Influence of Footwear on Posture and Comfort in Elite Rugby Players

Abstract

Influence of footwear on posture in athletes is poorly documented despite its potential impact on biomechanics and injury risk. The aim of this study was to investigate effects of different footwear geometries on comfort and posture on a cohort of 48 elite rugby players. Spine posture was characterized by photogrammetry, while center of pressure was measured by means of a force platform. Three different footwear outsoles architectures (one rugby shoe with flat outsole, one rugby shoe with a 10 mm heel rise and foot arch support, and a running shoe with a 10mm heel rise and foot arch support) were compared to non-shod in randomized order. Then comfort felt at the level of foot and spine was also estimated by subjective questionnaires. Compared to the flat rugby model, both other models induced significantly (p<0.05) greater comfort at the level of foot and spine, a slight shift toward of center of pressure and a spinal posture closer to that observed when non-shod. The footwear geometry influences comfort and posture at the level of the foot as well as spine and should be considered in a dual purpose of injury prevention and performance.

Key words

photogrammetry - biomechanics - rugby boots - spinal posture

Publication History

Received: 23 January 2020

Accepted: 19 August 2020

Article published online:
24 September 2021

• References

• 1 World Rugby. Rugby Count 2016. https://www.world.rugby/development/player-numbers; 2016
• 2 Fuller CW, Taylor A, Kemp SP. et al. Rugby World Cup 2015: World Rugby injury surveillance study. Br J Sports Med 2017; 51: 51-57. doi:10.1136/bjsports-2016-096275
• 3 Viviers PL, Viljoen JT, Derman W. A review of a decade of rugby union injury epidemiology: 2007–2017. Sports Health 2018; 10: 223-227. doi:10.1177/1941738118757178
• 4 Williams S, Trewartha G, Kemp S. et al. A meta-analysis of injuries in senior men's professional Rugby Union. Sports Med 2013; 43: 1043-1055 doi:10.1007/s40279-013-0078-1
• 5 Yeomans C, Kenny IC, Cahalan R. et al. The incidence of injury in amateur male Rugby Union: a systematic review and meta-analysis. Sports Med 2018; 48: 837-848 doi:10.1007/s40279-017-0838-4
• 6 Blair MR, Elsworthy N, Rehrer NJ. et al. Physical and physiological demands of elite rugby union officials. Int J Sports Physiol Perform 2018; 13: 1199-1207. doi:10.1123/ijspp.2017-0849
• 7 World Rugby. Rugby World Cup 2015 Statistical Report. https://www.world.rugby/documents
• 8 Ortega E, Villarejo D, Palao JM. Differences in game statistics between winning and losing rugby teams in the six nations tournament. J Sports Sci Med 2009; 8: 523-527
• 9 Ungureanu AN, Brustio PR, Mattina L. et al. “How” is more important than “how much” for game possession in elite northern hemisphere rugby union. Biol Sport 2019; 36: 265-272. doi:10.5114/biolsport.2019.87048
• 10 Vaz L, Rooyen MV, Sampaio J. Rugby game-related statistics that discriminate between winning and losing teams in IRB and Super Twelve close games. J Sports Sci Med 2010; 9: 51-55
• 11 Zunzarren G. Epiodémiologie Des Traumatismes Du Rachis Dans le Rugby Professionnel Français. Doctoral Thesis. Université Bordeaux II, France; 2013
• 12 Jaco RM, Puckree T. Injury incidence and balance in Rugby players. Pak J Med Sci 2014; 30: 1346-1350
• 13 Waddington G, Adams R. Discrimination of active plantarflexion and inversion movements after ankle injury. Aust J Physiother 1999; 45: 7-13
• 14 Waddington G, Adams R. Textured insole effects on ankle movment discrimination while wearing athletic shoes. Phys Ther Sport 2000; 1: 119-128
• 15 Davids K, Shuttleworth R, Button C. et al. “Essential noise” – enhancing variability of informational constraints benefits movement control: A comment on Waddington and Adams (2003). Br J Sports Med 2004; 38: 601-605. doi:10.1136/bjsm.2003.007427
• 16 Waddington G, Adams R. Football boot insoles and sensitivity to extent of ankle inversion movement. Br J Sports Med 2003; 37: 170-174. discussion 175
• 17 Kinchington M, Ball K, Naughton G. Monitoring of lower limb comfort and injury in elite football. J Sports Sci Med 2010; 9: 652-663
• 18 Kinchington M, Ball K, Naughton G. Reliability of an instrument to determine lower limb comfort in professional football. Open Access J Sports Med 2010; 1: 77-85
• 19 Kinchington MA, Ball KA, Naughton G. Effects of footwear on comfort and injury in professional rugby league. J Sports Sci 2011; 29: 1407-1415. doi:10.1080/02640414.2011.593041
