Jackson, AaronSheerin, KellyYoon, SangHoonWyatt, HannahReid, DuncanCarroll, Matthew2026-03-162026-03-162026-03-11Gait & Posture, ISSN: 0966-6362 (Print), Elsevier BV, 127, 110152-110152. doi: 10.1016/j.gaitpost.2026.1101520966-6362http://hdl.handle.net/10292/20769Background Lateral wedges are often prescribed to increase the first metatarsophalangeal joint (MPJ) range of motion or alter the centre of pressure (COP) in the foot. This study explored the effect of lateral wedge design and placement on first MPJ extension and COP during walking and running gait. Methods A randomised crossover design was used and 24 healthy participants ran and walked in 10 insole conditions comprising differing combinations of inclination, placement and contour. First MPJ extension and foot COP were examined. Time-series data were analysed across the stance phase using statistical parametric mapping. Results Lateral wedges significantly reduced first MPJ extension during both walking (p < 0.001; 100% of stance) and running (p = 0.004; 14–72%, and p = 0.017; 76–99% of stance). Similarly, lateral wedge placement reduced first MPJ joint extension during walking (p < 0.001; 100% of stance) and running (p = 0.003; 13–69%, and p = 0.012; 78–100%). Full-length or 6° lateral wedges shifted the COP medially relative to the midline of the foot (p = 0.01). Compared to sham, lateral wedges placed on contoured insoles exhibited a smaller reduction in first MPJ during walking (p = 0.008) and shifted the COP medially during both walking (p < 0.001) and running (p = 0.020). Conclusion Where the intention of using lateral wedging is to shift the COP medially, these data indicate that a wedge which is of higher inclination (6°) or spanning the full-length of the insole, should be used. Conversely, if the goal is to reduce extension at the first MPJ, these findings suggest that both 3° and 6° inclination wedges are suitable, with either forefoot or full-length applications proving effective.© 2026 The Authors. Published by Elsevier B.V. This is an open access article distributed under the terms of the Creative Commons CC-BY license, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. You are not required to obtain permission to reuse this article.0913 Mechanical Engineering1103 Clinical Sciences1106 Human Movement and Sports SciencesOrthopedics4003 Biomedical engineering4201 Allied health and rehabilitation science4207 Sports science and exerciseOrthotic devicesGaitWalkingRunningFoot orthosesPodiatryJournal ArticleOpenAccess10.1016/j.gaitpost.2026.110152