title: Pattern of outsole shoe heel wear in infantry recruits.
abstract: BACKGROUND
  Excessive shoe heel abrasion is of concern to patients, parents and shoe manufacturers, but little scientific information is available. The purpose of this study was to describe the phenomenon in a group of infantry recruits performing similar physical activity, and search for biomechanical factors that might be related.
  
  
  METHODS
  Seventy-six subjects (median age 19) enrolled. Pre-training parameters measured included height, weight, tibial length, foot arch height and foot progression angle. Digital plantar pressure maps were taken to calculate arch indexes. Shoe heel abrasion was assessed manually after 14 weeks of training with different-sized clock transparencies and a calliper.
  
  
  RESULTS
  Outsole abrasion was posterolateral, averaging 12 degrees on each shoe. The average heel volume that was eroded was almost 5 cm3. The angle of maximum wear was related to right foot progression angle (r = 0.27, p = 0.02). Recruits with lateral ankle sprains had higher angles of maximal abrasion (17° versus 10°, p = 0.26) and recruits with lateral heel abrasion had more lateral ankle sprains (14% versus 3%, p = 0.12).
  
  
  CONCLUSIONS
  While shoe heel wear affects many people, very little has been done to measure it. In this study in healthy subjects, we found the main abrasion to be posterolateral. This seems to be related to foot progression angle. It was not related to hindfoot valgus/varus or other factors related to subtalar joint motion. These findings do not warrant modification of subtalar joint motion in order to limit shoe heel abrasion.
authors.affiliation: Department of Orthopedics, Assaf Harofeh Medical Center, Zerifin, Israel. asff@inter.net.il.
authors.forename: Aharon S
authors.initials: AS
authors.lastname: Finestone
authors.forename: Kaloyan
authors.initials: K
authors.lastname: Petrov
authors.forename: Gabriel
authors.initials: G
authors.lastname: Agar
authors.forename: Assaf
authors.initials: A
authors.lastname: Honig
authors.forename: Eran
authors.initials: E
authors.lastname: Tamir
authors.forename: Charles
authors.initials: C
authors.lastname: Milgrom