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Three toe box shapes, (A) round, (B) square and (C) pointed. All shoes were a slip on flat pump. The volume of each shoe was measured using the indicated shoe width and upper for definition of toe box, highlighted by white arrows. The table indicates the volume (cm3), width and depth (cm) of the toe box for each shoe size tested.
Source publication
Ill-fitting footwear can be detrimental to foot health with the forefoot being an area for most discomfort. Studies on footwear have primarily examined sports or orthopaedic prescription shoes and little is known about the effects that everyday flat shoes have on the forefoot. The aim of this study was to investigate the effect of toe box shape in...
Contexts in source publication
Context 1
... types of foot- wear were used within this study. The key difference in the 3 footwear styles tested was the shape and dimen- sions of the toe box: square, round and pointed toe (Figure 1). Colour and design were controlled by includ- ing black ballet pumps with an accessory feature on the toe box. ...Context 2
... thickness and mater- ial were assessed and closely matched, however differences in sole material were present. The volume of each shoe's toe box was measured by calculating the average quantity of fine sand that filled the shoe to a level where the toe box upper finished (Figure 1). ...Similar publications
Slip-related accidents represent a significant public safety concern, particularly in environments where flooring may be exposed to various contaminants. This research investigates the slip resistance characteristics of selected shoe soles on different types of local floor tiles, employing the British Pendulum Tester (BPT) under diverse conditions,...
![Fig. 2 MBT ® Matwa footwear used in the trial. Figure from Menz et al. [8]](publication/316982062/figure/fig2/AS:513415869366272@1499419290193/MBT-R-Matwa-footwear-used-in-the-trial-Figure-from-Menz-et-al-8_Q320.jpg)
Background
Osteoarthritis of the first metatarsophalangeal joint (1st MTPJ OA) is a common and disabling condition commonly managed with footwear and orthotic interventions. The objective of this study was to identify factors associated with a successful treatment response in people with 1st MTPJ OA provided with prefabricated orthoses or rocker-so...
Running shoes were categorized either as motion control, cushioned, or minimal footwear in the past. Today, these categories blur and are not as clearly defined. Moreover, with the advances in manufacturing processes, it is possible to create individualized running shoes that incorporate features that meet individual biomechanical and experiential...
Background:
The purpose of this study was to determine the foot arch shape and the associated health status in a selected sample of individuals belonging to the adult majority population of eastern Slovakia and to evaluate which of the observed factors are involved in the occurrence and development of foot arch abnormalities.
Methods:
The weight...
Testing sports equipment with athletes is costly, time-consuming, hazardous and sometimes impracticable. We propose a method for virtual testing of running shoes and predict how midsoles made of BOOSTTM affect energy cost of running. We contribute a visco-elastic contact model and identified model parameters based on load-displacement measurements....
Citations
... This is justified especially since Hurst et al. [11] stressed that "street shoes" often don't fit well, and cause pressure on the digits and alter function, which may leading to structural changes and tissue breakdowns/ulceration. Branthwaite et al. [3] conclude that wearing a footwear with a reduced toe box volume and shape causes by constriction of the toes which are associated with the development of joint pathologies and forefoot lesions. According to Louwerens et al. [14], shoes which do not have the capacity to accommodate the forefoot will alter the dynamics of the transverse foot arch, restricting the metatarsal splay of the forefoot. ...
Purpose
This study aimed to evaluation of professional footwear comfort, functionality and style, as well as their relationships with the foot structure among nurses.
Methods
We examined 120 clinical nurses aged 40-50 years, occupationally active, wearing specific type of footwear at work for a minimum of 7 h a day, for 5 days prior to the research. The study relied on the CQ-ST podoscope for measurements of foot. Perception of footwear comfort, functionality and style scales were also used in the research. The results were analysed with the use of Mann-Whitney U test and Spearman's rank correlation.
Results
It was found statistically significant negative associations between right and left foot length and overall comfort of footwear (p=0.045, p=0.045), as well as between right and left foot width and arch height (p=0.015, p=0.028). Heel angle positively correlated with safety (p=0.008, p=0.050), ease of donning and doffing (p=0.001, p=0.004), as well as shoe style ratings (p=0.047). Variables determining shoe comfort were positively correlated with most shoe functionality characteristics, as well as with shoe style (p<0.05).
Conclusions
Tested medical footwear meets the requirements of nurses in terms of comfort, functionality and aesthetics, and the studied features of footwear can be a useful guideline for the selection of shoes for representatives of this professional group. These footwear can be an element of workwear, and even, in the case of women with transverse flat feet - an alternative to ordinary utility shoes. There is a need to consider different widths for the same length size in medical footwear designs.
