Torsion Control Index (TCI): measurement of midfoot shoe stability, in inch-pound units (in.-lbs.). TCI is measured through actively twisting a shoe around the longitudinal axis of the shoe, from the heel to the area of the toes joints, simulating rotational forces of the foot, and measuring the shoe’s resistance to this motion.
Vertical Compression Index (VCI): measurement of hindfoot shoe stability, in millimeters (mm). VCI is measured through compression of the heel portion of the shoe under a fixed amount of pressure, thereby measuring how the structure of the shoe controls rearfoot motion.
Rebound Index (RI): indicator of energy return of shoe to the foot, in millimeters (mm). RI is measured through compression of the heel portion of the shoe under a fixed amount of pressure, and then determining how much force the shoe exerts on the foot.
Shoe Stability Index (SSI):
indicator of shoe stability, as an index. SSI is derived through mathematically combining the quantified measurements of midfoot stability (TCI) and hindfoot stability (VCI), indicating the shoe’s overall ability to control the motion of the foot.


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  • Tenderness and pain between the metatarsal heads
  • Increased pain with walking and running activities

Possible Causes

  • Pronation may increase symptoms
  • Shoes with tight fitting toe box and insufficient torsional support in midsole

Shoe Profile

For moderate to excessive pronators, the long axis of the shoe should provide maximum torsional control of foot rotation (pronation) and the midsole should provide proper vertical support. Proper support reduces shearing forces on the metatarsal heads that leads to pain and tenderness. Shoes should have a wide toe box to reduce compression of the metatarsals.


Neutral (mild pronators) – Over-the-counter orthotics with appropriately placed metatarsal support
Moderate to excessive prontators – Custom orthotics

Shoe Recommendations

The following shoes meet these criteria. Please click on the appropriate link to see the shoes and their test data.

personal_male_2 personal_female_2