1. Football boots Anne-Marie O’Connor Musculoskeletal Podiatrist

2. Agenda Ongoing design evolution of the football boot The impact that has on injuries Research

3. Football Mechanics Running/ walking/sprinting Dribbling (running with the ball) Ball control (first touch) Accelerating/ decelerating Cutting Pivoting Long kicking/ volleying/ short passing

4. Evolution of the boot First football boot was a modified mining boot 1800’s (500g) Double that weight when wet. Pitches were boggy and uneven, play was slow Today the lightest weight boot (145g) Pitches are like carpet players are fitter, the game is faster

5. Manufacturers will break down every anatomical part of the boot with a view to improving it 1. Performance 2. Aesthetics 3. Injury prevention

6. Best boot Injuries to professional footballers in the UK directly attributed to incorrect boots have been estimated to cost £75 million a year (1). Choosing the most effective boot will depend on player preference sponsorship and advise from the medical team.

7. The Upper/ Lacing Lacing is for foot support. Upper protection of the foot from contact injuries Irregular -better control Thinner for better touch Fly-wire for tighter fit Injuries; Contact/ unsupportive upper feeling of instability/ toe box too narrow,shallow Research; Ankle injuries in football make up 17-23% of total injuries and foot injuries 5% (2)

8. The heel tab/ heel control Protect the hind foot/ Achilles against contact/ Provide rear foot control Injuries; Variation heel cup angles/ heights/ paddings

9. Sole plate House the studs/ moulds, protect the foot against stud penetration, forms a platform for the foot Injuries; Too narrow for the foot width/ too flexible/ too stiff. Research; Too narrow Santos (3) decreased SA so increased pressure. 85% more pressure when wearing a boot compared to trainer Coyles and Lake (4) stud positions and met pressure

10. Insole Comfort/ shock attenuation Injuries; Slip, insole riding up, too thin when ground hard Research; Waddington (5) textured insole sensory feedback propriception

11. Cleats To create optimum traction; Insufficient traction causing slip, decreased speed, which effects performance Excessive traction could lead to foot fixing esp. on rotation and potential injury Injuries; too much/ little traction/ position of certain studs causing metatarsal irritation

13. ‘The Worlds first football boot with a brain’ Adidas F50 Micoach Computer Chip based Technology (8g) Speed/ distance / work rate Uploaded to Micoach website Compare you data to Messi November 2011 £245

14. Do Blades cause more injuries 1996 the first bladed boot was introduced Increased SA to increase traction However shape is non-symmetrical therefore resistance varies with orientation of loading

15. Interaction of boot and playing surface Playing surface is the most significant uncontrollable variable in football and 24% of lower limb injuries associated to poor playing surfaces (6) The same pitch causing various levels of traction at; i. Different parts of the same pitch (7) ii. Different weather conditions, studies (2,8) have reported ‘early season bias’ to increased injuries due to player de-conditioning and surface hardness

16. Does this increased shoe-surface traction cause injuries? Most of this research has looked at ACL injuries rather than metatarsal ACL Knee injuries are one of the most costly injuries to clubs, approximately 6 month recovery time 70% of ACL injuries occur in non contact situations (16) ACL injuries involve foot fixation, hyperextension, torsional stress, or all 3 i.e. the plant and cut motion. Therefore rotation Stiffness at the shoe-surface interface is an important injury consideration

17. In summary Extrinsic factors increasing lower limb injuries Increased shoe-surface traction from; Hard/ dry ground Grass cover and density with thatch are greatest Greater traction with artificial turf Boots with edge shaped cleats Thin unsupportive uppers Over flexible sole-plates Unsupportive lacing system Poor boot-foot fit

18. Thank you

19. Research ( 1) Morag E. Recent advancements in football equipment design for youth and adult players. ‘The medical field; a Nike Sports research review’, vol. 9. Beaverton (OR): Nike, Inc; 2003. p. 1. (2) Hawkins RD, Fuller CW. A prospective epidemiological study of injuries in for English professional football clubs. Br J Sports Med 1999;33:196–203 (3)Santos D, Carline T, Flynn L, et al. Distribution of in-shoe dynamic plantar foot pressures in professional football players. Foot 2001;11:10–4. (4)Coyles VR, Lake MJ. Forefoot plantar pressure distribution inside the soccer boot during running. In: Proceedings of the Fourth Symposium on Footwear Biomechanics. Canmore (Canada): p. 30–1. (5) Waddinton G, Adams R. Football boot insoles and sensitivity to extent of ankle inversion movement. Br J Sports Med 2003;37:170–5. (6)Ekstrand J, Nigg BM. Surface-related injuries in soccer. Sports Med 1989;8: 56–62. (7)Caple MC, James IT, Bartlett MD. Spatial analysis of the mechanical behaviour of natural turf sports pitches. Sports Eng (8)Woods C, Hawkins R, Hulse M, et al. The Football Association medical research programme: an audit of injuries in professional football: an analysis of ankle sprains. Br J Sports Med 2003;37:233–8. (9)James IT. Advancing natural turf to meet tomorrow’s challenges. Proc Inst Mech Eng P J Sports Eng Tech 2011;225(P):115–29.

20. ( 10) Williams S, Hume PA, Kara S. A review of football injuries on third and fourth generation artificial turfs compared with natural turf. Sports Med 2011;41:903–23. (11)Williams S, Hume PA, Kara S. A review of football injuries on third and fourth generation artificial turfs compared with natural turf. Sports Med 2011;41:903–23. (12)Villwock MR, Meyer EG, Powell JW, et al. Football playing surface and shoe design affect rotational traction. Am J Sports Med 2009;37:518–25. (13)Livesay GA, Reda DR, Nauman EA. Peak torque and rotational stiffness developed at the shoe-surface interface: the effect of shoe type and playing surface. Am J Sports Med 2006;34:415–22. (14)Ford KR, Manson NA, Evans BJ, et al. Comparison of in-shoe foot loading patterns on natural grass and synthetic turf. J Sci Med Sport 2006;9:433–40. 31. (15) Crawley PW, Heidt RS, Scranton PE, et al. Physiological axial load, frictional resistance, and football shoe-surface interface. Foot Ankle Int 2003;24:551–6. (16)Lambson RB, Barnhill BS, Higgins RW. Football cleat design and its effect on anterior cruciate ligament injuries: a three-year prospective study. Am J Sports Med 1996;24:155–9. (17)Bentley JA, Ramanathan AK, Arnold GP, et al. Harmful cleats of football boots: a biomechanical evaluation. Foot Ankle Surg 2011;17:140–4.