Caring about the ‘foot’ in ‘football’ – how can England avoid injury scares?

Boot design is vital

Boots are personal for footballers, they have to feel and fit well to enable them to feel the ball and change direction quickly.

Wingers can run up to seven miles in a match, so boots need to be, well, like running shoes as much as football boots.

There are features of football boots that can change the biomechanics of running, kicking and twisting. Football boots are traditionally worn tight so the last shape that determines fit to some extent, is critical to avoiding pressure or friction lesions during play.

It sounds obvious but research on running shoes has shown that discomfort from athletic footwear can lead to changes in running gait and ultimately predispose runners to injury.

Playing on grass versus other sport surfaces also needs consideration in boot selection. Even grass can vary from firm to soft ground and selecting moulded studs that don’t penetrate and pick up the mud so much can keep footballers able to manoeuvre well and keep boots light weight to reduce strain on knee muscles and ligaments. The position of studs (cleats) underfoot can be problematic too. Different feet have different length metatarsals and can sometimes sit directly over a cleat. In poor quality boots (which I doubt very much the England team will be wearing!) the cleat can begin to press into the foot and cause pain during wear. Cleat adjustment is an option here and club podiatrists can help with this.

Studs over blades

There are cleats more like studs and other cleats more like blades which came into use in the late 1990s. Blades have come under fire for ‘their increased likelihood of causing injury’. They are designed with moulded soles with elongated studs – blades - facing in multiple directions, theoretically to maximise grip and minimise ankle injury. A study in the British Journal of Sports Medicine, however, suggested the blades increase friction with the ground as the knee flexes and twists – actually increasing the likelihood of tension in the ankle and lower leg.

Blades are also hazardous on the pitch as they can slice if they contact skin, which could leave someone out of action for longer than if a stud had contacted them.

In fact, in 2005, Manchester United manager Sir Alex Ferguson called for a ban on the blades – convinced they were responsible for the broken third metatarsal (long foot bone) which put captain Roy Keane out of action for two months.

The dreaded cruciate ligament

Many footballers have heard that fateful ‘pop’ in the knee and are faced with a damaged cruciate ligament.

The cruciates, as the name suggests, are two ligaments that cross from the front to the back of the knee and guide the movement of the thigh bone on the shin bone. They are also key to sensing the position of the knee joint as it flexes and extends.

In movements where the player anchors one foot and twists to kick with the other, the torsion forces peak to a point where the foot would normally be forces to rotate on the ground as well. In blades or in certain positions, the friction of the foot with the floor or the angle of the supporting limb lead to the foot being anchored and the knee twists instead, rupturing the anterior or posterior cruciate ligament.

A cruciate injury can be repaired with donated tendon from a player’s adductor muscles on the inside of their thigh but then the hard work of rehabilitation begins. Avoiding cruciate injuries – including optimal boot selection for the surface – can mean the difference between playing and not playing for an entire season – something that isn’t welcomed by players or their managers.