SYMPOSIA PAPER Published: 01 January 1985

Pressure-Induced Pain in the Foot and Leg


Pressure-induced pain is an important parameter in skiing safety. Pain is a complex phenomenon that includes not only the sensations evoked by tissue-damaging stimuli, but also the subject's response to those stimuli. Alpine skiers are willing to undergo “pain and discomfort” from their ski boots in order to improve their skiing performance. In this study, pressure-induced pain was applied to various areas of the foot and leg: the lateral and medial malleoli, the instep, the heads of the first and fifth metatarsals, the tibia, and the heel. The first six areas are regions of bony prominences, while the heel is an area that can undergo soft tissue damage from skiing in tight-fitting boots. Reliable and objective verbal descriptor pain scales have been developed that separate pain into two dimensions: the sensory and the affective. The sensory scale relates to the sensory discriminative aspects of pain, while the affective scale relates to the motivational and emotional aspects of pain. The pain-inducing pressure was applied with a hand-held plunger, in two testing sessions, one week apart. In one session the sensory scale was used, which contains such terms as weak and intense, and in the other session the affective scale was used, which uses such terms as unpleasant and excruciating. In each case, the subject determined the maximum value of force to be applied by indicating to the tester that the pain sensations were either “intense” or “excruciating.” At that time the force was removed and, later, random percentages (including a repeat application) of this subject-determined maximum force were applied to the same locations on the foot and leg of the same subject. Analysis of the data show this method to be a reliable technique for applying pressure-induced pain. A total of 15 subjects were used for the sensory testing session and 13 of those 15 for the affective testing. There were significant differences between locations of the foot and leg, with the tibia being the most sensitive and the heel the least sensitive.

Author Information

Medoff, Howard
Spring Garden College, Philadelphia, PA
Rosen, James
University of Vermont, Burlington, VT
Pope, Malcolm
University of Vermont College of Medicine, Burlington, VT
Johnson, Robert, J.
University of Vermont College of Medicine, Burlington, VT
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Developed by Committee: F27
Pages: 110–116
DOI: 10.1520/STP46630S
ISBN-EB: 978-0-8031-6832-9
ISBN-13: 978-0-8031-6833-6