• 20 Kinchington M, Ball K, Naughton G. Relation between lower limb comfort and performance in elite footballers. Phys Ther Sport 2012; 13: 27-34. doi:10.1016/j.ptsp.2011.02.001
• 21 Bonanno DR, Landorf KB, Menz HB. Pressure-relieving properties of various shoe inserts in older people with plantar heel pain. Gait Posture 2011; 33: 385-389. doi:10.1016/j.gaitpost.2010.12.009
• 22 Chen TH, Chou LW, Tsai MW. et al. Effectiveness of a heel cup with an arch support insole on the standing balance of the elderly. Clin Interv Aging 2014; 9: 351-356. doi:10.2147/CIA.S56268
• 23 Lee YC, Lin G, Wang MJ. Evaluating insole design with joint motion, plantar pressure and rating of perceived exertion measures. Work 2012; 41 (Suppl. 01) 1114-1117. doi:10.3233/WOR-2012-0290-1114
• 24 Mündermann A, Stefanyshyn DJ, Nigg BM. Relationship between footwear comfort of shoe inserts and anthropometric and sensory factors. Med Sci Sports Exerc 2001; 33: 1939-1945
• 25 Yung-Hui L, Wei-Hsien H. Effects of shoe inserts and heel height on foot pressure, impact force, and perceived comfort during walking. Appl Ergon 2005; 36: 355-362
• 26 Harriss DJ, MacSween A, Atkinson G. Ethical standards in sport and exercise science research: 2020 update. Int J Sports Med 2019; 40: 813-817. doi:10.1055/a-1015-3123
• 27 Drerup B, Hierholzer E. Movement of the human pelvis and displacement of related anatomical landmarks on the body surface. J Biomech 1987; 20: 971-977. doi:10.1016/0021-9290(87)90326-5
• 28 Turner-Smith AR. A television/computer three-dimensional surface shape measurement system. J Biomech 1988; 21: 515-529 doi:10.1016/0021-9290(88)90244-8
• 29 Drerup B, Ellger B, Meyer zu Bentrup FM. et al. Functional rasterstereographic images. A new method for biomechanical analysis of skeletal geometry. Orthopade 2001; 30: 242-250. doi:10.1007/s001320050603
• 30 Hazar Z, Karabicak GO, Tiftikci U. Reliability of photographic posture analysis of adolescents. J Phys Ther Sci 2015; 27: 3123-3126. doi:10.1589/jpts.27.3123
• 31 Zonnenberg AJ, Van Maanen CJ, Oostendorp RA. et al. Body posture photographs as a diagnostic aid for musculoskeletal disorders related to temporomandibular disorders (TMD). Cranio 1996; 14: 225-232
• 32 Kinel E, D’Amico M, Roncoletta P. Normative 3D opto-electronic stereo-photogrammetric sagittal alignment parameters in a young healthy adult population. PLoS One 2018; 13: e0203679. doi:10.1371/journal.pone.0203679
• 33 Kim SB, Heo YM, Hwang CM. et al. Reliability of the EOS imaging system for assessment of the spinal and pelvic alignment in the sagittal plane. Clin Orthop Surg 2018; 10: 500-507 doi:10.4055/cios.2018.10.4.500
• 34 Alfredson H, Cook J. A treatment algorithm for managing Achilles tendinopathy: new treatment options. Br J Sports Med 2007; 41: 211-216. doi:10.1136/bjsm.2007.035543
• 35 Baldassin V, Gomes CR, Beraldo PS. Effectiveness of prefabricated and customized foot orthoses made from low-cost foam for noncomplicated plantar fasciitis: a randomized controlled trial. Arch Phys Med Rehabil 2009; 90: 701-706. doi:10.1016/j.apmr.2008.11.002
• 36 Mayer F, Hirschmüller A, Müller S. et al. Effects of short-term treatment strategies over 4 weeks in Achilles tendinopathy. Br J Sports Med 2007; 41: e6. doi:10.1136/bjsm.2006.031732
• 37 Blanchard S, Palestri J, Guer JL. et al. Current soccer footwear, its role in injuries and potential for improvement. Sports Med Int Open 2018; 2: E52-E61 doi:10.1055/a-0608-4229
• 38 Zhang X, Li B. Influence of in-shoe heel lifts on plantar pressure and center of pressure in the medial-lateral direction during walking. Gait Posture 2014; 39: 1012-1016. doi:10.1016/j.gaitpost.2013.12.025
• 39 Johanson MA, Cooksey A, Hillier C. et al. Heel lifts and the stance phase of gait in subjects with limited ankle dorsiflexion. J Athl Train 2006; 41: 159-165
• 40 Santos D, Carline T, Flynn L. et al. Distribution of in-shoe dynamic plantar foot pressures in professional football players. Foot 2001; 11: 10-14
• 41 Vanore JV, Christensen JC, Kravitz SR. et al. Diagnosis and treatment of first metatarsophalangeal joint disorders. Section 2: Hallux rigidus. J Foot Ankle Surg 2003; 42: 124-136. doi:10.1053/jfas.2003.50037
• 42 Giannini S, Buda R, Mosca M. et al. Posterior ankle impingement. Foot Ankle Int 2013; 34: 459-465
• 43 Kee D, Lee I. Relationships between subjective and objective measures in assessing postural stresses. Appl Ergon 2012; 43: 277-282 doi:10.1016/j.apergo.2011.06.002