Coker and Arnold also concluded that football shoes can contribute to turf toe due to fitting issues.3 At the time of their study, most football shoes were sized primarily by length. Athletes who needed wider shoes were in general forced to wear longer shoes that created the potential for excess shoe length in the toe box. This created more of a lever during dorsiflexion of the forefoot, leading to potential turf toe injury.
Nigg and Segesser studied an increase in friction between the fixed forefoot and the artificial turf in turf toe injuries.6 Bowers and Martin wrote another paper commenting on the relationship between the shoe and the surface relationship causes of turf toe.1
Unfortunately, I feel the evaluation test that Bowers and Martin used to determine shoe stiffness was flawed. In their study, the midfoot and posterior aspect of the football shoe was clamped down while researchers tested the flexibility of the forefoot. However, this is a flawed test because the flexibility of many shoes can and will continue into the midfoot portion of a shoe.
The American Academy of Podiatric Sports Medicine utilizes a shoe evaluation process that evaluates both the forefoot and midfoot stiffness of running and athletic shoes as two of the three most prominent components in athletic shoe function. From my perspective as well as the the academy’s perspective, it is important to have some flexibility of the forefoot in a shoe so the MPJs are allowed to pivot in late midstance and early propulsion. Loss of this important portion of the gait cycle can lead to significant negative compensations throughout the foot, ankle and lower extremities.