Effects of heel apex position, apex angle and rocker radius on plantar pressure in the heel region.

Methods

In-shoe pressure was measured, while 10 healthy participants walked with control shoe and 10 different heel rocker settings. Peak pressure was determined in 7 heel masks, for all shoes. Generalized estimating equation was performed to test the effect of the different shoes on the peak pressure in the different heel masks.

Results In the proximal heel, a rocker shoe with distal apex position, small rocker radius and large apex angle (100°), shows the largest significant decrease in peak pressure compared to rocker shoes with more proximally located apex positions. In the midheel and distal heel, the same rocker shoes or any other rocker shoes, analyzed in this study, do not reduce the PP more than 2% compared to the control shoe. For the midheel and distal heel region with high pressure values (>200 kPa), rocker shoes alone are not the correct options to reduce the pressure to below 200 kPa.

Conclusion When using rocker shoes to reduce the pressure in the forefoot, a heel rocker midsole with a distal apex position, small rocker radius and apex angle of 100°, mitigates the negative effects on proximal heel pressure. For the midheel and distal heel, other footwear options as an addition or instead of rocker shoes are needed to reduce the pressure.