic and management approaches. Further research is needed to explore the implications of these findings for injury prevention and management in this population. Full article

Understanding the foot strike pattern (FSP) and impact force of running-related injuries is crucial for athletes and researchers. This study investigated a novel method for detecting FSP using the loadsol^® sensor insole during treadmill running. Twelve collegiate athletes ran at three different speeds (12, 15, and 20 km/h), with their FSP determined using both the kinematic method based on the foot strike angle and the loadsol^® method based on the plantar force applied to the rear-, mid-, and forefoot sensor areas. This study provides significant insights into FSP detection. Comparing the kinematic method to the loadsol^® method, the rearfoot, midfoot, and forefoot strike detection rates were 94.7%, 37.1%, and 81.8%, respectively. Moreover, the FSP was not uniform, even during treadmill running at a constant speed, with most participants exhibiting mixed patterns across different speeds. The loadsol^® sensor insole could offer a promising device for in-field measurement of FSP and impact forces, potentially helping researchers and athletes better understand and predict the potential running-related injury risks by monitoring step-to-step variations in running biomechanics. Full article

Background/Objectives: Subtalar arthroereisis (STA) is a widely used surgical procedure for symptomatic pediatric flexible flatfoot. However, implant migration remains a concern due to its potential impact on long-term correction and complications. This study evaluated the migration pattern of STA implants and assessed long-term clinical and radiographic outcomes. Methods: This retrospective cohort study included 47 feet from children aged 8–13 years who underwent STA with adjunctive soft tissue procedures between 2014 and 2018, following ≥6 months of failed conservative treatment, with a minimum follow-up of 5 years. Exclusion criteria included neuromuscular or rigid flatfoot. Weight-bearing radiographs assessed anteroposterior (AP) and lateral Meary’s angles, reflecting forefoot-to-hindfoot alignment, and calcaneal pitch, indicative of longitudinal arch height. Implant migration was recorded and clinical outcomes were measured by the American Orthopedic Foot and Ankle Society (AOFAS) score. Measurements were recorded preoperatively, immediately postoperatively, and at 1 month, 3 months, 6 months, 1 year, and 5 years. Results: Radiographic correction was significant and sustained at 5 years. The AP Meary’s angle improved from 13.09° to 5.26° at 1 month and 6.69° at 5 years (p < 0.001); lateral Meary’s angle from 9.77° to 4.06° and 4.88° (p < 0.001); and calcaneal pitch from 14.52° to 16.87° and 16.89° (p < 0.001), respectively. AOFAS scores increased from 67.52 to 90.86 at 1 month and 96.33 at 5 years (p < 0.001). Implant migration peaked within the first postoperative month (mean: 3.2 mm on ankle AP view; 3.0 mm on foot AP view) and stabilized thereafter. Four cases of complications included implant dislodgement, subsidence, and persistent sinus tarsi tenderness, which were successfully resolved after appropriate management. No recurrence of deformity was observed. Conclusions: STA implant migration is most pronounced during the first month, likely due to physiological settling as the foot adapts to altered biomechanics. With appropriate implant selection, technique, and follow-up, migration does not compromise long-term correction or outcomes. In general, symptomatic cases can often be managed conservatively prior to implant removal. Full article

Background: Charcot-Marie-Tooth (CMT) disease is a hereditary motor and sensory neuropathy that affects foot morphology and gait patterns, potentially leading to abnormal plantar pressure distribution. This systematic review synthesizes the existing literature examining plantar pressure characteristics in CMT patients. Methods: A comprehensive search was conducted across PubMed, Scopus, and Web of Science databases. Risk of bias was assessed using the Newcastle–Ottawa Scale. Results: Six studies comprising 146 patients were included. Four studies employed dynamic baropodometry, and two used in-shoe pressure sensors to evaluate the main plantar pressure parameters. The findings were consistent across different populations and devices, with a characteristic plantar-pressure profile of marked midfoot off-loading with peripheral overload at the forefoot and rearfoot, often accompanied by a lateralized center-of-pressure path and a prolonged pressure–time exposure. These alterations reflect both structural deformities and impaired neuromuscular control. Interventional studies demonstrated a load redistribution of pressure after corrective surgery, though residual lateral overload often persists. Conclusions: Plantar pressure mapping seems to be a valuable tool to identify high-pressure zones of the foot in order to personalize orthotic treatment planning, to objectively monitor disease progression, and to evaluate therapeutic efficacy. Further longitudinal studies with standardized protocols are needed to confirm these results. Full article

