Footwear Toe‐Box Shape and Medial Forefoot Pressures in Women With Hallux Valgus

ABSTRACT Background Narrow fitting footwear is a modifiable risk factor for the development of hallux valgus (HV). Despite this, the pressure that footwear exerts at the medial forefoot has not been fully evaluated in people with HV. Therefore, the objective of this study was to determine whether th...

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Main Authors: Katrina J. Bajraszewski, Polly Q. X. Lim, Andrew K. Buldt, Sheree E. Hurn, Karen J. Mickle, Edward Roddy, Anita E. Wluka, Bircan Erbas, Shannon E. Munteanu, Hylton B. Menz
Format: Article
Language:English
Published: Wiley 2025-06-01
Series:Journal of Foot and Ankle Research
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Online Access:https://doi.org/10.1002/jfa2.70041
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author Katrina J. Bajraszewski
Polly Q. X. Lim
Andrew K. Buldt
Sheree E. Hurn
Karen J. Mickle
Edward Roddy
Anita E. Wluka
Bircan Erbas
Shannon E. Munteanu
Hylton B. Menz
author_facet Katrina J. Bajraszewski
Polly Q. X. Lim
Andrew K. Buldt
Sheree E. Hurn
Karen J. Mickle
Edward Roddy
Anita E. Wluka
Bircan Erbas
Shannon E. Munteanu
Hylton B. Menz
author_sort Katrina J. Bajraszewski
collection DOAJ
description ABSTRACT Background Narrow fitting footwear is a modifiable risk factor for the development of hallux valgus (HV). Despite this, the pressure that footwear exerts at the medial forefoot has not been fully evaluated in people with HV. Therefore, the objective of this study was to determine whether the toe box of footwear habitually worn by women with HV is associated with pressure exerted on the medial forefoot. Methods In‐shoe peak pressure and maximum force at the medial forefoot (distal and proximal sites) were recorded from 28 women (mean age 60.7 years, SD 10.7) with moderate or severe HV using the pedar pad pressure system (Novel GmbH, Germany). The shape (width and area) of the participants' most symptomatic foot and toe‐box of their usual footwear was determined using an INFOOT 3D laser scanner (I‐Ware Laboratory, Japan) and hand tracing, respectively. The difference between the foot and corresponding footwear measurements as well as differences in the magnitude and timing of peak pressure and maximum force between the proximal and distal forefoot were determined using independent t‐tests. Correlations between forefoot pressures with toe‐box differential were determined using Spearman's ρ analyses. Results Peak pressure and maximum force were significantly greater (mean difference [MD] = 33.0 ± 15.4 kPa; p < 0.001 and 12.8 ± 7.3 N; p = 0.001) and occurred slightly later in the stance phase at the distal forefoot compared to the proximal forefoot (MD = 6.0 ± 6.9%; p = 0.083 and 6.9 ± 6.8%; p = 0.045, respectively). There were no significant correlations between toe‐box differential and medial forefoot pressures, with all correlations less than 0.35 (p > 0.05). Conclusion Toe‐box shape and fit of footwear typically worn by older women with painful HV was not associated with increased medial forefoot pressures in this study sample. Therefore, changing the toe‐box width and area of the usual footwear worn by older women with painful, moderate or severe HV may not necessarily reduce medial forefoot pressures where footwear does not appear to play a role.
