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Biomechanical analysis of the plantar and upper pressure with different

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Article  in  International Journal of Biomedical Engineering and Technology · January 2014

DOI: 10.1504/IJBET.2014.059668

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Int. J. Biomedical Engineering and Technology, Vol. 14, No. 3, 2014 181

Biomechanical analysis of the plantar and upper

pressure with different sports shoes

Qichang Mei
Human Movement Research Center,
Faculty of Sports Science,
Ningbo University,
Zhejiang 315211, China
Email: joemay900221@gmail.com

Michael Graham
Institute of Health, Medical Science and Society Science,
Glyndwr University,
Wrexham, Wales, UK
Email: llantarnamhealthcare.ac.uk@hotmail.co.uk

Yaodong Gu*
Human Movement Research Center,
Faculty of Sports Science,
Ningbo University,
Zhejiang 315211, China
Email: guyaodong@nbu.edu.cn
*Corresponding author

Abstract: The purpose of the study is to probe into the difference in plantar
pressure and dorsal pressure of three types of sports shoes: Basketball Shoes
(BS); Running Shoes (RS); Tennis Shoes (TS). The novel insole measurement
system and pressure sensor chips are utilised to obtain plantar and dorsal
pressure. As to dorsal pressure, maximal Lateral Metatarsophalangeal (LM)
joint of TS is distinctively different from BS and RS, mean LM of RS is
apparently distinct from BS and TS. These distinctions might be of importance
while designing shoes; factors like athletic performance, perceived comfort and
injury prevention should be taken into consideration.

Keywords: footwear design; athletic performance; perceived comfort; injury

prevention; biomedical engineering.

Reference to this paper should be made as follows: Mei, Q., Graham, M. and
Gu, Y. (2014) ‘Biomechanical analysis of the plantar and upper pressure with
different sports shoes’, Int. J. Biomedical Engineering and Technology, Vol. 14,
No. 3, pp.181–191.

Biographical notes: Qichang Mei is a Research Student in Faculty of Sports

Science, Ningbo University, China. He received BSM from Hubei University,
China. His research areas focus on evaluating lower limb biomechanical
function and foot anatomy imaging analysis.

Copyright © 2014 Inderscience Enterprises Ltd.

182 Q. Mei, M. Graham and Y. Gu

Michael Graham is a BASES accredited research physiologist, with a specialised

interest in performance in sport.

Yaodong Gu is an Associate Professor at the Faculty of Sports Science, Ningbo

University, China. He received his PhD in Biomechanics in 2010 from
Liverpool John Moores University, UK. His current research areas include
lower biomechanics and footwear development.

1 Introduction

Nowadays with people attaching more importance to daily exercise, sports shoes as
one of the most important necessities not only play a key role in improving sports
performance but also take up a crucial position in preventing injury. It has been
summarised in a review of the book Biomechanics of Sports Shoes by Benno M. Nigg
that sports shoes which encourage muscle vibration may serve as training tools and those
shoes that minimise muscle vibration could reduce the energy expended on vibration
damping and potentially enhance performance (Hamill, 2011; Shorten, 2011). Also,
people tend to participate in different kinds of activities; thus, shoes needed are becoming
diversified and sports-specified. In terms of specific-sport shoes, researches have been
conducting to analyse the potential relationship between performance and shoes design.
The performance attributes of running shoes (RS), such as shoe weight, impact
absorption, energy return, stability, flexibility and traction, were selected to measure
different running shoes among participants and participants’ basic profiles were collected
so as to design user-centred running shoes (Clifton et al., 2011). Performance of
time related to different basketball shoes (BS) was evaluated by testing the forefoot
stability, while skilled subjects dribbled and shot, as forefoot stability is important while
basketball players perform different movements. Sport-specific movements such as
rapid stopping and jumping were applied to test the stability and kinetics of different
shoes with different cushions (Valiant and Himmelsbach, 1992; Valiant and Eden, 1993).
Soccer shoes are also concerned with kicking performance. Amateur football players
participated in an experiment with different brands soccer shoes (labelled as A, P, N and
U) to kick ball with instep. The result turned out P shoe with highest velocity and N shoe
with biggest force (Ismail et al., 2013).
Another key point to be considered while choosing sport shoes is to assure perceived
comfort and avoid chronic and acute sport injuries. Due to the shoes pressure of different
plantar and dorsal zones, first and fifth metatarsal area and rearfoot zone are inclined to
bear more compression. While engaging in basic physical activity or high intensity
exercise, the repetitive practice is closely linked to the skin lesions such as corns and
calluses. These are the result of prolonged pressure, friction and excessive mechanical
stress. What’s worse, it may result in serious skin problems (Grouios, 2004). Plantar
fasciitis is another common chronic foot disorder, which may result from improper
footwear or overuse strain due to windlass effect (Lin et al., 2013). As to acute trauma or
injury, ankle sprain takes up a great part concerning foot injuries, especially in female
 Biomechanical analysis of the plantar and upper pressure 183