... However, there appears to be some evidence to support the use of footwear and foot orthoses to reduce pressure on the first metatarsophalangeal joint. Footwear with a narrow toe box may predispose to hallux valgus by placing excessive pressure on the medial aspect of the metatarsophalangeal and interphalangeal joints [8,9], so changing footwear to that with a rounded toe box [10] or flexible upper [11,12] may be beneficial. Similarly, foot orthoses may be effective at reducing symptoms of hallux valgus [13] by decreasing plantar pressures beneath the hallux [14]. ...
... The changes in pressure we observed with the intervention footwear are similar to Branthwaite et al. [12] who used an individual sensor system and found that medical grade footwear decreased medial first metatarsophalangeal joint pressure but not hallux interphalangeal joint pressure compared to participants' own footwear [12]. Interestingly, these authors also found that a round toe box, as featured in our intervention, was associated with lower peak pressure than a square or pointed toe box at both the metatarsophalangeal and interphalangeal joints in healthy young women [10]. Although both of these studies involved people without hallux valgus, a similar study by Saeedi et al. [11] reported that metatarsophalangeal and interphalangeal joint pressures in those with hallux valgus were lower when walking in footwear with a compliant upper compared to their usual shoes. ...
... One biomechanical study evaluated the effect of toe box shape and demonstrated that shoes with a narrow toe box placed more pressure on the medial foot and interdigital area compared to those with a wider toe box [13]. Another study found that high heel shoes limit motion of the first metatarsophalangeal joint, suggesting that pressure on the first toenail is also high [14]. ...
... However, there are opinions indicating that the difference between the foot shape and the shape of the shoe is not enough to evaluate the feeling of fit for the runner. In response to that Branthwaite et al. (2013); Weerasinghe et al. (2016) proposed a method for evaluating the contact pressure actually acting on the foot. The contact pressure is determined not only by the difference between the shoe shape and the foot shape, but also by the rigidity difference between the foot and the upper. ...
A method for finding the optimum distribution of the slit density in a shoe upper, such that the contact pressure with the foot approaches an ideal distribution is presented in this paper. In a shoe upper made of warp knitting, slits are made by discontinuously knitting the weft under a uniform arrangement of the warp fiber. In this study, the shoe upper is modeled as an orthotropic hyperelastic body in which the slit density is defined as the design variable for controlling the intermediate density for the maximum and minimum slit densities. Referring to a formulation of a topology optimization problem of the density variation type, an inverse problem for finding the optimum distribution of the slit density is formulated with the objective and constraint cost functions defined by the squared error norm between the actual and ideal contact pressures and the deviation of the rate of the material with the maximum slit density from a limit value, respectively. This problem is solved in the same way as a topology optimization problem. The validity of this method is confirmed by numerical examples using a simple finite element model, which resembles the domain around the big toe.
... First, changes in length-related parameters suggest that slight compensation may be required for ill-fitting wedge-heeled shoes. Consistent with the studies by Wan et al. (2017) and Branthwaite et al. (2013), in the forefoot region, the toe box design in wedge-heeled shoes may also need to be slightly compensated for. The length parameters should maintain some leeway and should be 9-15 mm longer than the foot when properly fitted. ...
Wedge-heeled shoes, which are formed by elevating both the forefoot and heel, have been popular among young women. However, research on the foot shape in wedge-heeled shoes is lacking. This study aimed to access the effects of forefoot height (10, 20, and 30 mm) and heel height (30, 50, 70, and 90 mm) on foot shape and perceived comfort when wearing wedge-heeled shoes. Three-dimensional (3D) foot scanning was performed on 35 females and the 14 foot dimensions were measured. Increased forefoot height generated larger lengths (foot, ball and out ball), smaller girths (ball and instep) and heights (instep and navicular) (p < 0.05). Thus, when the forefoot height increased, the foot became longer, slimmer and flatter. Moreover, elevated heel height resulted in larger dimensions for girths (ball and instep), heights (instep and navicular), and smaller dimensions for lengths (foot, ball and out ball), widths (diagonal and horizontal) and toe 5 angles of the foot (p < 0.01). That means shorter, narrower and more convex foot shapes were observed when heel height increased. Subjective measurements implied that increased forefoot height significantly enhanced perceived comfort, whereas increased heel height diminished comfort. It was found that forefoot elevation could result in less deformation and discomfort which accompanied heel elevation, especially in the low heel-toe drop combinations (10 × 30 and 20 × 30 mm). The findings provide valuable references for enhancing shoe fitting and comfort for wedge-heeled shoes by providing dimensional data on the toe, ball, arch and instep regions.
