Athletic footwear: unsafe due to perceptual illusions.

Modern athletic footwear provides remarkable plantar comfort when walking, running, or jumping. However, when injurious plantar loads elicit negligible perceived plantar discomfort, a perceptual illusion is created whereby perceived impact is lower than actual impact, which results in inadequate impact-moderating behavior and consequent injury. The objective of this study was to examine how plantar tactile (mechanical) events affect perceived plantar discomfort. Also, we evaluated the feasibility of a footwear safety standard we propose, which requires elimination of the above illusion. Twenty subjects gave numerical estimates of plantar discomfort produced by simulated locomotion (concurrent vertical (0.1-0.7 kg.cm-2) and horizontal (0.1-0.9 kg.cm-2) plantar loads), with the foot supported by either a smooth rigid surface or a rigid surface with 2 mm high rigid irregularities. Vertical or horizontal load alone evoked no discomfort (P greater than 0.05), whereas together, discomfort emanated from loads as low as 0.4 kg.cm-2. Irregularities heightened discomfort by a factor of 1.89. This suggests that the proposed safety standard is feasible, since compliance could be achieved simply by adding surface irregularities to insoles and by other changes that heighten localized plantar loads. However, until this standard is adhered to, it might be more appropriate to classify athletic footwear as "safety hazards" rather than "protective devices".