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Long distance running increases plantar pressures beneath the metatarsal heads A barefoot walking investigation of 200 marathon runners. Gait Posture. 2007 Feb 2;
Nagel A, Fernholz F, Kibele C, Rosenbaum D
Quote:
BACKGROUND: The growing popularity of endurance sports activities is associated with a growing number of metatarsal stress fractures in recreational runners. Excessive foot loading has been suggested as a potential cause for these problems. Therefore, the question arises whether long distance running affects foot loading characteristics like ground reaction forces and peak pressure in specific areas of the foot.
PURPOSE: To investigate the effects of long distance running on plantar pressure patterns before and after a marathon race.
STUDY DESIGN: Repeated measurements of recreational runners before and after a marathon race.
METHODS: Two hundred participants of the third Muenster marathon, 2004, were measured before and after the race with plantar pressure measurements during barefoot walking on a capacitive platform. The ratio between forefoot and toe loading was calculated to assess a suggested loading shift between these areas.
RESULTS: The results of the whole group of participants revealed a significant difference in foot loading characteristics before and after the race. Post-race peak pressure and impulse values were higher in the forefoot regions and reduced under the toes.
CONCLUSIONS: The increased peak pressure under the metatarsal heads after the race indicates a load shift from the toes to the metatarsal heads. This suggests an increased loading of the metatarsal bones and could explain the increased incidence of metatarsal stress fractures in long distance runners.
Re: Metatarsal head pressures higher at end of marathon
Are the results from this study much of a surprise???
They recorded barefoot plantar pressure readings the day before a marathon, and then within an hour afterwards with an Emed system.
Most people will be a bit proppy after running a marathon and will likely to be tending to be somewhat apropulsive- particularly if they are barefoot after being in running shoes.
'The increased peak pressure under the metatarsal heads after the race indicates a load shift from the toes to the metatarsal heads' - I know thats how I walked after my half marathons... mainly to take some load off the calves- blistered toes would not help either.
Relating this to met stress fractures is probably drawing a long bow...
__________________
Craig Tanner
Podiatrist ASPETAR-
Qatar Orthopaedic and Sports Medicine Hospital
Doha
QATAR http://www.aspetar.com/
The purpose of this study was to assess plantar pressure deviations due to fatigue. Plantar pressure was assessed using a portable system while eleven healthy subjects performed three walking tests, one before, one immediately after and another 30-min after intensive running. Pressure peak, intra-subject coefficient of variation and relative impulse were recorded. Significant decrease in pressure peak and the relative impulse under the heel and the midfoot along with significant increase in pressure peak and relative impulse under the forefoot were observed 30min after the run. After a 30-min rest, the heel and forefoot loading remained significantly affected compared to the pre-test conditions while variability, step length and frequency remained unchanged. The study demonstrates short- and long-term plantar pressure deviations due to fatigue induced by an intensive 30-min run, while previous studies showed negligible deviation of the ground reaction force.
Re: Metatarsal head pressures higher at end of marathon
Quote:
Originally Posted by CraigT
Are the results from this study much of a surprise???
They recorded barefoot plantar pressure readings the day before a marathon, and then within an hour afterwards with an Emed system.
Most people will be a bit proppy after running a marathon and will likely to be tending to be somewhat apropulsive- particularly if they are barefoot after being in running shoes.
'The increased peak pressure under the metatarsal heads after the race indicates a load shift from the toes to the metatarsal heads' - I know thats how I walked after my half marathons... mainly to take some load off the calves- blistered toes would not help either.
Relating this to met stress fractures is probably drawing a long bow...
Craig T;
tight hamstrings and achilles after the race probably played into this as well since most walk a little w/ knee flexed adn this can shift CoP to the forefoot more than the heels.
All valid points above adn I agree completely. Interesting information, but of little value in its lack of specificity.
I hope you are well in the middle east? All your tech equipment running well too?
Re: Metatarsal head pressures higher at end of marathon
I think the key thing here is (and I heard CP talk about it often), is the effect of fatigue on foot function when all the research and our clinical testing is done on "fresh" research subjects and patents.
Re: Metatarsal head pressures higher at end of marathon
What about fatigue of the small intrinsics such as the lumbricals and interossei. being smaller mucles, may be more susceptable to fatigue and therefore unable to adequately stabilise the digits, leading to less flexion of the toes, therefore less area under which GRFs can act under the forefoot?