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spelling doaj-art-e0101ccdcd5a47f3a879b7c2010a5c3d2025-08-20T03:32:32ZengWileyJournal of Foot and Ankle Research1757-11462025-06-01182n/an/a10.1002/jfa2.70041Footwear Toe‐Box Shape and Medial Forefoot Pressures in Women With Hallux ValgusKatrina J. Bajraszewski0Polly Q. X. Lim1Andrew K. Buldt2Sheree E. Hurn3Karen J. Mickle4Edward Roddy5Anita E. Wluka6Bircan Erbas7Shannon E. Munteanu8Hylton B. Menz9Discipline of Podiatry School of Allied Health Human Services and Sport La Trobe University Bundoora AustraliaDiscipline of Podiatry School of Allied Health Human Services and Sport La Trobe University Bundoora AustraliaDiscipline of Podiatry School of Allied Health Human Services and Sport La Trobe University Bundoora AustraliaSchool of Clinical Sciences Faculty of Health Queensland University of Technology Kelvin Grove AustraliaApplied Sport Science and Exercise Testing Laboratory College of Health Medicine and Wellbeing University of Newcastle Ourimbah AustraliaSchool of Medicine Keele University Keele UKSchool of Public Health and Preventive Medicine Monash University Victoria AustraliaSchool of Psychology and Public Health La Trobe University Victoria AustraliaDiscipline of Podiatry School of Allied Health Human Services and Sport La Trobe University Bundoora AustraliaDiscipline of Podiatry School of Allied Health Human Services and Sport La Trobe University Bundoora AustraliaABSTRACT Background Narrow fitting footwear is a modifiable risk factor for the development of hallux valgus (HV). Despite this, the pressure that footwear exerts at the medial forefoot has not been fully evaluated in people with HV. Therefore, the objective of this study was to determine whether the toe box of footwear habitually worn by women with HV is associated with pressure exerted on the medial forefoot. Methods In‐shoe peak pressure and maximum force at the medial forefoot (distal and proximal sites) were recorded from 28 women (mean age 60.7 years, SD 10.7) with moderate or severe HV using the pedar pad pressure system (Novel GmbH, Germany). The shape (width and area) of the participants' most symptomatic foot and toe‐box of their usual footwear was determined using an INFOOT 3D laser scanner (I‐Ware Laboratory, Japan) and hand tracing, respectively. The difference between the foot and corresponding footwear measurements as well as differences in the magnitude and timing of peak pressure and maximum force between the proximal and distal forefoot were determined using independent t‐tests. Correlations between forefoot pressures with toe‐box differential were determined using Spearman's ρ analyses. Results Peak pressure and maximum force were significantly greater (mean difference [MD] = 33.0 ± 15.4 kPa; p < 0.001 and 12.8 ± 7.3 N; p = 0.001) and occurred slightly later in the stance phase at the distal forefoot compared to the proximal forefoot (MD = 6.0 ± 6.9%; p = 0.083 and 6.9 ± 6.8%; p = 0.045, respectively). There were no significant correlations between toe‐box differential and medial forefoot pressures, with all correlations less than 0.35 (p > 0.05). Conclusion Toe‐box shape and fit of footwear typically worn by older women with painful HV was not associated with increased medial forefoot pressures in this study sample. Therefore, changing the toe‐box width and area of the usual footwear worn by older women with painful, moderate or severe HV may not necessarily reduce medial forefoot pressures where footwear does not appear to play a role.https://doi.org/10.1002/jfa2.70041biomechanicsforefoothallux valgushumanpressureshoes
spellingShingle Katrina J. Bajraszewski
Polly Q. X. Lim
Andrew K. Buldt
Sheree E. Hurn
Karen J. Mickle
Edward Roddy
Anita E. Wluka
Bircan Erbas
Shannon E. Munteanu
Hylton B. Menz
Footwear Toe‐Box Shape and Medial Forefoot Pressures in Women With Hallux Valgus
Journal of Foot and Ankle Research
biomechanics
forefoot
hallux valgus
human
pressure
shoes
title Footwear Toe‐Box Shape and Medial Forefoot Pressures in Women With Hallux Valgus
title_full Footwear Toe‐Box Shape and Medial Forefoot Pressures in Women With Hallux Valgus
title_fullStr Footwear Toe‐Box Shape and Medial Forefoot Pressures in Women With Hallux Valgus
title_full_unstemmed Footwear Toe‐Box Shape and Medial Forefoot Pressures in Women With Hallux Valgus
title_short Footwear Toe‐Box Shape and Medial Forefoot Pressures in Women With Hallux Valgus
title_sort footwear toe box shape and medial forefoot pressures in women with hallux valgus
topic biomechanics
forefoot
hallux valgus
human
pressure
shoes
url https://doi.org/10.1002/jfa2.70041
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