Among all the things that I learned during my sports medicine fellowship at the Barry University School of Podiatric Medicine, I became fascinated by one particular phenomenon. There seems to be a relationship between foot type and specific sporting events. After close observation and an ongoing study, I have noticed that athletes with tibia varum, cavus foot type and, sometimes, an in-toe gait tend to excel in sporting events that primarily involve quickness in acceleration, stop and go maneuvers, and cutting.
Researchers have made correlations between foot type and specific athletic abilities in the past. Orendurff, et al., compared plantar pressure in straight running, accelerating, jumping and cutting maneuvers.1 They concluded that plantar pressure in straight running is less than that in accelerating, jumping and cutting maneuvers. While the purpose of this study was to determine shoe gear cushioning requirements, the study shows there is more stress on the foot during acceleration and cutting maneuvers. The foot has to supinate to achieve a rigid lever necessary for pushing off during acceleration, stop and go maneuvers and cutting.
Another study by Lees, et al., looked at the relationship of ground reactive forces to arch height.2 They determined that the structure of the foot was not the major factor in determining the transmission of ground forces to the musculoskeletal system in forefoot running. This study may imply that the foot type should not matter when it comes to certain athletic abilities. However, this study looked at straight running in relation to a vertical ground force rather than cutting and acceleration.2
As foot and ankle specialists, we agree that pronation is necessary for absorbing shock. This implies that an individual with a reduced medial arch will pronate to absorb shock on foot strike before resupinating in order to push off. On the other hand, an individual with a high arch is likely to pronate less, depending on how rigid the foot is, and accordingly resupinates more readily.
This may explain why an individual with an increased arch may be more successful in sports like soccer, which involves a great deal of stop and go maneuvers, cutting and acceleration.
The correlation of arch height and athletic ability makes sense on a biomechanical level. As biomechanists, we should understand how the ankle joint, subtalar joint and midtarsal joints work together to absorb the shock at foot strike. (We would not necessarily be looking at shock absorption at heel strike because the heel does not always hit the ground in a running gait.) Then we should evaluate the subsequent realignment to form a rigid lever for propulsion.
Accordingly, the mechanism goes from supination to pronation at foot strike to midstance (shock absorption) and then back to supination for propulsion. Since those with high arched feet are supinated in relaxed or neutral stance positions, they usually form a rigid lever quicker than others. This is an advantage as far as athletic ability is concerned. However, it leaves the athlete prone to certain injuries.
A high percentage of athletes I saw who were involved in physically demanding events like soccer and basketball usually presented with injuries consistent with a high arched foot type and tibia varum. Examples of these injuries include ankle sprains, styloid process irritation, Jones fractures, fifth metatarsal head pain, inflamed peroneals, shin splints, etc. The frequency of these types of injuries provides insight to the common denominators. In these cases, the common denominators are foot type, shoe gear and type of sporting event.
Just to be clear, this connection between arch height and specific athletic abilities is based on anecdotal observation. It is currently not supported by any study published at this time.
However, I am currently working on a study designed to investigate this possible connection. This study involves comparing a number of athletes with increased medial arches in one group and reduced medial arches in another group. All athletes in the study are in good physical condition and are on soccer, baseball and basketball teams. Players will be required to go through an obstacle course that involves stop and go maneuvers, cutting and acceleration.
The study will compare the obstacle course times recorded for the athletes with reduced arch height to the times recorded for those with increased arch height. The study can encompass all men or all women as long as one records the times and compares them fairly. Specifically, men will be included in this study in order to achieve more of a consistency with the comparison. I anticipate that the study will confirm my observations that arch height does affect athletic abilities.
What is the relevance of this information? Will this affect the way one practices? These are legitimate questions. The fact of the matter is that it may not change or affect your current style of practice. However, for sports medicine physicians, it seems essential to have a great deal of knowledge and understanding of anatomy, biomechanics, maneuvers associated with the different sporting events and shoe gear (such as soccer cleats). The ability to anticipate an injury by understanding the athletes’ anatomy creates an opportunity for preventive care.
At the professional sports level, knowledge of the interaction between foot morphology and performance may help in evaluating and selecting athletes for a high end professional sports franchise. It also provides background knowledge and insight necessary to educate athletes on realistic goals for participating in certain sporting events.
Dr. Eleyae completed a Sports Medicine Fellowship at the Barry University School of Podiatric Medicine in Miami, Florida.
Dr. Richie is an Adjunct Associate Professor in the Department of Applied Biomechanics at the California School of Podiatric Medicine at Samuel Merritt College. He is a Past President of the American Academy of Podiatric Sports Medicine.
1. Orendurff MS, et al. Regional foot pressure during running, cutting, jumping and landing. Am J Sports Med 36:566-571, 2008.
2. Lees A, et al. Shock absorption during forefoot running and its relationship to medial longitudinal arch height. Foot Ankle Intl 26(12):1081-1088, 2005.