Everyday footwear: An overview of what we know and what we should know on ill-fitting footwear and associated pain and pathology

Footwear has been used to protect feet for millennia with socially exclusive population adopting stylish and fashionable shoes with expensive materials. In terms of historic timeline, only more recently footwear has been worn by all classes in the western world as an integral part of their apparel. Traditionally, footwear has been constructed from natural materials, mainly leather, but has recently benefitted from the flexibility that technology has provided with a plethora materials and new design innovations. Although it has expanded the availability for a variety of consumers, the choice and fit continue to be problematic with many individuals wearing shoes that are ill-fitting. Provision of specific footwear advice for problem feet is poorly evidenced and is heavily practitioner dependant limiting its efficacy. There is limited understanding as to the changes that can occur from regularly wearing footwear that is unsuitable in shape, style and construction which is referred to as ill-fitting. Current research on the effect that everyday footwear has on foot function and pain focuses mainly on women’s shoes, particularly high heels. Defining what is a good fitting shoe, that does not damage the foot or mechanics of walking, may need to be individualised, but best fit is based on loose historical parameters rather than research evidence. The aim of this overview is to highlight aspects of current research, establishing what is known about the effect’s shoes have on the feet as well as exploring the mythology around footwear fit and advice that is often historical in nature.     

Crisis-related observations in competition: a case study in basketball

This study presents a unique observational approach to basketball, based on the theory of psychological performance crisis in competition. The approach used takes into account the responses of a player's actions to significant social factors such as team-mates, spectators, the coach and the referees. The contribution of this approach beyond traditional observational techniques is discussed. In our investigation, a single case design was used, in which a professional basketball player was observed during 10 home and 3 away games of the regular season. The relations between the observations and the crisis concept are discussed in detail. In addition, some relevant methodological and applied aspects are presented.     

Examining the Degree of Pain Reduction Using a Multielement Exercise Model with a Conventional Training Shoe Versus an Ultraflexible Training Shoe for Treating Plantar Fasciitis

Abstract

Plantar fasciitis is a common injury to the plantar aponeurosis, manifesting as pain surrounding its proximal insertion at the medial calcaneal tubercle. Pain is typically worse in the morning when getting out of bed, and may subside after the tissue is sufficiently warmed up. For running-based athletes and individuals who spend prolonged periods of time on their feet at work, plantar fasciitis may become recalcitrant to conservative treatments such as ice, rest, and anti-inflammatory medication. Exercise-based therapies have received only limited attention in the literature for this common problem, yet they are becoming increasingly validated for pain relief and positive tissue remodeling at other sites of similar soft-tissue overuse injury. This study reports on pain outcomes in individuals experiencing chronic plantar fasciitis whiles wearing a shoe with an ultraflexible midsole (Nike Free 5.0) (FREE) versus a conventional training (CON) shoe in a 12-week multielement exercise regimen, and after a 6-month follow-up. Adults with ≥ 6-month history of painful heel pain were recruited and randomly assigned to wear 1 of the 2 shoes. All subjects completed the same exercise protocol. A visual analogue scale item tracked peak pain in the preceding 24 hours taken at baseline, 6- and 12-week points, and at the 6-month follow-up. Twenty-one subjects completed the program (9 FREE; 12 CON). Both groups reported significant improvements in pain by the 6-month follow-up, and the FREE group reported an overall reduced level of pain throughout the study as a result of lower mean pain scores at the midpoint and post-test compared with the CON group. The exercise regimen employed in this study appears to reduce pain associated with chronic plantar fasciitis, and in doing so, the Nike 5.0 shoe may result in reductions in pain earlier than conventional running shoes.     