basketball players (Yentes et al., 2012). Nowadays the incidence of lateral ankle sprain,
with highly propagated basketball shoes along with cushioned column systems under
heel, which will improve athletic performance, is not increased (Curtis et al., 2008).
Or even worse, ankle’s over-inversion sprain leads to the fracture of ankle.
Different shoes have been taken into research to analyse both kinematics and kinetics
changes of lower extremity, in which plantar pressure distribution analysis holds an
important part with sports shoes and any other functional shoes. Plantar pressure has
been taking advantage to assess running fatigue, which is a crucial index to determine
overuse injuries (Bisiauxa and Moretto, 2008; Willems et al., 2012a; Willems et al.,
2012b) and peak and mean plantar pressure are interlinked with body mass (Arnold et al.,
2011). What’s more, in-shoe plantar pressure is utilised to assess diabetic patients and
avoid the recurrence of ulceration (Bus et al., 2012) and diagnose pre-diabetic patients by
comparing the planter pressure distribution patterns of healthy individuals with diabetic
patients (Robinson, 2013). On the contrary, though investigations of plantar pressure
pertaining to different movements have been conducted, the study of dorsal pressure is
scantly enough. One study used a capacitive plantar pressure measuring device to
research the pressure between the prosthesis and the dorsal aspect of the foot in a patient
who had undergone rotationplasty (Hillmann et al., 2000). These data could not be
generally used to participants who had not undergone this surgical intervention. Some
researcher take advantage of a three-dimension (3D) footwear simulator to animate foot,
while walking for the virtual testing of footwear using dorsal pressures to performs
virtual evaluations of the footwear features (Ruperez et al., 2009). But as to the testing of
real shoes, this method is not feasible.
In this paper, we adopt three pairs of sports shoes, i.e. basketball shoes, running shoes
and tennis shoes, to analyse the difference of plantar pressure and upper pressure among
participants. Shoes are randomly taken by nine participants to run on the treadmill. Data
concerning plantar pressure and upper pressure are collected to investigate the difference
between the same positions of different types of sports shoes. It is hypothesised that
(a) plantar pressure with different sports shoes may be different while running; (b) the
upper pressure of different sports shoes may be different, owing to specialised-shoes
designing. The potential distinction will be of great significance for better shoes-design
combining sports-specified features, perceived comfort and injury prevention.

2 Methods

2.1 Participants
Nine young males, with ages of 24 ± 2.13 years, height of 171 ± 4.96 cm and weight of
63 ± 6.78 kg, participated in the experiment. All of them are recreational runners with the
experience of treadmill running. They all have the shoes size of 41(EU) and they do not
have a history of lower extremity injuries.
184 Q. Mei, M. Graham and Y. Gu

2.2 Methods and statistical analysis

Three pairs of sports shoes with the size of 41 (Figure 1) are used in the experiment: one
pair of basketball shoes, one pair of tennis shoes and one pair of running shoes. The
velocity of treadmill is controlled at 8 km/h.

