Metatarsal Loading During Gait—A Musculoskeletal Analysis

Abstract

Detailed knowledge of the loading conditions within the human body is essential for the development and optimization of treatments for disorders and injuries of the musculoskeletal system. While loads in the major joints of the lower limb have been the subject of extensive study, relatively little is known about the forces applied to the individual bones of the foot. The objective of this study was to use a detailed musculoskeletal model to compute the loads applied to the metatarsal bones during gait across several healthy subjects. Motion-captured gait trials and computed tomography (CT) foot scans from four healthy subjects were used as the inputs to inverse dynamic simulations that allowed the computation of loads at the metatarsal joints. Low loads in the metatarsophalangeal (MTP) joint were predicted before terminal stance, however, increased to an average peak of 1.9 times body weight (BW) before toe-off in the first metatarsal. At the first tarsometatarsal (TMT) joint, loads of up to 1.0 times BW were seen during the early part of stance, reflecting tension in the ligaments and muscles. These loads subsequently increased to an average peak of 3.0 times BW. Loads in the first ray were higher compared to rays 2-5. The joints were primarily loaded in the longitudinal direction of the bone.

A framework for the etiology of running‐related injuries

“…Moreover, methods for estimating forces applied to individual structures all involve some form of mathematical optimization, which requires fairly speculative assumptions about how the central nervous system coordinates activation of individual muscles. 100,109,110 Despite these limitations, the model proposed in the present article is appealing given that it provides a conceptual framework that, if used in practice, would lead to more accurate quantification of running exposure compared with traditional measures. This makes sudden changes in cumulative structure-specific load an interesting area of study because it permits an in-depth examination of the association between changes in training-related variables (eg, pace, distance, surface, and technique) and runner characteristics (eg, equipment usage, weight) in relation to injury development in specific structures.…”

“…Valid biomechanical measures of these areas are hard to obtain, not least because they vary considerably during the step cycle. Moreover, methods for estimating forces applied to individual structures all involve some form of mathematical optimization, which requires fairly speculative assumptions about how the central nervous system coordinates activation of individual muscles . Despite these limitations, the model proposed in the present article is appealing given that it provides a conceptual framework that, if used in practice, would lead to more accurate quantification of running exposure compared with traditional measures.…”

Musculoskeletal modeling of total ankle arthroplasty using force-dependent kinematics for predicting in vivo joint mechanics

“…The predicted normalized muscle activations of the major muscles (lateral gastrocnemius, medial gastrocnemius, peroneus longus, soleus, and tibialis anterior) around the ankle joint are presented in Figure 7. As shown in Figure 7, the predicted muscle activations are compared to the electromyography (EMG) data measured by Al-Munajjed et al 39…”

Effect of toe exercises and toe grip strength on the treatment of primary metatarsalgia

“…During walking, the load increases to about 2 times that of body weight before toe-off at the MTP joints [17] due to the combined effect of forward-falling and ground reaction force loads applied to the forefoot. When the toes lose the ability to functionally push off the ground, it places an increased load on the metatarsal area.…”