A cross-sectional study on foot loading patterns in elite soccer players of different ages

Article type: Research Article

Authors: Hotfiel, Thilo^{a; b; *} | Golditz, Tobias^c | Wegner, Jessy^a | Pauser, Johannes^{d; e} | Brem, Matthias^{c; e} | Swoboda, Bernd^a | Carl, Hans-Dieter^{a; f}

Affiliations: [a] Division of Orthopedic Rheumatology, Department of Orthopedic Surgery, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany | [b] Center for Musculoskeletal Surgery Osnabrück (OZMC), Klinikum Osnabrück, Osnabrück, Germany | [c] Department of Orthopedic and Trauma Surgery, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany | [d] Department of Orthopedic and Trauma Surgery, Klinikum Nuremberg, Nuremberg, Germany | [e] CURATHLETICUM, Nuremberg, Germany | [f] Department of Orthopedic Surgery and Trauma Surgery, Martha-Maria Hospital Nuremberg, Nuremberg, Germany

Correspondence: [*] Corresponding author: Thilo Hotfiel, Division of Orthopedic Rheumatology, Department of Orthopedic Surgery, Friedrich-Alexander-University Erlangen-Nuremberg, Rathsberger Str. 57 D-91054 Erlangen, Germany. Tel.: +49 9131 822 0; Fax: +49 9131 822 3340; E-mail: thilo.hotfiel@fau.de.

Abstract: BACKGROUND: Alterations in plantar loading patterns are risk factors for stress injuries of the lower limb, particularly of the foot and ankle. Epidemiological studies have revealed a higher incidence of soccer-related stress fractures of the fifth metatarsal (MT V) in younger athletes than in their adult counterparts. OBJECTIVE: The aim of the present study was to assess the plantar pressure distributions of members of four high-level soccer teams of different age groups to identify age-related differences in loading patterns. METHODS: A total of 65 elite soccer players were included in the study. Data were computed with sensor-loaded insoles (pedar® X system, novel Inc., Munich, Germany) while the players ran in soccer shoes. Plantar pressures for nine defined regions on the preferred and nonpreferred foot were analyzed. RESULTS: The participants consisted of 17 elite male soccer professionals from the first national league (mean 23 years, height 184 cm, weight 81 kg), 14 players from the under-21 squad (U21, 20 years, 180 cm, 75 kg), 15 players from the U17 squad (16 years, 176 cm, 69 kg) and 19 players from the U16 squad (15 years, 179 cm, 70 kg). We detected statistically significantly elevated peak pressures on the lateral aspects of the nonpreferred foot compared with the preferred foot in the U16 and U17 players, corresponding to a relative increase by 29% (p= 0.044) in the lateral midfoot, a relative increase by 24% (p= 0.031) in MT heads 4–5 in the U16 players and a difference of 18% (p= 0.049) in the lateral midfoot in the U17 players. In contrast, the U21 and adult professional players displayed symmetric plantar pressure distributions in all foot regions. CONCLUSIONS:In contrast to adult elite soccer players, adolescents demonstrate asymmetric foot loading patterns with increased peak loads in the lateral aspects of the nonpreferred foot. Our results may provide some explanation for MT V stress fractures that occur in elite adolescents.

Keywords: Sports injuries, pedobarography, soccer, foot injury, overuse injuries, stress fractures, stress reaction, fifth metatarsal

DOI: 10.3233/BMR-181436

Journal: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 6, pp. 939-946, 2020