2.2.1 Equipments
In-shoe plantar pressure measurement is assessed with Novel Pedar insole system
(Novel, Germany), including a pair of insoles and four sensor chips all with 100 Hz. Four
sensor chips with no. 1, 2, 3 and 4 are positioned at the medial first metatarsophalangeal
joint, the lateral fifth metatarsophalangeal joint, the contact position between right under
the medial condyle and medial-upper and the contact position between right under the
lateral condyle and lateral-upper (Figure 2). Subjects run for 3 min on the treadmill to
warm up and adjusted the treadmill’s velocity. Then they randomly chose one pair of
shoes. And plantar pressure and upper pressure were collected by Novel insoles and
sensor chips in five steps. Other two pairs of shoes were also tested randomly with a
three-minute rest interval till all the nine participants finished testing.

Figure 1 Testing shoes (left to right – basketball shoes; running shoes; tennis shoes)

Figure 2 Position of novel insole (black) and sensor chips (blue)

2.2.2 Statistical analysis

Data are exported from Novel insole measuring system. Microsoft Excel 2010 is used to
pile up five-step’s data of three pairs of shoes and mean values are used to reflect
pressure of every subject. The statistics is analysed with ANOVA. The descriptive
analysis with SPSS 13.0 is used to analyse the plantar pressure in different zones and
upper pressure in four areas.
 Biomechanical analysis of the plantar and upper pressure 185

3 Result

The distribution of plantar pressure is measured by the Novel insole system. To precisely
and accurately collect the data, plantar is divided into anterior-posterior zone with toes
(T), forefoot (FF), midfoot (MT), heel (H) and medial-lateral zone with medial forefoot
(MF), lateral forefoot (LF), medial heel (MH) and lateral heel (LH). Other four pressure
sensor chips are utilised to obtain upper pressure of four positions: medial condyle (MC),
lateral condyle (LC), medial first metatarsophalangeal joint (MM) and lateral fifth
metatarsophalangeal joint (LM).

3.1 Plantar pressure

3.1.1 The anterior-posterior plantar pressure
According to the foot anatomy and running phase, the researcher divides foot into four
parts: heel (H), midfoot (MF), forefoot (FF) and toes (T). The maximum and mean of
plantar pressure in different zones are measured (Table 1).
Table 1 Plantar pressure distribution of three pairs of sports shoes (n = 9)

Toes (T) Forefoot (FF) Midfoot (MF) Heel (H)

max mean max mean max mean max mean
Mean 184.2 82.1 186.1 115.1 111.4 58.3 187.6 108.4
BS
SD 43.1 19.5 24.4 14.4 27.6 17.9 42.1 21.9
Mean 203.2 100.6 214.4 103.4 103.2 67.9 151.5 93.0
RS
SD 42.9 19.1 38.6 15.0 20.9 15.7 31.9 22.3
Mean 201.0 83.5 175.2 101.1 94.6 58.9 170.6 104.4
TS
SD 61.2 23.0 25.8 9.7 13.8 16.1 41.4 25.9
Notes: BS – basketball shoes; RS – running shoes; TS – tennis shoes; SD – standard
deviation.
The one-way ANOVA is used to analyse the plantar pressure of four zones (T, FF, MF
and H) with three different shoes; the results are shown in Table 2. As indicated in the
table, both the maximal pressure and mean pressure of four zones with three shoes are
not statistically different (p > 0.05), which means the pressures from interior to posterior
of four zones with three different shoes are not significantly different.
Table 2 The ANOVA of anterior-posterior plantar pressure with three pairs of shoes (n = 9)

Position Pressure One-way ANOVA (p-values)

max 0.546
Toes
mean 0.080
max 0.079
Forefoot
mean 0.109
max 0.494
Midfoot
mean 0.340
max 0.412
Heel
mean 0.589
186 Q. Mei, M. Graham and Y. Gu

To further probe into different plantar pressures on the basis of foot anatomy, the
researcher divides the plantar into medial forefoot (MF), lateral forefoot (LF), medial
heel (MH) and lateral heel (LH). The maximal pressure and mean pressure of different
zones (MF, LF, MH and LH) are measured (Table 3).
Table 3 The medial-lateral plantar pressure with three pairs of shoes (n = 9)

MF LF MH LH
max mean max mean max mean max mean
Mean 210.3 105.3 167.4 84.1 187.4 105.0 170.0 87.6
BS
SD 27.1 11.2 23.0 15.2 41.9 23.6 43.1 22.2
Mean 225.8 102.4 174.2 82.7 151.1 90.4 145.6 87.6
RS
SD 35.8 14.7 36.2 9.3 30.5 18.8 35.0 22.6
Mean 216.2 94.0 155.7 81.0 169.5 93.5 164.3 89.6
TS
SD 49.6 9.7 28.4 15.7 41.0 23.0 40.3 24.3
Notes: MF – medial forefoot; LF – lateral forefoot; MH – medial heel; LH – lateral
heel; BS – basketball shoes; RS – running shoes; TS – tennis shoes; SD –
standard deviation.