__________________
Adrian Misseri
B.Pod.,M.Hlth.Sci.(Pod.)
Re: Metatarsal head pressures higher at end of marathon
Quote:
Originally Posted by Adrian Misseri
What about fatigue of the small intrinsics such as the lumbricals and interossei. being smaller mucles, may be more susceptable to fatigue and therefore unable to adequately stabilise the digits, leading to less flexion of the toes, therefore less area under which GRFs can act under the forefoot?
I have seen it suggested (without data), that the cause of plantar fasciitis is fatigue of the plantar intrinsic muscles .... interesting hypothesis.
__________________
Craig Payne
Department of Podiatry
La Trobe University
Melbourne, Australia http://www.latrobe.edu.au/podiatry
__________________________________________________ ___________________________________ God put me on this earth to accomplish a certain number of things - right now I am so far behind, I will never die.
The views expressed above are those of the author and not that of La Trobe University This is where I am, where are you?
Re: Metatarsal head pressures higher at end of marathon
Cheers Craig!
Interesting thread, although I'm struggling with the concept of getting the subject to do a voluntary isometric abductor hallucius contracture, and although it should be the most appropriate intrinsic muscle with regards to arch height, I wonder if measuring the navicular height really identifies the role of the abductor hallucius in arch height. isthere a better solution though? Perhaps force required under the hallux to activate windlass (i.e. modified Jacks test?). Dont know....
This article does stimulate an interesting idea. Has anyone done any studies looking at running a marathon/half marathon with an Fscan/PEDAR system in the shoes to se what happens to the foot during over such a prolonged time of excessive activity?
And in light of research such as this, and the foot injuries that I've seen sustained after a marathon, I do raise the point, liek ballet, should we be encouraging such outrageous requests of our bodies? (Obviously I don't run....)
__________________
Adrian Misseri
B.Pod.,M.Hlth.Sci.(Pod.)
Re: Metatarsal head pressures higher at end of marathon
The effects of fatigue on plantar pressure distribution in walking
M. Bisiaux, P. Morettoa Gait & Posture (in press)
Quote:
The purpose of this study was to assess plantar pressure deviations due to fatigue. Plantar pressure was assessed using a portable system while eleven healthy subjects performed three walking tests, one before, one immediately after and another 30-min after intensive running. Pressure peak, intra-subject coefficient of variation and relative impulse were recorded. Significant decrease in pressure peak and the relative impulse under the heel and the midfoot along with significant increase in pressure peak and relative impulse under the forefoot were observed 30min after the run. After a 30-min rest, the heel and forefoot loading remained significantly affected compared to the pre-test conditions while variability, step length and frequency remained unchanged. The study demonstrates short- and long-term plantar pressure deviations due to fatigue induced by an intensive 30-min run, while previous studies showed negligible deviation of the ground reaction force.
Re: Metatarsal head pressures higher at end of marathon
The impact of the spartathlon ultramarathon race on athletes' plantar pressure patterns.
Karagounis P, Prionas G, Armenis E, Tsiganos G, Baltopoulos P. Foot Ankle Spec. 2009 Aug;2(4):173-8.
Quote:
More than 90% of injuries in runners are recorded in the lower extremity, equally affecting the regions of the knee, shank, and foot. Stress fractures are responsible for numerous running-related injuries. In the current study, the plantar pressure patterns of prerace, immediately postrace, and 24 hours after long-distance running in the Spartathlon were analyzed to compare foot loading in the respective conditions. Forty-six male participants of the Spartathlon ultramarathon were examined before, immediately after completion of the race, and 24 hours later with plantar pressure measurements during barefoot walking on a capacitive platform. The results revealed a significant increase in the peak pressure and impulse values in the forefoot areas and a decrease under the toes before and immediately after the race. On the contrary, no significant differences were found between the prerace and the 24-hour postrace values. The present findings indicate that the Spartathlon race leads to significant variations in foot-loading characteristics, especially in the peak pressure and impulse values under the forefoot and toe regions. Twenty-four-hour postrace data measurements reveal insignificant differences from the prerace statement, probably because of the restoration of local muscular activity
Metatarsal head pressures higher at end of marathon
(Obviously I don't run....)
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