It is important to evaluate proper shoe fit when treating soccer players. Soccer players want to feel the ball and often want the soccer shoe to feel like a tight glove. However, improper fitting shoes cause toenail problems.
To evaluate an athlete’s shoe fit, have him or her stand straight. Check to see that the tips of the toes are not protruding into the leather distally. There should be a small amount of room from the longest toe to the tip of the shoe. Check that the foot is not hanging over the edge of the sole of the soccer cleat, either too much laterally or medially. Here, instability can lead to sprain or stress injury.
If this is the case, then either recommend a different cleat or remove the inlay within the soccer shoe and replace it with a more stable orthotic device. You may need to rip out the inlay within the soccer shoe and, using a straight edge screwdriver, proceed to remove any unwanted foam material that still adheres. This allows you to insert an orthotic without crowding the foot and causing other problems.
Check that the heel counter is still firm. When a shoe is worn for a period of time and subjected to the elements of rain, mud, etc., the heel counter may weaken and no longer be supportive for the foot. A weak heel counter enables the foot to go through excessive motions that may aggravate conditions such as calcaneal apophysitis, plantar fasciitis and Achilles tendinitis.
Set the shoe on a countertop and make sure the upper portion of the shoe is still firmly mounted on the sole and the shoe does not have excessive eversion or inversion lean. Check the cleats of the shoe for excessive wear. When treating patients who have metatarsal pain, make sure there is no cleat protruding upward through the sole of the shoe, irritating the involved metatarsal area
Finally, check the tongue of the shoe, making sure it remains well cushioned and centered underneath the laces. Soccer players like to optimally strike the ball with the instep of their foot and if the tongue is no longer providing cushioning, this may cause irritation to the dorsum of the foot over a period of time.