Article

Plantar heel pain is aggravated by weight-bearing, yet limited evidence exists
regarding how people with heel pain load their feet during walking. Knowledge of
loading patterns in people with plantar heel pain would enhance the understanding
of their foot function and assist in developing intervention strategies. Plantar
pressure using the Emed-AT platform (Novel Gmbh, Germany) was collected from 198
people with plantar heel pain and 70 asymptomatic controls during normal walking.
Maximum force, force-time integral, peak pressure, pressure-time integral and
contact time were measured in four quadrants of the heel, the midfoot and the
medial and lateral forefoot. The symptomatic group was sub-divided into equal
low-pain and high-pain groups using the Foot Health Status Questionnaire pain
score. Following age and body mass comparison, multivariate analyses of
covariance were performed to compare the heel pain group to the controls, and the
low-pain group to the high-pain group, for each loading variable. The heel pain
group displayed lower maximum force beneath the heel, lower peak pressure beneath
the postero-lateral heel and lower maximum force beneath the medial forefoot.
Force-time integrals were lower beneath the posterior heel regions and higher at
the lateral forefoot. People with heel pain also had longer midfoot and forefoot
contact time. Higher pain level was associated with lower peak pressure and
maximum force beneath regions of the heel. Compared to the controls, people with
plantar heel pain demonstrated reduced heel loading and modified forefoot loading
consistent with a strategy to offload the painful heel.
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