Effect of high and low‐supportive footwear on female tri‐planar knee moments during single limb landing

Abstract

BackgroundHigher landing-related external knee joint moments at later stages of female pubertal development likely contribute to a higher incidence of non-contact anterior cruciate ligament (ACL) injury. Athletic footwear may provide a potential strategy to alter higher knee moments.MethodsThirty-one late/post-pubertal girls (Tanner stage IV-V, menarche and growth spurt attained) performed a single limb drop lateral jump in three footwear conditions (barefoot, low support shoes and high support shoes), in which peak knee abduction moment (KAbM), flexion moment (KFM) and internal rotation moments (KIRM) were measured. Repeated measures ANOVA and ANCOVA were used to test for a main effect of footwear with and without foot posture index (FPI) as a covariate (p < 0.05) with post-hoc test carried out via Fisher’s Least Significant Difference (LSD).ResultsA main effect of footwear condition was observed for peak KFM (p < 0.05), but not KAbM or KIRM, in both unadjusted and adjusted models. Post-hoc analysis demonstrated that both high- and low-support shoes increased peak KFM compared with barefoot (p < 0.001).ConclusionOur findings indicate commercially available high- and low-supportive footwear increase peak KFM, but do not effect KAbM or KIRM while landing among late/post-pubertal girls. This suggests that these styles of footwear are inadequate at reducing higher knee moments in an at-risk cohort.

Effects of Footwear on Anterior Cruciate Ligament Forces during Landing in Young Adult Females

“…After task familiarization, participants performed three trials of a standardized drop–land–lateral jump for each footwear condition: barefoot, low-support shoes (Zaraca, ASICS), and high-support shoes (Kayano, ASICS). We defined low- and high-support footwear consistent with the categorization in [ 15 ]. Briefly, “high-support” was defined to include midsoles with higher density/stiffness medially compared to laterally, <10° torsional stiffness, <10° heel counter stiffness, and <45° midfoot longitudinal stability.…”

“…Low-support was defined by uniform midsole density, 10–45° heel counter stiffness, 10–45° torsional stiffness, and >45° midfoot longitudinal stiffness. At the time of the original study [ 15 ] from which data for the current study were obtained the only neutral ASICS shoe with similar cushioning features to ASICS Kayano but classified “low-support” based on our criteria was ASICS Zaraca. We acknowledge that the cushioning is slightly different between the two shoes, as both contain ASICS rearfoot and forefoot gel, whereas Zaraca has SpEVA and Kayano ‘Flytefoam’.…”

“…In the current market, a wide variety of low- and high-support athletic footwear options exist. Although no international consensus exists as to the definition of “support” in footwear, the recommendations from the Footwear Assessment Tool [ 14 ] have been used previously [ 15 ] to identify footwear features that may alter external knee loading. Therein, high-support footwear possesses a medial post (i.e., midsole that is stiffer medially compared to laterally), increased longitudinal bending stiffness, and midfoot rotational stability to minimize excessive foot pronation during activity, whereas low-support footwear does not [ 16 ].…”

“…However, modifying medial and lateral support in footwear does affect frontal and transverse-plane knee loads [ 18 , 19 , 20 ], which may affect ACL loads [ 21 ]. Furthermore, both low- and high-support shoes have been shown to increase external knee flexion moments compared to barefoot in females during a standardized drop–land–jump task [ 15 ]. Collectively, footwear has been shown to alter external knee loads, which might affect ACL loading, although this remains to be investigated.…”

“…In this study, we determined whether and how low- and high-support shoes modulate ACL force during a standardized drop–land–jump task in late-/post-pubertal females. As previous analysis of females performing a drop–land–jump task revealed, both low- and high-support shoes resulted in larger external knee flexion moments compared to barefoot performance [ 15 ]. Hence, we hypothesized that compared to barefoot, ACL forces during the drop–land–jump would be greater when wearing either low- or high-support shoes.…”