... As jogging often lasts longer than running, it also may produce some overuse injuries, such as plantar fasciitis, metatarsal stress fracture, and Achilles tendinitis [19]. Regrettably, only a few researchers studied jogging just for optimizing footwear [19,20] or describing mechanics of lower extremities and lumbar spine [21,22]. While jogging styles have not yet been compared for optimizing foot strike patterns until now. ...
Background and Aim. In order to reduce foot and ankle injuries induced by jogging, two-foot strike patterns, rearfoot strike (RFS), and forefoot strike (FFS), were adopted and compared. First, RFS jogging and FFS jogging were experimentally studied, so as to acquire kinematic and kinetic data, including foot strike angle, knee flexion angle, and ground reaction force (GRF). Then, a 3D finite element model of foot–ankle complex was reconstructed from the scanned 2D-stacked images. Biomechanical characteristics, including plantar pressure, stress of metatarsals, midfoot bone, calcaneus and cartilage, and tensile force of plantar fascia and ligaments, were obtained. The results showed that RFS jogging and FFS jogging had a similar change trend and a close peak value of GRF. Since possessing more momentum in the push stage and less momentum in the brake stage, FFS jogging could be in favor of a higher jogging speed. However, FFS jogging produced larger metatarsal stress in the 5th metatarsal and much larger tensile force of plantar fascia, which might cause metatarsal fracture and heel pain. While RFS jogging produced larger plantar pressure in the hindfoot area, larger calcaneus stress, and much larger tarsal navicular stress, which might cause heel tissue injury, calcaneus damage, and stress fracture of naviculocuneiform joint. In addition, talocrural and talocalcaneal joint cartilage could bear jogging loads, as the peak contact pressure were both small in RFS jogging and FFS jogging. Therefore, jogging with rearfoot or FFS pattern should be chosen according to the health condition of foot–ankle parts.
... In some cases, footwear assessment can be subjective and focus purely on the style rather than the suitability of the footwear [5]. Body image plays an important role in footwear choice [11] and should be included in the evaluation of footwear along with establishing a partnership between clinician and patient [12]. However, developing a reliable clinical record of footwear utilised by a patient remains challenging due to the complexity of previous tools and their relevance to clinical practice. ...
... Having catalogues to demonstrate suitable footwear was disregarded at the final round of consensus as there was disagreement around the interpretation of an individual's style preference (Theme 2.1). This component of footwear advice and choice is however thought to play a role in habits of selection and image should be discussed when discussing footwear [11]. The raters were able to identify footwear style with a high level of reliability observed. ...
Footwear has been documented as a significant factor in the aetiology of foot pain in the general population. Assessing footwear in a clinical setting continues to be practitioner specific and there is limited guidance to direct advice. Health professionals must have access to clinically appropriate and reliable footwear assessment tools to educate patients on healthier footwear choices. The primary aim of this study was to critique what elements should be in a footwear assessment tool with a secondary aim of testing the agreed tool for validity.
A combined Nominal Group Technique and then a Delphi technique from purposively sampled experts of foot health professions were employed to critique elements of footwear assessment. The agreed tool was then tested by practising podiatrists on 5 different shoes to assess the validity and reliability of the measures.
Twelve test evaluation criteria were identified receiving significant ratings to form the final footwear assessment tool consisting of five footwear themes. Application of the tool in a clinical setting validated the themes of footwear characteristics, footwear structure, motion control and wear patterns. However, the assessment of footwear fit was not reliable.
The footwear tool was refined based on the collective consensus achieved from the rounds creating a more clinically appropriate tool. The validity of this tool was assessed as high in some of the themes but for those that were lower, a training need was identified.
... Females in the shod group have significantly larger HVA than males (Barnicot and Hardy 1955;Kouchi 1998). Shoe toe box shape (Branthwaite, Chockalingam, and Greenhalgh 2013), opened-toed vs. closed-toed shoes (Martin-Casado et al. 2021), and shoe fitting (McRitchie, Branthwaite, and Chockalingam 2018) are essential factors influencing the increase of HVA. Women wearing shoes with a narrow toe box between the ages of 20 and 39 are more likely to undergo hallux valgus in later life (Menz et al. 2016). ...
