Relationship between Foot Progression Angle and Exercise-related Lower Leg Pain

INTRODUCTION Exercise-related lower leg pain (ERLLP) is a common and enigmatic overuse problem in athletes and military populations [1]. Runners, track athletes and athletes participating in jumping sports are frequently diagnosed with ERLLP which is usually induced by repetitive tibial strain imposed by loading during intensive, weight bearing activities. Retrospective and prospective studies have identified a relationship between an increased subtalar eversion and ERLLP [2,3,4]. As highly potential risk factor, also an increased medial pressure distribution during the forefoot contact phase has been identified [4]. In clinical practice, an increased foot progression angle (abducted) is often linked with an increased eversion as it is suggested that the lower leg follows the direction of progression. Therefore, we hypothesize that ERLLP could be related to an increased foot progression angle which could relate to the increased eversion and the increased medial pressure distribution. However, to our knowledge, in the literature, the relationship between foot progression angle and ERLLP or the eversion excursion or the medio-lateral pressure distribution has not been investigated. Therefore, the purpose of this study was 1) to investigate the relationship between the foot progression angle and the amount of eversion and the medio-lateral pressure distribution and 2) subsequently gain insight in a potential underlying mechanism that might be implicated as precursor to ERLLP.