The Association of Foot Arch Variations With Patellofemoral Pain Syndrome in Recreational Athletes.Orthop J Sports Med. 2025 Jun; 13(6):23259671251334776.OJ
Background
Patellofemoral pain syndrome (PFPS) is one of the common causes of anterior knee pain, especially in the young and athletic population. Although there are many intrinsic and extrinsic factors causing PFPS, the foot arch variations have been theorized to be associated with or contribute to the condition.
Purpose
To study the association of foot arch variations with PFPS in recreational athletes.
Study Design
Cross-sectional study; Level of evidence, 3.
Methods
This study investigated the foot arch index, categorizing the foot as flat foot, high-arch foot, or normal foot in 35 recreational athletes with PFPS and 35 healthy individuals (12 women, 23 men in each group). The foot posture index was calculated by taking the impression of the foot on a paper using ink and uploading it on a computer to determine the area of the foot. The midfoot area was then divided by the total area to obtain the foot arch index. Based on this, the foot was categorized as flat foot, high-arch foot, or normal foot.
Results
Using the chi-square test, the authors observed that there were significantly more individuals with foot arch variations in the PFPS group as compared with the healthy individuals. A chi-square test was used to study the association between the foot arch variations and PFPS and found a significant (P < .001) association between the two, and a post hoc comparison showed a significant (P < .001) association of flat foot with PFPS.
Conclusion
A more pronated or flat foot is associated with PFPS and should be assessed when evaluating individuals with PFPS. Hence, the evaluation of foot arch may be an important addition to other clinical measurements taken to explore the factors associated with PFPS.
Registration
CTRI/2024/01/061538 (Clinical Trials Registry-India code).
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