The forefoot is the foot part most affected by ill-fitting shoes. Footwear fitting considers the measurements of length, width, and arch length. Toe shape has not yet been used in sizing feet and fitting shoes. This study aims to investigate the variation in toe shape, as measured by the hallux valgus angle. An automatic and reproducible hallux valgus angle measuring method using 3D foot scans with no palpation markers is proposed and applied to about half a million samples collected across North America, Europe, and Asia. The measuring method is robust and can detect the medial contour along the proximal phalanx even in extreme cases. The hallux valgus angle has a normal distribution with long tails on both sides in the general population. Large dispersions of HVA values were observed for both genders and in all three geographical regions.
Practitioner summary: The hallux valgus angle has a broad distribution in the general population. Females have larger hallux valgus angles than males, and people from Asia have larger hallux valgus angles than people from North America and Europe. Shoe toe boxes should be designed to fit the actual shapes of shoppers’ toes. The proposed method for measuring HVA opens a new opportunity to study the causal relationship between shoe wearing habits and HVA on a large scale.
... However, recent studies indicate that no genetic inheritance exists as such but that shared environmental factors determine the development of a HV [7]. Some authors suggest that the use of constrictive footwear produces pressure on the medial aspect of the hallux and can lead to both reactive bone formations at that level (exostosis of DP), and valgus deviations of the first toe [3,[8][9][10][11][12][13][14][15]. ...
Purpose
A question still remains as to whether constrictive toe-box shoes (TBS) cause disability only due to pain on pressure points or if they can cause permanent changes in the hallux anatomy. The aim of this study is to compare the hallux morphology in 3 groups classified according to their use of constrictive or open TBS.
Methods
424 patients were classified into 3 groups: group A used open TBS daily; group B used constrictive TBS daily; group C used both open and constrictive TBS. Hallux’s angles, presence of exostoses and shape of the distal phalanx (DP) were analyzed on dorsoplantar weight-bearing radiographs and compared amongst groups.
Results
The intermetatarsal (IMA), metatarsophalangeal (MTPA), DASA, PASA, interphalangeal (IPA), obliquity (AP1), asymmetry (AP2) and joint deviation (JDA) angles for group A were 10°, 8°, 5°, 4°, 9°, 3°, 5°, 3°; for group B were 9°, 19°, 5°, 6°, 12°, 2°, 8°, 2°; and for group C were 10°, 10°, 4°, 4°, 12°, 3°, 8°, 1°. Only the differences in the MTPA, IPA and AP2 were statistically significant (p < 0.05). The prevalence of exostoses on the tibial side of the DP was 22, 36, and 29% in groups A, B and C, respectively (p < 0.05). We found similar distributions of the different DP shapes in the three groups.
Conclusions
Our results suggest that the use of constrictive TBS, even if used only occasionally, could change hallux anatomy from a young age increasing MTPA, IPA and AP2. Moreover, we have found that DP exostoses are present as a “normal variation” in patients who wear an open TBS, but their prevalence is higher in those wearing constrictive toe-box shoes. This could be due to a reactive bone formation secondary to the friction caused by the inner border of the shoe.
Level of clinical evidence
3.
... This is especially true of women, who should decide to change their past habits when they wore high-heeled shoes with narrow toes [16,17]. In order to neutralize the effects of progressive involutional changes and maintain the optimal-in relation to age-level of quality of life and functional fitness, the younger-old should be guided by functionality and comfort instead of fashion or aesthetic considerations in the decision to choose footwear [18][19][20][21][22]. ...
Objective:
The present study aimed to analyze the relationships between the perceptions of footwear comfort with fear of falls in younger-old women and men.
Participants:
the population sample involved 100 free-living community dwellers aged 65-74.
Design:
the Falls Efficacy Scale-International and a visual analogue scale to assess perception of footwear comfort were used as research tools.
Results:
there were statistically significant differences in the FES-I results in people who suffered a fall in the last year compared to those who did not experience a fall (p < 0.001), as well as in the subjective assessment of mediolateral control in people who have suffered and have not suffered a fall in the last year (p = 0.033). In women, statistically significant relationships were found in the subjective assessment of shoe comfort in terms of arch height (p = 0.025) and material properties of the footwear (p = 0.036) with the results of FES-I.
Conclusions:
People who have fallen show a higher level of fear of falling. The assessment of footwear comfort in terms of mediolateral control was lower in the younger-old who had experienced a fall in the last year. In women, a worse assessment of arch height and material properties of the footwear is accompanied by greater fear of falling.
