Signs of wear observed at the upper, midsole, and outsole in worn footwear after 6 months may affect forefoot loading patterns in people with gout, according to a study published in BMC Musculoskeletal Disorders. With prior re- search indicating that the short-term improve- ments (2 months) in foot pain and disability that come with good-quality athletic shoes are not sustained over time, possibly due to wear and subsequent changes to the structural integrity of the shoe, researchers examined the effects of wear on plantar pressures and footwear char- acteristics in shoes during 6 months in people with gout. Participants all had gout and wore a pair of commercially available athletic foot- wear for 6 months before attending a study visit during which the worn footwear was compared with a new pair of the same model and size. In worn shoes, increases in the hardness of the medial midsole, lateral midsole, and heel mid- sole were observed, as were normal upper and outsole wear patterns. Although no differences were observed in peak plantar pressures between the two footwear conditions, reduced pressure time integrals at the first metatarsophalangeal joint, second metatarsophalangeal joint, and hallux were seen in the worn shoes.
