The association between foot posture and lower leg and foot injuries in long-distance runners.

Abstract

Objective

Lower leg and foot injuries in long-distance runners are commonly associated with foot morphology although other extrinsic factors may be implicated. The purpose of this study was to determine if there is any association between foot posture and lower leg and foot injuries in Maltese long-distance runners.

Research Method

30 non-recreational long-distance runners, following a regular schedule by running 25 km every week or more, and had previously sustained at least one lower leg injury, participated in a quantitative, retrospective, cross-sectional study. The Foot Posture Index, FPI-6, was used to classify the foot type, i.e. neutral, pronated, (low-arched), or supinated, (high-arched). Each participant was asked to fill in a questionnaire, designed to obtain specific information about the type and nature of injury, influencing factors and other basic data. For the purpose of this study the lower leg and the foot were divided in 4 sites, namely, the forefoot, rearfoot, lower leg and knee. Descriptive and statistical analysis were both used to point out any association between foot posture and lower leg and foot injury patterns in long-distance runners.

Results

The results of this study show that although there is no direct association between foot posture and lower leg and foot injuries, the effect of static foot posture can be injury specific. The most common site of injury was the rearfoot, (54.1 %), followed by the knee, (21.6%), the lower leg, (16.2%) and the forefoot, (8.1%). Low-arched runners reported a greater incidence of plantar rearfoot and anterior knee injuries, while high-arched runners complained more from lateral injuries such as lateral ankle pain and lateral knee pain. 14 out of the 37 injuries were reported by runners exhibiting a neutral foot structure. However in the latter group, the reported injuries were distributed more evenly between the 4 sites, with most of the athletes complaining from mild pain in contrast with the moderate to severe pain reported by both the low-arched and high-arched participants.

Conclusion

The results of the current study are consistent with previous studies and confirm that the nature and pattern of injuries in long-distance running is multi-factorial. It is evident that while foot type predisposes the runners to injury, the onset can be facilitated by extrinsic factors. In conclusion, understanding the association between different foot types and injury patterns is very relevant in clinical practice because this will certainly facilitate and improve treatment strategies when addressing running injuries.