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Foot & ankle injuries in footballers

Discussion in 'Biomechanics, Sports and Foot orthoses' started by NewsBot, Sep 20, 2012.

  1. NewsBot

    NewsBot The Admin that posts the news.

    Effect of specific exercise-based football injury prevention programmes on the overall injury rate in football: a systematic review and meta-analysis of the FIFA 11 and 11+ programmes
    Kristian Thorborg
    Br J Sports Med doi:10.1136/bjsports-2016-097066 13 January 2017
  2. NewsBot

    NewsBot The Admin that posts the news.

    Functional Assessment and Injury Risk in a Professional Soccer Team
    Pedro Gómez-Piqueras et al
    Sports 2017, 5(1), 9; doi: 10.3390/sports5010009
  3. NewsBot

    NewsBot The Admin that posts the news.

    Justin Wai-Yuk Lee et al
    Br J Sports Med 2017;51:348 doi:10.1136/bjsports-2016-097372.164
  4. NewsBot

    NewsBot The Admin that posts the news.

    Press Release:
    February 8, 2017
  5. NewsBot

    NewsBot The Admin that posts the news.

    A comparison of injuries in elite male and female football players: A 5-Season prospective study
    Jon Larruskain et al
    Scandinavian Journal of Medicine & Science in Sports 16 February 2017
  6. NewsBot

    NewsBot The Admin that posts the news.

    Perceptions of football players regarding injury risk factors and prevention strategies.
    Zech A, Wellmann K
    PLoS One. 2017 May 1;12(5):e0176829. doi: 10.1371/journal.pone.0176829. eCollection 2017.
  7. NewsBot

    NewsBot The Admin that posts the news.

    Risk factors for football injuries in young players aged 7 to 12 years.
    Rössler R et al
    Scand J Med Sci Sports. 2017 Sep 18. doi: 10.1111/sms.12981.
  8. NewsBot

    NewsBot The Admin that posts the news.

    The Epidemiology of Overuse Conditions in Youth
    Football and High School Football Players

    Kevin Morris, et al
    Journal of Athletic Training 2017;52(10):000–000
  9. Jeff Wolter

    Jeff Wolter Member

    I took a job as store manager at one of the top soccer retailers in Denver CO, Soccer Stop in Highlands Ranch just to get the opportunity to sell and make sports orthotics for increased sports performance. I did have success making a few devices for healthy players. One of my most appreciative players was a U14 US Soccer National Team starting midfield players. I only made a few pairs of sports orthotics for performance use using softer materials then I use to make alpine ski devices. I wanted to just control a bit of movements in the foot that don't seem to be needed.
    At first I thought that if you could make the foot better at edging during a quick turning motion you would improve overall performance related to fatigue and quickness of movements. I used and tested a number of custom made devices in my own soccer shoes first. I liked the feeling of a more stable platform under my foot while changing direction on well maintained fields (soft surface).
    I started to question that approach after playing on a poor fields that lacked softness in the surface.
    Many players use OTC devices and many are not correct at creating a neutral STJ position base. Not a lot of problems without a well positioned stance from those devices as far as I know??

    After 18 months I stopped even talking about custom made devices because too many of the speed, agility, coordination coaches kept sending me players with overuse injuries. I'm not a medically trained person and that was not my area. Also the age of the player I met with overuse injuries seemed to relate to their changes upon reaching puberty and it was just too complicated for me.
    Most all were growth plate issue related pain symptoms. Most all players and parents did not want to stop the activity to give the body a chance to catch up with the changes of growth or to allow time for the pain to go away. They wanted to how to stop the pain and also keep training. ?? I would tell them I was unaware of any methods to do that, that was not my area of experience, and that they should talk to their doctors/professional trainers about that.
    #1 Do no harm...
    I went back to the adult sports of alpine skiing, cycling and golf.

    Second point.
    I also started to question the use of supportive custom made devices in this type of sports application?
    When I looked at close up photos of the foot making a powerful/quick movement of a flat grass surface I saw what to me was a need for the foot to change shape to conform to the flat surface that is almost never right straight under COM. The foot is always planted way out laterally away from COM. The distance varies depending on the speed the player is moving forward and the new path that intend to change to. The need of the foot to roll and flatten to match the shape of the surface became something I needed to understand better??
    Q- was the edging support even a right approach for running at speed and changing directions on a soft surface?

