Plantar loading characteristics during walking in females with and without patellofemoral pain

Patellofemoral pain (PFP) is a common injury, particularly in females. Foot pronation may promote knee and hip transverse plane joint kinematics during gait thought to contribute to PFP. Greater knowledge of plantar loading characteristics in females with PFP may be valuable to provide a basis for clinical decisions regarding footwear and foot orthoses. The purpose of this study was to compare plantar loading distribution in females with and without PFP during gait.

Plantar pressure during walking was recorded from 19 females with PFP and 20 females without PFP. Contact area, peak force, and force-time integral were evaluated in ten plantar areas. Arch index was also calculated from contact area data during gait.

Contact area in females with PFP was 9% smaller in the first metatarsal region (P = .039) and 20% smaller in the midfoot region (P = .042) than in females without PFP. Peak force was 31% lower in the midfoot region for females with PFP (P = .027) and 13% lower in the first metatarsal region (P = .064). Force-time integral was 18% lower in the first metatarsal region in females with PFP (P = .024). Females with PFP demonstrated a lower arch index (suggesting a higher arch) (P = .028).

Decreased medial forefoot loading and decreased midfoot contact suggest decreased foot pronation during gait in females with PFP relative to females without PFP. Decreased foot pronation may foster increased patellofemoral joint loading rates. These data contribute to rationale for footwear modifications to modify plantar loading characteristics in people experiencing PFP.