Changes in windlass effect in response to different shoe and insole designs during walking

Lin, Shih-Cherng<sup>1</sup>; Chen, Carl P. C.<sup>2</sup>; Tang, Simon F. T.<sup>2</sup>; Wong, Alice M. K.<sup>3</sup>; Hsieh, Jui-Hsiang<sup>1</sup>; Chen, Weng-Pin<sup>4</sup>

Affiliations

¹Department of Biomedical Engineering, Chung-Yuan Christian University, Taoyuan, Taiwan

²Department of Physical Medicine & Rehabilitation, Chang-Gung Memorial Hospital at Linkou and Chang-Gung University College of Medicine, Taoyuan, Taiwan

³Department of Physical Medicine & Rehabilitation, Chang-Gung Memorial Hospital at Taoyuan and Chang-Gung University College of Medicine, Taoyuan, Taiwan

⁴Department of Mechanical Engineering, National Taipei University of Technology, Taipei, Taiwan

Abstract and keywords

Windlass effect occurs during the pre-swing phase of gait cycle in which the peak tensile strain and force of the plantar aponeurosis (PA) is reached. The increased dorsiflexion angle of the 1st metatarsophalangeal (MTP) joint is the main causing factor. The aim of this study was to investigate thoroughly in finding the appropriate shoe and insole combination that can effectively decrease the windlass effect. Foot kinematic analyses of 10 normal volunteers (aged 25.2 ± 2.1 years, height of 167.4 ± 9.1 cm, and weight of 66.2 ± 18.1 kg) were performed during gait under the conditions of barefoot, standard shoe (SS) with flat insole (FI) or carbon fiber insole (CFI), and rocker sole shoe (RSS) with FI or CFI. The shoe cover consisting of transparent polymer was used for accurate measurement of kinematic data as specific areas on the cover can be cut away for direct placement of reflective markers onto the skin. Under barefoot condition, the mean of maximum dorsiflexion angle of the 1st MTP joint was measured to be 48.0 ± 7.3°, and decreased significantly to 28.2 ± 5.7° when wearing SS with FI, and 24.1 ± 5.7° when wearing SS with CFI. This angle was further decreased to around 13° when wearing RSS with FI or CFI. Subjects wearing footwear alone can increase the minimum medial longitudinal angle and decrease the maximum plantarflexion angle of metatarsus related to the calcaneus as compared with barefoot condition, resulting in flatter medial foot arch. Results suggested that RSS is the effective footwear in reducing the windlass effect regardless the type of insole inserted. The findings in this study provided us with the evidences in finding the appropriate footwear for treating foot disorders such as plantar fasciitis by effectively reducing the windlass effect.

Keywords: Plantar aponeurosis; Windlass effect; Rocker sole shoe; Foot kinematics; Plantar fasciitis

Links

DOI: 10.1016/j.gaitpost.2012.07.010

PubMed: 22884544

WoS: 000315323500018

History

Received: 2011-10-27

Revised: 2012-07-9

Accepted: 2012-07-13

Online: 2012-08-9

Cited Works (11)

Year	Entry
1992	Perry J. Gait Analysis: Normal and Pathological Function. Thorofare, NJ: SLACK Incorporated; 1992.
2009	Caravaggi P, Pataky T, Goulermas JY, Savage R, Crompton R. A dynamic model of the windlass mechanism of the foot: evidence for early stance phase preloading of the plantar aponeurosis. J Exp Biol. 2009;212(15):2491-2499.
1987	Sarrafian SK. Functional characteristics of the foot and plantar aponeurosis under tibiotalar loading. Foot Ankle. 1987;8(1):4-18.
2004	Erdemir A, Hamel AJ, Fauth AR, Piazza SJ, Sharkey NA. Dynamic loading of the plantar aponeurosis in walking. J Bone Joint Surg. March 2004;86A(3):546-552.
2000	Fuller EA. The windlass mechanism of the foot: a mechanical model to explain pathology. J Am Podiatr Med Assoc. 2000;90(1):35-46.
1994	Kitaoka HB, Luo ZP, Growney ES, Berglund LJ, An K-N. Material properties of the plantar aponeurosis. Foot Ankle Int. 1994;15(10):557-560.
2003	Gefen A. The in vivo elastic properties of the plantar fascia during the contact phase of walking. Foot Ankle Int. March 2003;24(3):238-244.
2000	Carlson RE, Fleming LL, Hutton WC. The biomechanical relationship between the tendoachilles, plantar fascia and metatarsophalangeal joint dorsiflexion angle. Foot Ankle Int. January 2000;21(1):18-25.
1995	Kim W, Voloshin AS. Role of plantar fascia in the load bearing capacity of the human foot. J Biomech. September 1995;28(9):1025-1033.
2007	Leardini A, Benedetti MG, Berti L, Bettinelli D, Nativo R, Giannini S. Rear-foot, mid-foot and fore-foot motion during the stance phase of gait. Gait Post. 2007;25(3):453-462.
1954	Hicks JH. The mechanics of the foot, II: the plantar aponeurosis and the arch. J Anat. 1954;88(pt 1):25-30.

Cited By (2)

Year	Entry
2016	Santone D, Daniels TR. Running. In: Valderrabano V, Easley M, eds. Foot and Ankle Sports Orthopaedics. Cham, Switzerland: Springer International Publishing; 2016:521-526.
2021	Mettler JH. Strain Estimations of the Plantar Fascia and Other Ligaments of the Foot: Implications for Plantar Fasciitis [PhD thesis]. Iowa State University; 2021.