    Contrast that to my experiences as a alpine ski boot fitter who makes devices for sports where we also use the foot in aggressive edging/balancing actions that are far away from our COM but use the foot primarily in a edging and balancing position and I became more confused about the use of a custom made neutral position supportive device for soccer/football players.
    I do know many of the top players do use custom made devices. CR7 Real Madrid is said to use a thin carbon device in his shoes.

    Just adding some of my own personal experience info to your discussion about orthotics and their use for soccer players and their sport related injuries.
  10. Jeff Wolter

    Jeff Wolter Member

    I use a French made Sidas HD Vac system for making custom sports devices. I use different types of blanks depending on the intended use.
    Some I use with a neutral posting material (EVAs) under the device to create a better and more stable interface with the shoe, but not always.
    The stiffness of the device is dependent of the type of action and movement control I'm looking to achieve with the device's use, and/or want to allow to happen naturally. That's not an easy area to figure out?? It happens mostly with a judgement call based on the sport's biomechanic movements involved, the foot type observed, and the type of shoe involved and the type of surface the foot will come in contact with during use. *Not a lot of material to find on some of those interrelated topics.

    I'm not currently medically trained but have worked under a few C-Peds, and have worked at many of the top alpine ski retailers in the US as well as the ski shop where Superfeet products were developed in Mammoth Lakes CA.
    I have over the years, and do currently study most of the current materials out there related to the use of neutral molded sports performance orthotic devices. I have studied many medical related books also. I'm also about to formally train and take the C-Ped exam myself in the next year after working under a third C-Ped run store/lab that fills RX for doctors.
  11. Jeff Wolter

    Jeff Wolter Member

    I'm also trying to get to my ten posts level where the site will then allow me to post links...
  12. davidh

    davidh Podiatry Arena Veteran

    Nice reply, thanks.

    The following comments apply to adult players only.
    Part of the problem (I found) was that soccer players at speed, like their sprinter counterparts, weightbear mostly on their forefoot, rendering rearfoot control obsolete.
    Of course I could go on and on about how orthotics are fitted to soccer boots which leave little room for the foot, or how Premiership players in the UK are not keen on orthotics - because they like their boots to be tight as they are, for better "feel" and "control".

    There is no one-fit orthotic for soccer. For frontal plane control a forefoot post on a soft device made to fit the boot AND the foot can work well in some instances. For pre-season forefoot blistering the same type of device works well.
    A successful modus operandi is to cast the foot as normal. Use the positive cast to make a thin EVA device - post the forefoot valgus or varus, in mm or degrees - then add padding as needed. Then strip the inside of the boot and throw it away. Replace inside of boot with the orthotic, suitably trimmed to fit, and ensuring that the device approximates the thickness of the original innersole. Cover with nice leather (blue for Birmingham, red for Liverpool).

    I saw several players in whom the need to see a podiatrist was less to do with my clinical work, and more to do with being able to justify invasive treatment and/or surgery. The "yes, he's tried everything, and nothing worked" syndrome. One particular case was justifying ESWT for plantar fasciosis. The podiatrist was finally called in, but way too late. The club doc owned the machine.....

    And I know of one particularly high-profile Premiership club whose first team players all had two pairs of orthotics for their boots. I used the same lab at the time, and I know that those "soccer" orthotics could never fit into a soccer boot and allow the foot to fit in comfortably.
    That was not that long ago - I like to think things have changed for the better in UK soccer injury management.
  13. Jeff Wolter

    Jeff Wolter Member

    It's really not that hard to fit them into a soccer shoe. Even tight ones.
    As I said, most shops now sell OTC devices and those can also fit into the most all of the new shoes.

    Yes, you want the shoes tight but not so tight they will cause blistering (#1-friction, #2-movement, and #3-moisture) and also not so tight that they over compress the forefoot which needs to splay just a bit for good balance. Lots of old info still out there about how the newer shoes are to be initially fit. We have some shoes that are still real leather and those will stretch. Those shoes are best for odly shaped feet. But many normal foot shapes and normal functioning feet can be fit nicely into a synthetic material shoe that will not stretch with use, and as so does not need to be fit overly tight to start with. You don't really need to overcompress the foot in a soccer shoe. You want feel through the shoe and you want a bit of shock absorption by letting the foot move a bit and allowing the foot functions to work they way they were intended to as you run, stop, and change directions quickly.
    The tight as you can get them is an old myth that came from a time when just about shoes were made from leather and they would grow bigger with use espically after getting wet (England) A current synthetic performance shoe fit when too tight or too small just produces unhappy players with too many blisters to do "the work" of the game.

