The aim of this study was to examine regional foot loading in people with heel pain compared to asymptomatic control participants.
198 people with plantar heel pain and 70 asymptomatic control participants were recruited into the study.
Each participant in the heel pain group completed the Foot Health Status Questionnaire (FHSQ), an instrument which has demonstrated high content, criterion and construct validity, as well as test-retest reliability.
Plantar pressure was recorded from a single limb of each participant to satisfy the independence requirements for statistical analysis.
The symptomatic foot was chosen for participants with unilateral heel pain and the most painful side was chosen for those who presented with symptoms bilaterally.
As plantar heel pain is experienced primarily in the anteromedial section of the heel at the site of the medial calcaneal tuberosity, the possibility of altered loading within the heel region itself was considered.
The heel pain and control groups were first compared on demographic and physical characteristics including age, gender, height and body mass using analyses of variance (ANOVA).
The main findings of this study are that people with heel pain demonstrate lower peak pressure beneath the postero-lateral heel, lower maximum force throughout the entire heel and lower force-time integral beneath the posterior heel during walking.
This is indicative of a strategy to reduce loading beneath the painful heel.
Reduction of loading beneath the heel appears likely to be a direct strategy, carried out to offload the locus of pain.
This view is reinforced by the greater reduction in maximum force and peak pressure beneath regions of the heel observed in the high-pain group.
People with heel pain appear to contact the ground earlier with their mid-foot and forefoot, most likely in an attempt to reduce load on the heel; this indicates that people with plantar heel pain adopt strategies aimed at offloading the painful heel during walking.
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