The one-way ANOVA is conducted with maximum and mean of medial-lateral plantar
pressure with three pairs of shoes; the results are shown in Table 4. As it depicts in the
table, the plantar pressures (maximum and mean) of the same zone (MF, LF, MH and
LH) with different shoes show no statistical difference (p > 0.05). As a result, the
discrepancy of medial-lateral plantar pressure in the same zone with different shoes is not
prominently obvious.
Table 4 The ANOVA of medial-lateral plantar pressure with three pairs of shoes (n = 9)

Position Pressure One-way ANOVA (p-values)

max 0.908
MF
mean 0.533
max 0.715
LF
mean 0.979
max 0.406
MH
mean 0.644
max 0.600
LH
mean 0.940
Notes: MF – medial forefoot; LF – lateral forefoot; MH – medial heel; LH – lateral
heel.

In order to fully analyse the distinction of plantar pressure and upper pressure with
different shoes, Novel Pedar pressure sensor chips are used to collect the pressure
between upper and four right-foot positions (medial first metatarsophalangeal joint and
lateral fifth metatarsophalangeal, medial condyle and lateral condyle). The maximal and
mean pressures are taken as the measurement of upper pressure (Table 5).
 Biomechanical analysis of the plantar and upper pressure 187

The one-way ANOVA is used to analyse upper pressure so as to illustrate the

pressure difference among the same zone of different shoes. As Table 5 shows, pressures
of three positions (MC, LC and MM) including maximum and mean (p > 0.05) are not
statistically significant. The pressures of three positions (MC, LC and MM) with three
pairs of shoes are almost equal to each other.
However, the pressure of LM (lateral fifth metatarsophalangeal joint) is distinctly
different, with maximal pressure (p < 0.05) and mean pressure (p < 0.05). As it shows in
Table 5, the multiple comparison method is adopted to further excavate the difference
among specific shoes. In terms of maximal LM pressure, LM pressure of TS is
82.1 ± 59.9 kpa, which is greatly statistically different from other shoes. On the contrary,
the peak LM pressures of other two pairs of shoes are not obviously different.
Considering mean pressure, the result is quite different from maximal pressure.
Apart from non-difference between BS and TS, differences are greatly obvious while
comparing RS with other two pairs of shoes, among which the mean LM pressure of BS
and TS, 21.5 ± 11.5 kpa and 33.3 ± 26.6 kpa, respectively, are significantly different
from RS, with 8.0 ± 4.7 kpa, p < 0.05.
Table 5 The comparison of ANOVA of upper pressure with three pairs of shoes (n = 9)

MC LM LC MM
Upper Pressure
max mean max mean max mean max mean
12.4±1 4.3± 44.2± 21.5± 15.2± 4.0± 84.4± 41.1±
BS
9.9 7.4 20.0* 11.5 16.9 4.5 31.2 19.1
20.0± 7.0± 24.6± 8.0± 14.6± 5.2± 52.8± 31.2±
RS
26.7 9.1 11.0* 4.7# 27.8 11.5 25.6 15.0
16.9± 8.3± 82.1± 33.3± 5.6± 1.4± 63.0± 38.0±
TS
26.1 13.5 59.9 26.6 11.4 2.8 31.7 20.3
F 1.191 1.287 4.343 4.031 0.481 0.374 2.091 0.874
P 0.330 0.292 0.005 0.008 0.749 0.826 0.100 0.488
Notes: MC – medial condyle; LC – lateral condyle; LM – lateral metatarsophalangeal
joint; MM – medial metatarsophalangeal; BS – basketball shoes; RS – running
shoes; TS – tennis shoes.
*indicates that TS is compared with other two pairs of shoes, p < 0.05;
#indicates that RS is compared with other two pairs of shoes, p < 0.05.