    CR7 is Christiano Ronaldo of Real Madrid. Custom devices are used very often by players who get to play on professionally maintained (soft) fields. I have made them for pro level players. I have also talked to quite a few pro players about their use at the pro level.
    It differs for youth players, many youth fields are not kept soft where edging with the shoe would be the most useful.

    The blanks I use are the same thickness, or if I chose even thinner than the stock insoles that come out of most good shoes these days.
    The exception is the indoor shoe which because of the surface usually has a glued in stock insole. That can also be removed using a little bit of heat and a flat scrapping bar.

    The question I would like someone in the medical field is:
    Can the foot edge while attempting to turn quickly and still be injury free?
  14. Jeff Wolter

    Jeff Wolter Member


    If you are involved in making sports products and have not looked through what Sidas is currently offering through their medical division, you might find some very interesting new products now.
    Look at their international catalog.
    * I'm not a salesmen and I don't work for them.
    The direct foot negative molding system - Sidas HD Vac system is currently the best in the world.
    Why the medical industry still used a casting and vacuum method is a bit confusing to some of us in the sports world??

    This HD Vac creates a negative mold which can be minulipited if needed.
    The negative mold can be made with no weight, semi weighted, or full weighted and then corrected back to a neutral position if that what you want.
    A negative mold can be made, the device molded, and the device finished in under 45 minutes by a well trained person.
  15. davidh

    davidh Podiatry Arena Veteran

    I no longer work in professional football. I can tell you that as of seven years ago the "myth" of tight boots = better boots was alive and well in five of the top professional soccer clubs in the UK - probably more - those were just the ones I worked with.

    Plaster casting for a foot impression is good for one-offs. I'll take your word about the SIDAS system - I assume that's for volume casting since it must come with a price tag (either up-front, or built into each pair of orthotics).

    On your question about a foot edging whilst turning.
    I'm sure a player can edge their foot whilst turning without injury. Fatigue will play a part, of course, in the probability of injury, as will COP, and what the contralateral limb is doing. Thinking about this, the intention of the player is important too. Is he about to tackle, just been tackled, or is he going for a high ball. Or she, of course.

    Big question. I don't think there is a simple answer, I'm afraid.
    Last edited: Oct 3, 2017
  16. NewsBot

    NewsBot The Admin that posts the news.

    Muscle injury rate in professional football is higher in matches played within 5 days since the previous match: a 14-year prospective study with more than 130 000 match observations
    Håkan Bengtsson et al
    Br J Sports Med Published Online First: 03 November 2017
  17. NewsBot

    NewsBot The Admin that posts the news.

    The Epidemiology of Overuse Conditions in Youth Football and High School Football Players.
    Kevin Morris, Janet E. Simon, Dustin R. Grooms, Chad Starkey, Thomas P. Dompier, and Zachary Y. Kerr
    Journal of Athletic Training: October 2017, Vol. 52, No. 10, pp. 976-981.
  18. NewsBot

    NewsBot The Admin that posts the news.

    The FIFA 11+ injury prevention program for soccer players: a systematic review
    David Sadigursky et al
    BMC Sports Science, Medicine and RehabilitationBMC series – 28 November 2017
  19. NewsBot

    NewsBot The Admin that posts the news.

    Intrinsic modifiable risk factors for
    lower extremity injuries in female
    soccer players:
    a prospective study during one season.

    Vansant Elise
    Wauters Evi
    A dissertation submitted to Ghent University in partial fulfilment of the requirements for the degree of
    Master of Rehabilitation Sciences and Physiotherapy

  20. NewsBot

    NewsBot The Admin that posts the news.

    The “sequence of prevention” for musculoskeletal injuries among adult recreational footballers: A systematic review of the scientific literature
    Ozgur Kilic et al
    PTS; Article in Press
  21. NewsBot

    NewsBot The Admin that posts the news.

    Analysis of Football Injuries by Position Group in Division I College Football: A 5-Year Program Review
    Krill, Michael K. MD, ATC et al
    Clinical Journal of Sport Medicine: February 12, 2018 - Volume Publish Ahead of Print - Issue - p

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