Effect of metatarsal pads and their positioning: a quantitative assessment.

Many conditions of the foot have been related to pressure maldistribution. Alteration of plantar pressure through improvements of shoe fit, orthoses, and surgery are presumed to correct pressure maldistribution. We evaluated 10 volunteers with normal, asymptomatic feet. With the use of an ultrathin in-shoe sensor, plantar pressures were measured within the shoe at the shoe/foot interface. Test conditions included three pad types: large foam, large felt, and small felt. They were evaluated in three positions: normal (at the metatarsal head base) and 5 mm proximal and 5 mm distal to the normal position. When compared with the control condition without the pad, each pad type and position caused a variable effect upon plantar pressure. On average, the small felt pad caused the greatest and most consistent decrease in pressure at the metatarsal heads (19.15%). Distal positioning tended to cause the greatest decreases in pressure for all pad types. A pad type and position was found to decrease metatarsal pad pressure in each subject. Metatarsal pads can effectively decrease plantar pressures within the shoe.