4 Discussion

The study collects the data related to the plantar pressure and four upper positions’
pressure using Novel insole measurement system and pressure sensor chips. Firstly, as to
plantar pressure, the study divide plantar pressure into anterior-posterior planter pressure
and medial-lateral planter pressure so as to precisely illustrate the possibly-existed
difference among the same zone of three pairs of shoes. As the result turns out, the
discrepancy between different shoes in anterior-posterior (Tables 1 and 2) and medial-
lateral (Tables 3 and 4) plantar pressure is not obviously significant, with p > 0.05. One
reason might be that all the shoes are the same brand with similar material, while
manufacturing soles, hardness or softness of which is a contributory factor to the
188 Q. Mei, M. Graham and Y. Gu

outcome. Improper shoes sole may lead to great plantar pressure, which is the key result
in foot disorders, such as plantar fasciitis, common seen in both professional and
recreational runners (Lin et al., 2013). Sole hardness’s effect on lower extremity tends to
be different among subjects. Other variables such as gender, age and health status may
affect the lower extremity kinematics and plantar pressure (Queen et al., 2010). The
conclusions are diversified; gender and age effects are separable and classifiable with age
being more dominant and gender being less dominant (Nigg et al., 2012). Age difference
is recorded on plantar pressure distribution because elderly subjects tend to have more
weight-bearing in the lateral side during heel touch and toes push-off phase while
walking, which will affect walking stability (Hessert et al., 2005). Also, subjects
diagnosed with diabetes or with lower limbs orthotics are selected to analyse their plantar
pressure distribution to better instruct shoes-design with the purpose of improving
perceived comfort, e.g. diabetic patients are advised to take rocker shoes to reduce in-sole
pressure (Chapman et al., 2013). All these factors should be kept in mind while designing
shoes for different individuals. Running is the basic characteristic involved in many kinds
of sports. Subjects are running on the treadmill, but these shoes are all designed with
relatively soft sole which can alleviate ground reaction force, thus reducing fatigue,
though sports-specific features are considered (García-Pérez et al., 2013). Further
research should be conducted to illustrate the difference of plantar pressure while
practicing on various situations such as running on the natural grass, athletic field or
outdoor ground.
Second, in terms of the significant upper pressure distinction among three pairs of
sports shoes in LM, as what we have hypothesised, the distinction is obvious p < 0.05
(Table 5). The maximal pressure of LM in TS, with 82.1 ± 59.9 kpa, is quite different
from that of BS and RS, with 44.2 ± 20.0 kpa and 24.6 ± 11.0 kpa, respectively. Sports-
specified features are taken into account when designing these shoes; TS is designed with
combined features of tennis in which total direction-changes are the basic elements.
Shoes’ ground contact, as the first stage during lower extremity movements, is an
important part in switching directions. The forefoot stability has been selected as a key
element to test direction-changing performance (Valiant and Himmelsbach, 1992). To
best fulfil the performance of shifting direction, while running on the treadmill, the
contact between fifth metatarsophalangeal joint and the upper position is tight and
comprehensive so that direction-changes will occur at any time. Forefoot will not slip
relative to sole or upper in the shoes so that the incidence of lapsing is reduced and
performance is improved. What’s more, it will be beneficial to comfort and injury
prevention, such as over-use calluses and corns due to excessive compression while
repetitive practice (Grouios, 2004). Compared to TS, other two pairs of shoes are not
originally designed to perform the function of changing directions. In terms of BS, sport-
featured performance, such as jump or instant bounce, should be taken into considered
owing that most of the time players should jump to catch a ball or shoot (Blache et al.,
2011). Also, sports injuries are inevitable issues while designing shoes, in which the most
common is ankle sprain. Apart from sports shoes prevention, seasonal training of lower
extremity strength to improve peak eversion torque is not only vital for injury prevention
but also helpful for promoting performance (Yentes et al., 2012). The plantar pressure in
females wearing hiking shoes while walking on tilted and flat grounds have been
analysed to measure pressure distribution, which found higher pressure in forefoot area
(Gu and Shen, 2013). The function of shoes should possess not only sport-specific
 Biomechanical analysis of the plantar and upper pressure 189

