The effects of wedged footwear on lower limb frontal plane biomechanics during running.
Patellofemoral pain syndrome (PFPS) has been linked to a.o. inadequate patellar tracking, deficiencies or delays in activation of the vasti muscles, hip abductor weakness and excessive foot pronation. It has been shown that runners with PFPS have increased internal knee abduction angular impulses (KAAIs) during the stance phase; this may produce lateral tracking of the patella.
In this study, 9 healthy male volunteers performed 5 successful trials running under a 3-, 6- and 9-mm lateral and medial wedged condition, while 3-D motion analysis and force registration systems were used to obtain information on KAAIs, peak knee abduction and ankle inversion moments, frontal plane knee and shoe angles and the mediolateral center-of-pressure position under these varying conditions.
Laterally wedged footwear decreased KAAIs and medially wedged footwear led to an increase in KAAIs due to mediolateral shifts in the center-of-pressure. This is surprising, since the current treatment standard is in fact 4- to 6-degree medially wedged footwear! The supposed mechanism behind this is based on an increase in ankle inversion moments with laterally wedged footwear, subsequently causing a decrease in knee abduction moments. Laterally wedged footwear should be tested in runners with PFPS in order to determine its effect on pain reduction > From Lewinson et al., Clin J Sports Med 23 (2013) 208-215. All rights reserved to Lippincott Williams & Wilkins.
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