Foot Structure Problems May Lead to Injury in Athletes
WebMD News Archive
Nov. 22, 1999 (Baltimore) -- A study of more than 400 Navy SEAL trainees
shows that the structure of the foot is related to injuries suffered from
intensive training. For civilians with high arches or flat feet who engage in
strenuous activities, such as running, the study may offer helpful advice for
preventing injuries to the leg and foot.
The study researchers stress in an article in American Journal of Sports
Medicine that the injury risk factors -- flat feet, high arches, and
restricted movement of the ankle -- can all be corrected. They point out that
appropriate footwear can compensate for these structural conditions and,
therefore, be effective in reducing the risk of injury.
"There were really three significant findings to come out of this
study," the study's lead author, Kenton R. Kaufman, PhD, tells WebMD.
"We found that those people who had low arches in this study were at
increased risk of injury. Most of the literature supports the view that those
with high arches experience more injuries, but in this study we found that low
arches could also cause problems."
"Another significant finding is that we did not see a relationship
between knee problems and pronation of the feet, which many have thought are
associated," he says. People who pronate walk on the inner side of their
feet. "Finally, we found that people with tight heel cords were more likely
to develop Achilles tendonitis." Achilles tendonitis is one of the most
common injuries to the leg in athletes and is characterized by a sore Achilles
tendon. Kaufman is an associate professor at the Mayo Clinic in Rochester,
Using several methods, the researchers evaluated the structure of the feet
in male SEAL trainees before they began intensive training. The trainees were
followed throughout training to see who developed leg and foot injuries.
One-third of the SEAL trainees had injuries to their lower legs caused by
the training. Out of 449 SEALs studied, 149 suffered 348 such injuries, most of
them within the first 9 weeks of training. The most common injuries were stress
fractures, inflammation, and pain in the different structures of the lower leg.
Stress fractures typically occurred in the lower leg, the foot, and the
According to Bruce Jones, MD, MPH, the association of high and low arches
with injury is important. "In the past, we've looked at flat feet as the
most significant risk factor for injury, but the association between high and
low arches and their relationship to injury needs to be explored further,"
he tells WebMD. Jones is a retired Army colonel with more than 20 years of
experience researching foot injuries in military personnel and is now with the
CDC injury prevention division.
While this study did not look at any specific ways to prevent injury,
Kaufman says that some interventions might be tried. "People should be
aware of potential relationships between their foot structure and the types of
injuries they might sustain. Those with tight heel cords should stretch before
exercising, while those with low arches might consider some type of footwear