features, which will improve sports performance, but also another essential element,
which will prevent injury, on the basis of combining special characteristics of sports
events. More investigation concerning sport-specific movements should be carried out in
the near future to deeply penetrate into the plantar and upper or dorsal pressure
distribution, thus providing implication for better shoes design.
Finally, considering the mean values of LM upper pressure, RS, with 8.0 ± 4.7 kpa, is
greatly distinguished from that of BS and TS, with 21.5 ± 11.5 kpa and 33.3 ± 26.6 kpa,
respectively, p < 0.05. RS is relatively less of binding than BS and TS, because the latter
two shoes are sports-feature-oriented, which are tightly close with metatarsophalangeal
joint to stabilise forefoot, improve sports performance and prevent injury while repetitive
practice, high intensity movement or fierce competition. The tightness or looseness of
shoes dorsum is also connected to the perceived comfort of the shoes. Even different
shoes lacing pattern may affect the dorsal pressure; the loosest lacing might not be the
most comfortable and a certain amount of lacing tightness is necessary to feel
comfortable in the running shoes (Hagen et al., 2008). Dorsal pressure is an inevitable
aspect to consider in terms of shoes’ perceived comfort. Additionally, the material used
to make the shoe surface is also play a crucial role in shoe’s comfort. The cleat pattern of
soccer shoes and artificial ground surface influence the rotation torque and upper material
may influence rotational stiffness. These factors may be the latent factors contributing to
the discomfort or even injury of lower limb (Villwock et al., 2009). Artificial neural
networks have been used to collect pressure exerted from shoes surface to dorsum while
walking, so as to obtain new materials strengthening shoes’ comfort (Rupérez et al.,
2012a). Material like calfskin is chosen to be the shoe surface; Computer-aided Design
(CAD) and finite element method have been widely used to simulate upper deformation
in gait. And tests of the leather resisting to lasting damage and shoes forming process
after lasting are conducted to select shoe upper material (Rupérez et al., 2012b). Shoes
perceived comfort is also a necessary factor which should be involved in designing
shoes. Apart from sole hardness, upper material is another element deserving special
attention. In terms of laced sports shoes, the position of lace, lacing pattern and lacing
tightness or looseness also matter to the perceived comfort and fatigue, which will lead to
over-use chronic injuries.
In this study, we find a great difference of upper pressure existed while running on
the treadmill with different sports shoes. Particularly, running with TS, the peak pressure
of LM is obviously distinct from RS and BS. Considering the mean pressure of RS, as
compared to TS and BS, RS is the least apparent. Upper pressure of different shoes is
apparently different, so it is of great vitality for shoes designing considering these
differences. With these implications, they not only beneficial to promote athletic
performance, but also promote perceived comfort and thus decrease the rate of injury.
The research investigated the plantar pressure and upper pressure of young male
participants with three types of sports shoes. The plantar pressure distribution among
three pairs of shoes was not significantly obvious; the reason might be subjects’ number
is not enough. Also, participants are young male with treadmill running history, which
are not efficient to analyse the potential difference of gender and age. In the future study,
participants can broad to both female and male with a wide range of age, so that the
difference might be obvious. And it may be more beneficial to provide suggestion for
shoes designers. Additionally, as to upper pressure, sport-specific movements should be
included so as to completely simulate real features of sports. The data concerning upper
190 Q. Mei, M. Graham and Y. Gu

pressure may be more true and comprehensive, and its implication for shoes design with
comfort, injury prevention and performance improvement will be meaningful. Dorsal
pressure is not exhaustively analysed because the device is so limited that pressure of
dorsum is hard to fully obtain. Future research should focus on both planter and dorsal
pressures to completely illustrate the pressure distribution of shoes.

Acknowledgements

The study sponsored by National Natural Science Foundation of China (81301600), SRF
for ROCS, SEM, and Ningbo Natural Science Foundation (2013A610262).

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