Gait biomechanics in individuals with chronic metatarsalgia: A case-control study.

Individuals with chronic metatarsalgia showed significantly greater maximum within-mask pressure under the lateral midfoot, 1st metatarsal head and the toes during stance than controls.

• Maximum within-mask pressure was measured in nine foot regions during level walking.
• Group comparisons used two-sample t-tests with statistical parametric mapping.
• The abstract reports these differences as significant during the stance phase.

Ankle eversion angles were significantly greater in individuals with chronic metatarsalgia than in controls.

• This contrasts with the hypothesis of reduced ankle pronation in the CM group.
• Three-dimensional kinematics of the midfoot, ankle, knee and hip were compared using statistical parametric mapping.

Knee and hip flexion angles were significantly greater in the chronic metatarsalgia group than in controls during walking.

• Kinematics were computed during level walking and compared with two-sample t-tests using statistical parametric mapping.
• The authors interpret the proximal differences as potential compensatory mechanisms in response to forefoot pain.

Ankle plantarflexion moments were significantly greater in individuals with chronic metatarsalgia than in controls.

• Internal joint moments were calculated in the sagittal, frontal and transverse planes.
• The hypothesis of increased midfoot dorsiflexion moments is not reported as supported in the abstract; the abstract only reports greater ankle plantarflexion moments.

The study was a case-control comparison of 23 individuals with chronic metatarsalgia and 23 pain-free controls with matched sex distribution.

• Each group included 17 females and 6 males.
• Controls had no lower limb pain.
• Outcomes included plantar pressure in nine foot regions, 3D kinematics (midfoot, ankle, knee, hip) and kinetics.

The authors conclude that the biomechanical differences suggest compensatory mechanisms in response to forefoot pain and that individualized biomechanical and clinical assessment is needed to guide orthotic and therapeutic strategies.

• Most existing treatments focus on reducing forefoot plantar pressure.
• Prior to this study, no study had identified a link between chronic metatarsalgia and metatarsal head overload during level walking.