鞋跟高度对青年女性下楼梯步态的影响

目的 研究鞋跟高度对青年女性下楼梯步态的影响,分析女性穿高跟鞋下楼梯时的风险因素。方法 利用红外高速运动捕捉系统测试17名青年女性穿4种不同鞋跟高度皮鞋下楼梯的步态,计算受试者的步态时空参数和下肢关节角度。结果 与穿平跟鞋相比,穿3、5、7 cm高跟鞋下楼梯时步态周期增大,支撑相和双支撑相所占步态周期比例减小,步宽显著减小。与穿平跟鞋相比,穿5、7 cm高跟鞋下楼梯时踝关节矢状面内关节活动幅度均较小,穿3、5、7 cm高跟鞋时踝关节水平面内关节活动幅度均较大。穿3、5 cm高跟鞋时膝关节矢状面内关节活动度显著小于穿平跟鞋,穿3、5、7 cm高跟鞋时膝关节水平面内关节活动幅度显著大于穿平跟鞋。穿5、7 cm高跟鞋时髋关节最大屈曲角度显著大于穿平跟鞋,穿3、5、7 cm高跟鞋时髋关节最小屈曲角度显著大于穿平跟鞋。结论 随着鞋跟高度的增加,下楼梯时摆动期占步态周期百分比和步态周期都增大,而支撑相占步态周期百分比、双支撑相（后期）占步态周期百分比和步宽都减小,增加了下楼梯时跌倒的危险;同时,踝、膝关节矢状面内的关节活动幅度逐渐减小,水平面内的关节活动幅度增大。研究结果有助于深入了解鞋跟高度对穿着者下楼梯步态的影响特征和规律,为分析下楼时可能出现的损伤危险提供依据。     

着鞋类型和步速对膝关节载荷的影响

目的探讨着鞋类型(裸足、普通鞋、极简鞋)与步行速度(快步走、常速行走)对膝关节生物力学指标的影响,为科学健身提供理论参考。方法采用Vicon三维运动捕捉系统、Kisler三维测力台同步采集10名男性在裸足、穿着不同鞋常速行走与快步走时下肢运动生物力学指标。采用双因素(2种行走方式×3种着鞋类型)重复测量方差分析对各指标进行统计分析。结果相对于快步走,常速行走时足底压力中心(center of pressure,COP)向外偏移较大,额状面膝关节力臂、膝关节内收外力矩和第1峰值负载率均较小,但额状面膝关节冲量矩较大;相对于穿着普通跑鞋,裸足或穿着极简鞋时,步幅变小,COP向外偏移较大,额状面膝关节力臂、膝关节内收外力矩、第1峰值负载率和额状面膝关节冲量矩较小。结论为降低额状面膝关节冲量矩以及峰值负载率,建议着极简鞋采用小步幅进行快步走锻炼。     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

Autonomic cardiovascular control and sports classification in Paralympic athletes with spinal cord injury

Purpose To investigate the relationship between the classification systems used in wheelchair sports and cardiovascular function in Paralympic athletes with spinal cord injury (SCI). Methods 26 wheelchair rugby (C3–C8) and 14 wheelchair basketball (T3‐L1) were assessed for their International Wheelchair Rugby and Basketball Federation sports classification. Next, athletes were assessed for resting and reflex cardiovascular and autonomic function via the change (delta) in systolic blood pressure (SBP) and heart rate (HR) in response to sit-up, and sympathetic skin responses (SSRs), respectively. Results There were no differences in supine, seated, or delta SBP and HR between different sport classes in rugby or basketball (all p?>?0.23). Athletes with autonomically complete injuries (SSR score 0‐1) exhibited a lower supine SBP, seated SBP and delta SBP compared to those with autonomically incomplete injuries (SSR score?>1; all p?2?=^?1.63, p?=?0.20). Conclusion We provide definitive evidence that sports specific classification is not related to the degree of remaining autonomic cardiovascular control in Paralympic athletes with SCI. We suggest that testing for remaining autonomic function, which is closely related to the degree of cardiovascular control, should be incorporated into sporting classification.

• Implications for Rehabilitation

• Spinal cord injury is a debilitating condition that affects the function of almost every physiological system.

• It is becoming increasingly apparent that spinal cord injury induced changes in autonomic and cardiovascular function are important determinants of sports performance in athletes with spinal cord injury.

• This study shows that the current sports classification systems used in wheelchair rugby and basketball do not accurately reflect autonomic and cardiovascular function and thus are placing some athletes at a distinct disadvantage/advantage within their respective sport.