Background: Arthrodesis of the first metatarsophalangeal joint (MTP1) is a common intervention for hallux rigidus (HR). The procedure eliminates MTP1 motion but results in significant pain relief and high satisfaction rates, although MTP1 is eliminated. Less evidence is available regarding the effects on gait and the presence of compensatory mechanisms. The aim of this study is to investigate the effects of MTP1 arthrodesis on gait and patient-reported outcome measures (PROMs) compared with preoperative functioning and healthy individuals. Methods: In this prospective study, 10 patients (10 feet) with HR who underwent MTP1 arthrodesis were evaluated before and after surgery and compared with 15 healthy controls (30 feet). Gait analysis was performed with a motion capturing system using the multi-segment Oxford foot model. Spatiotemporal parameters and kinematics were quantitatively analyzed. PROMs were evaluated using validated questionnaires including the American Orthopedic Foot and Ankle Society Hallux Metatarsophalangeal-Interphalangeal (AOFAS-HMI) scale, the Numeric Pain Rating Scale (NPRS), and the Manchester–Oxford Foot Questionnaire (MOXFQ). Results: MTP1 joint motion was reduced in HR and further reduced after MTP1 arthrodesis compared with healthy controls. Furthermore, intersegmental ROM analysis revealed increased forefoot frontal plane motion (pronation and supination) in HR compared with healthy controls. This was also observed after MTP1 arthrodesis, while additionally increased frontal plane motion in the hindfoot (inversion and eversion) was observed compared with HR and healthy controls. PROM evaluation revealed improved AOFAS-HMI (from 55.7 to 79.1 points, p = 0.002) and NPRS (from 5.7 to 1.5 points, p = 0.004) scores after surgery. Additionally, improvements in the MOXFQ score (from 51.0 to 20.0 points, p = 0.002) were observed. Conclusions: Due to the loss of sagittal hallux motion, foot and ankle kinematics are changed in HR patients and after MTP1 arthrodesis compared with healthy controls. Loss of MTP1 motion results in increased frontal plane motion of the forefoot in HR, and increased frontal plane motion of the fore- and hindfoot after MTP1 arthrodesis. Additionally, substantial improvements in PROMs were recorded after surgery. Full article

(1) Background: The paper focuses on foot biomechanics in static situations. The aim was to determine the distribution of the load exerted by the human body on the ground in order to establish reference points on the foot for correct human body posture. (2) Methods: A model was developed to describe the body weight-ground relationship, consisting of a support platform and a part imitating the rest of the human body. Experiments consisted of tilting the general centre of gravity from the maximum forward through midfoot, a passive, neutral position, to the maximum backwards while maintaining balance. The ground load was measured in each position. (3) Results: The loads of the front and rear parts of the support platform and the resultant load force at different degrees of body tilt were calculated. It has been shown that at the maximum inclination of the body to the extreme support point, the entire weight falls on this point. For the neutral position (in the Basic Balance Point), the load on the front and rear parts of the support platform was 26% and 74%, and 40% and 60% for the passive position (in the Passive Balance Point). (4) Conclusions: The distribution of body weight on the ground is determined by the projection of the general centre of gravity on the ground through the feet. The resultant ground reaction force defines both the magnitude and direction of the load exerted on the support platform. Ground reaction forces associated with body weight were assessed at five anatomical points of the foot: the forefoot, rearfoot, midfoot, and the Passive and Basic Balance Point. In an upright standing posture, the projection of the general centre of gravity fluctuates between the Passive and Basic Balance Point, corresponding to the passive and neutral positions, respectively. Only in the neutral position, the body’s weight, as concentrated in the general centre of gravity, falls on the axis of the upper ankle joint and distributes the load between the forefoot and rearfoot. Determining the correct distribution of foot loads may serve in the future to study abnormalities in human body posture Full article

Hallux valgus (HV) is a common forefoot deformity for which numerous surgical techniques have been proposed, with the Lapidus procedure representing a powerful and durable solution, especially in cases of moderate to severe deformities and first ray hypermobility. Initially described in the early 20th century, the Lapidus procedure involves first tarsometatarsal joint (TMTJ) arthrodesis and has undergone multiple modifications over time to reduce complications such as nonunion, malunion, shortening, and recurrence. The technique offers triplanar correction, addressing axial, sagittal, and coronal deformity components. Despite its proven corrective potential, the procedure remains technically demanding, and no universal consensus exists on the ideal fixation method or postoperative protocol. Recent developments in fixation strategies—including crossed screws, locking plates, intramedullary nails, nitinol staples, external fixation, and arthroscopic approaches—have aimed to improve stability, union rates, and the possibility of earlier weight-bearing. This narrative review provides a comprehensive overview of the Lapidus procedure, focusing on surgical indications, technical variants, fixation methods, clinical outcomes, and complications, with the goal of offering practical guidance for optimizing surgical decision-making in various clinical settings. Full article

Background: Cheerleading is an emerging and increasingly popular sport among girls. The figures performed during routines require a high level of balance from the athletes. The aim of the study was to analyze the impact of participation in cheerleading classes on body balance in girls during early adolescence. Methods: A total of 35 female cheerleaders from the Power Stars Sząbruk Club (Poland) were divided into three age groups: 8–9 years (n = 15), 10–11 years (n = 11), and 12–14 years (n = 9). Balance assessment was performed using the E.P.S R/1 pedobarographic platform. The Kruskal–Wallis test with Bonferroni post hoc correction was used to analyze intergroup differences in foot load distribution and balance parameters. Results: The analysis revealed statistically significant differences in the pressure on the forefoot area of the right foot (p = 0.007) between the 8–9 and 12–14 age groups, and in the balance level between the youngest group (8–9 years) and the oldest group (12–14 years) at p = 0.028, as well as between the middle group (10–11 years) and the oldest group (p = 0.004). Conclusions: Participation in cheerleading classes may influence the increase in balance, particularly in terms of the distance of center of pressure (C.O.P.) shifts and the average speed of these shifts. In adolescence, muscle development is crucial, and when closely linked with motor coordination, it helps maintain body stability. Full article