Tibial torsion and pressures in the feet during walking: Implications for patterns of metatarsal robusticity.

OBJECTIVES: The Dmanisi Homo fossils include a tibia with a low degree of torsion and metatarsals with a pattern of robusticity differing from modern humans. It has been proposed that low tibial torsion would cause a low foot progression angle (FPA) in walking, and consequently increased force applied to the medial rays. This could explain the more robust MT III and IV from Dmanisi. Here we experimentally tested these hypothesized biomechanical relationships in living human subjects. MATERIALS AND METHODS: We measured transmalleolar axis (TMA, a proxy for tibial torsion), FPA, and plantar pressure distributions during walking in young men (n = 40). TMA was measured externally using a newly developed method. A pressure mat recorded FPA and pressure under the metatarsal heads (MT I vs. MT II-IV vs. MT V). RESULTS: TMA is positively correlated with FPA, but only in the right foot. Plantar pressure under MT II-IV does increase with lower TMA, as predicted, but FPA does not affect pressure. Body mass index also influenced plantar pressure distribution. DISCUSSION: Lower tibial torsion in humans is associated with slightly increased pressures along the middle rays of the foot during walking, but not because of changes in FPA. Therefore, it is possible that the low degree of torsion in the Dmanisi Homo tibia is related to the unusual pattern of robusticity in the associated metatarsals, but the mechanism behind this relationship is unclear. Future work will explore TMA, FPA, and plantar pressures during running.