Flatfoot deformity is a prevalent hind‐ and midfoot disorder. Given its complexity, single‐plane radiological measurements omit case‐specific joint interaction and bone shape variations. Three‐dimensional medical imaging assessment using statistical shape models provides a complete approach in characterizing bone shape variations unique to flatfoot condition. This study used statistical shape models to define specific bone shape variations of the subtalar, talonavicular, and calcaneocuboid joints that characterize flatfoot deformity, that differentiate them from healthy controls. Bones of the aforementioned joints were segmented from computed tomography scans of 40 feet. The three‐dimensional hindfoot alignment angle categorized the population into 18 flatfoot subjects (≥7° valgus) and 22 controls. Statistical shape models for each joint were defined using the entire study cohort. For each joint, an average weighted shape parameter was calculated for each mode of variation, and then compared between flatfoot and controls. Significance was set at p < 0.05, with values between 0.05 ≤ p < 0.1 considered trending towards significance. The flatfoot population showed a more adducted talar head, inferiorly inclined talar neck, and posteriorly orientated medial subtalar articulation compare to controls, coupled with more navicular eversion, shallower navicular cup, and more prominent navicular tuberosity. The calcaneocuboid joint presented trends of a more adducted calcaneus, more abducted cuboid, narrower calcaneal roof, and less prominent cuboid beak compared to controls. Statistical shape model analysis identified unique shape variations which may enhance understanding and computer‐aided models of the intricacies of flatfoot, leading to better diagnosis and, ultimately, surgical treatment.

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BACKGROUND: Strength differences between performance levels remain unclear in female football. Furthermore, the relationship between fulltime training and strength has been unexplored despite increased professionalisation in the sport. OBJECTIVE: The aims of this research were to examine knee flexor/extensor and hip adductor/abductor strength differences between elite and sub-elite female footballers, and then determine the relationship of strength performance to age, years of football experience (FE), and years of fulltime training (FTT). METHODS: 15 elite and 15 sub-elite professional female footballers were tested. The main outcomes were concentric isokinetic knee flexor and extensor peak moment at 60, 180, and 300∘/s, and isometric hip adductor (ADD) and abductor (ABD) force. RESULTS: The elite team had higher absolute (300∘/s: 47.13–49.33 Nm vs 37.33–38.93 Nm, p< 0.05) and normalised (300∘/s: 0.76–0.80 Nm/kg vs 0.59–0.62 Nm/kg, p< 0.05) knee flexor values, and higher normalised ADD (5.64–5.66 N/kg vs 4.98–5.05 N/kg, p< 0.05) and ABD force (5.80–6.00 N/kg vs 5.26–5.39 N/kg, p< 0.05), compared to the sub-elite team. Age, FE, and FTT were correlated to knee flexor values (r= 0.381–0.559, p< 0.05). Additionally, FTT was correlated with normalised ADD and ABD force (r= 0.362–0.546, p< 0.05). CONCLUSION: Sub-elite female footballers may require additional knee flexor and hip strengthening in order to make the step up to the elite level. Those who are younger or have low FTT may also be recommended additional lower limb strengthening ahead of joining a fulltime training environment.