Written by: Cherri Choate, DPM
12/2/2009

Although the term center of pressure is used widely in research circles, and infrequently in clinical practice, it is an important concept to consider when fabricating orthoses. The center of pressure is a representative map of where the body weight is focused during each step.  If we are attempting to offer control of medial or lateral instability, then we are trying to modify the patient's natural center of pressure.   An article in our eJournal this week (Paton 2006) is about the impact of different types of rearfoot posts on the center of pressure of a foot during gait.  The study found that the most significant changes were seen in the early stages of gait with the use of a long medial rearfoot post. This is one of only a few studies that focus on the role of the rearfoot post, so the information is important to evaluate. 

Clinical Significance:
    In the foot with medial overload, such as posterior tibiial tendon dysfunction, the value of the longer medial post would be a diminshed shift of the center of pressure toward the medial foot, thus avoiding PT tendonitis.  In a foot with lateral overload, such as a pes cavus foot, the value of the longer lateral post, maybe a diminished shift of the center of pressure to the lateral column, improving stability and decreasing the odds of lateral ankle sprains.

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