There is a significant negative correlation between hip internal rotation (HIR) range of motion and lateral plantar pressure, indicating that reduced HIR is associated with increased lateral plantar pressure during both standing and walking.
Key Findings
Results
Hip internal rotation (HIR) measured in the prone position was significantly negatively correlated with plantar pressure at the second through fourth metatarsophalangeal joints (MTPJ2-4), fifth metatarsophalangeal joint (MTPJ5), and midfoot during standing.
The study included 120 college students (60 males and 60 females).
HIR was measured using a smartphone inclinometer app in the prone position.
Plantar pressure was assessed using the Gaitview AFA-50 system during standing.
Correlation analysis was performed using SPSS 27.0.
The negative correlation indicates that as HIR range of motion decreases, pressure at lateral forefoot and midfoot regions increases during standing.
Results
HIR measured in the prone position was significantly positively correlated with first toe (T1) pressure during standing.
This positive correlation contrasts with the negative correlations found for lateral and midfoot plantar pressure regions.
The finding suggests that reduced HIR is associated with a shift of pressure away from the medial forefoot (first toe) toward lateral regions.
This was observed among all 120 subjects during standing conditions.
Results
During walking, prone-position HIR was significantly negatively correlated with plantar pressure at MTPJ2-4, MTPJ5, midfoot (FM), and lateral heel (LH).
The negative correlations during walking extended to the lateral heel region, a finding not reported for standing conditions with prone HIR measurement.
Plantar pressure during walking was assessed using the Gaitview AFA-50 system.
The correlations were observed across all 120 college student participants.
Results
HIR measured in the supine position was significantly negatively correlated with plantar pressure at MTPJ2-4, MTPJ5, midfoot (FM), medial heel (MH), and lateral heel (LH) during walking.
HIR in the supine position was measured using a compass app on a smartphone.
Supine HIR correlations during walking included both medial heel and lateral heel pressures.
This suggests that supine HIR measurement captures heel pressure relationships not observed with prone measurement during walking.
Both measurement positions (prone and supine) showed consistent negative correlations with lateral forefoot and midfoot pressure.
Methods
Two different smartphone-based methods were used to measure HIR, with the prone position using an inclinometer app and the supine position using a compass app.
The study assessed 120 college students equally divided by sex (60 males, 60 females).
Both measurement positions produced significant correlations with lateral plantar pressure, suggesting robustness of findings across measurement approaches.
Use of smartphone apps for HIR measurement represents a clinically accessible methodology.
Conclusions
The authors concluded that improving HIR through targeted rehabilitation may reduce lateral plantar pressure, offering new approaches for non-surgical treatment of little toe capsulitis and reducing the risk of fifth metatarsal stress fractures.
The clinical motivation for the study came from prior research on football players with fifth metatarsal stress fractures showing reduced HIR and increased lateral forefoot pressure.
The authors propose that HIR rehabilitation could serve as a non-surgical intervention strategy.
The conclusion links hip joint mobility to foot pressure distribution as a potential modifiable risk factor.
What This Means
This research suggests that the amount of inward rotation available at the hip joint is linked to how pressure is distributed across the foot during standing and walking. Specifically, people with less hip internal rotation tend to have higher pressure on the outer (lateral) parts of their feet — including the outer toes, outer forefoot, and outer heel — and lower pressure under the big toe. The study measured hip rotation using smartphone apps and foot pressure using a specialized pressure mat in 120 college students (60 men and 60 women).
The findings were consistent across two different ways of measuring hip rotation (lying face down vs. lying face up) and across two different activities (standing still and walking). This consistency strengthens the conclusion that hip mobility and foot pressure distribution are genuinely related, not just a chance finding in one test condition.
This research suggests that limited hip internal rotation — which can result from muscle tightness, joint stiffness, or other factors — may contribute to increased stress on the outer foot structures. Over time, this could raise the risk of injuries like fifth metatarsal stress fractures (a common injury in athletes) or inflammation around the little toe joint. The findings open the possibility that exercises targeting hip rotation could help redistribute foot pressure and potentially reduce the risk of these foot problems, though further research would be needed to confirm whether such interventions actually achieve these outcomes in practice.
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Yang Z, Yan C, Yan X, Ge C, Jiang D, Hu N, et al.. (2026). Correlation Analysis Between Hip Internal Rotation Range and Plantar Pressure During Standing And Walking.. Journal of the American Podiatric Medical Association. https://doi.org/10.7547/24-144