Effect of neutral-cushioned running shoes on plantar pressure loading and comfort in athletes with cavus feet: a crossover randomized controlled trial

Am J Sports Med. 2008 Nov;36(11):2139-46. doi: 10.1177/0363546508318191. Epub 2008 Jun 24.


Background: High injury rates observed in athletes with cavus feet are thought to be associated with elevated plantar pressure loading. Neutral-cushioned running shoes are often recommended to manage and prevent such injuries.

Purpose: To investigate in-shoe plantar pressure loading and comfort during running in 2 popular neutral-cushioned running shoes recommended for athletes with cavus feet.

Study design: Controlled laboratory study.

Methods: Plantar pressures were collected using the in-shoe Novel Pedar-X system during overground running in 22 athletes with cavus feet in 2 neutral-cushioned running shoes (Asics Nimbus 6 and Brooks Glycerin 3) and a control condition (Dunlop Volley). Comfort was measured using a validated visual analog scale.

Results: Compared with the control, both neutral-cushioned running shoes significantly reduced peak pressure and pressure-time integrals by 17% to 33% (P < .001). The Brooks Glycerin most effectively reduced pressure beneath the whole foot and forefoot (P < .01), and the Asics Nimbus most effectively reduced rearfoot pressure (P <.01). Both neutral-cushioned running shoes reduced force at the forefoot by 6% and increased it at the midfoot by 12% to 17% (P < .05). Contact time and area increased in both neutral-cushioned running shoes (P < .01). The Asics Nimbus was the most comfortable, although both neutral-cushioned running shoes were significantly more comfortable than the control (P < .001).

Conclusion: Two popular types of neutral-cushioned running shoes were effective at reducing plantar pressures in athletes with cavus feet.

Clinical relevance: Regional differences in pressure reduction suggest neutral-cushioned running shoe recommendation should shift from being categorical in nature to being based on location of injury or elevated plantar pressure.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Athletic Injuries / prevention & control
  • Biomechanical Phenomena
  • Female
  • Foot / physiology*
  • Foot Deformities*
  • Foot Injuries / prevention & control
  • Fractures, Stress / prevention & control
  • Humans
  • Male
  • Orthotic Devices*
  • Pain / prevention & control
  • Pressure
  • Running* / injuries
  • Shoes