Fifth metatarsal stress fracture in elite male football players: An on-field analysis of plantar loading

Athol Thomson, Richard Akenhead, Rodney Whiteley, Pieter D'Hooghe, Ken Van Alsenoy, Chris Bleakley

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Abstract

Objective Evaluate plantar loading during 'on-field' common football movements in players after fifth metatarsal (MT-5) stress fracture and compare with matched healthy players. Methods Fourteen elite male soccer players participated in the study conducted on a natural grass playing surface using firm ground football boots. Seven players who had suffered a primary stress fracture (MT-5 group) and seven matched healthy players (controls, CON) performed three common football movements while in-shoe plantar loading data were collected. Results Large between-group differences exist for maximal vertical force normalised to bodyweight (F max) at the lateral toes (2-5) of the stance leg during a set-piece kick (MT-5: 0.2±0.06 bodyweight (BW), CON: 0.1±0.05 BW, effect size (ES) 1.4) and the curved run where the MT-5 group showed higher F max with very large effect size at the lateral forefoot of the injured (closest to curve) limb when running a curve to receive a pass (MT-5 injured-CON=0.01 BW, ES 1.5). Small between-group differences were evident during straight-line running. However, between-limb analysis of MT-5 group showed significant unloading of the lateral forefoot region of the involved foot. Conclusions Elite male football players who have returned to play after MT-5 stress fracture display significantly higher maximum plantar force at the lateral forefoot and lateral toes (2-5) compared with healthy matched control players during two football movements (kick and curved run) with the magnitude of these differences being very large. These findings may have important implications for manipulating regional load during rehabilitation or should a player report lateral forefoot prodromal symptoms.

Original languageEnglish
Article numbere000377
Pages (from-to)1-8
Number of pages8
JournalBMJ Open Sport and Exercise Medicine
Volume4
Issue number1
Early online date20 Jun 2018
DOIs
Publication statusPublished - 20 Jun 2018

Fingerprint

Stress Fractures
Metatarsal Bones
Football
Toes
Extremities
Prodromal Symptoms
Soccer
Shoes
Poaceae
Running
Foot
Leg
Research Design
Rehabilitation

Keywords

  • football
  • metatarsal
  • Plantar pressure
  • Soccer
  • stress fracture

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Thomson, Athol ; Akenhead, Richard ; Whiteley, Rodney ; D'Hooghe, Pieter ; Van Alsenoy, Ken ; Bleakley, Chris. / Fifth metatarsal stress fracture in elite male football players : An on-field analysis of plantar loading. In: BMJ Open Sport and Exercise Medicine. 2018 ; Vol. 4, No. 1. pp. 1-8.
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abstract = "Objective Evaluate plantar loading during 'on-field' common football movements in players after fifth metatarsal (MT-5) stress fracture and compare with matched healthy players. Methods Fourteen elite male soccer players participated in the study conducted on a natural grass playing surface using firm ground football boots. Seven players who had suffered a primary stress fracture (MT-5 group) and seven matched healthy players (controls, CON) performed three common football movements while in-shoe plantar loading data were collected. Results Large between-group differences exist for maximal vertical force normalised to bodyweight (F max) at the lateral toes (2-5) of the stance leg during a set-piece kick (MT-5: 0.2±0.06 bodyweight (BW), CON: 0.1±0.05 BW, effect size (ES) 1.4) and the curved run where the MT-5 group showed higher F max with very large effect size at the lateral forefoot of the injured (closest to curve) limb when running a curve to receive a pass (MT-5 injured-CON=0.01 BW, ES 1.5). Small between-group differences were evident during straight-line running. However, between-limb analysis of MT-5 group showed significant unloading of the lateral forefoot region of the involved foot. Conclusions Elite male football players who have returned to play after MT-5 stress fracture display significantly higher maximum plantar force at the lateral forefoot and lateral toes (2-5) compared with healthy matched control players during two football movements (kick and curved run) with the magnitude of these differences being very large. These findings may have important implications for manipulating regional load during rehabilitation or should a player report lateral forefoot prodromal symptoms.",
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Fifth metatarsal stress fracture in elite male football players : An on-field analysis of plantar loading. / Thomson, Athol; Akenhead, Richard; Whiteley, Rodney; D'Hooghe, Pieter; Van Alsenoy, Ken; Bleakley, Chris.

In: BMJ Open Sport and Exercise Medicine, Vol. 4, No. 1, e000377, 20.06.2018, p. 1-8.

Research output: Contribution to journalArticle

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T1 - Fifth metatarsal stress fracture in elite male football players

T2 - An on-field analysis of plantar loading

AU - Thomson, Athol

AU - Akenhead, Richard

AU - Whiteley, Rodney

AU - D'Hooghe, Pieter

AU - Van Alsenoy, Ken

AU - Bleakley, Chris

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Y1 - 2018/6/20

N2 - Objective Evaluate plantar loading during 'on-field' common football movements in players after fifth metatarsal (MT-5) stress fracture and compare with matched healthy players. Methods Fourteen elite male soccer players participated in the study conducted on a natural grass playing surface using firm ground football boots. Seven players who had suffered a primary stress fracture (MT-5 group) and seven matched healthy players (controls, CON) performed three common football movements while in-shoe plantar loading data were collected. Results Large between-group differences exist for maximal vertical force normalised to bodyweight (F max) at the lateral toes (2-5) of the stance leg during a set-piece kick (MT-5: 0.2±0.06 bodyweight (BW), CON: 0.1±0.05 BW, effect size (ES) 1.4) and the curved run where the MT-5 group showed higher F max with very large effect size at the lateral forefoot of the injured (closest to curve) limb when running a curve to receive a pass (MT-5 injured-CON=0.01 BW, ES 1.5). Small between-group differences were evident during straight-line running. However, between-limb analysis of MT-5 group showed significant unloading of the lateral forefoot region of the involved foot. Conclusions Elite male football players who have returned to play after MT-5 stress fracture display significantly higher maximum plantar force at the lateral forefoot and lateral toes (2-5) compared with healthy matched control players during two football movements (kick and curved run) with the magnitude of these differences being very large. These findings may have important implications for manipulating regional load during rehabilitation or should a player report lateral forefoot prodromal symptoms.

AB - Objective Evaluate plantar loading during 'on-field' common football movements in players after fifth metatarsal (MT-5) stress fracture and compare with matched healthy players. Methods Fourteen elite male soccer players participated in the study conducted on a natural grass playing surface using firm ground football boots. Seven players who had suffered a primary stress fracture (MT-5 group) and seven matched healthy players (controls, CON) performed three common football movements while in-shoe plantar loading data were collected. Results Large between-group differences exist for maximal vertical force normalised to bodyweight (F max) at the lateral toes (2-5) of the stance leg during a set-piece kick (MT-5: 0.2±0.06 bodyweight (BW), CON: 0.1±0.05 BW, effect size (ES) 1.4) and the curved run where the MT-5 group showed higher F max with very large effect size at the lateral forefoot of the injured (closest to curve) limb when running a curve to receive a pass (MT-5 injured-CON=0.01 BW, ES 1.5). Small between-group differences were evident during straight-line running. However, between-limb analysis of MT-5 group showed significant unloading of the lateral forefoot region of the involved foot. Conclusions Elite male football players who have returned to play after MT-5 stress fracture display significantly higher maximum plantar force at the lateral forefoot and lateral toes (2-5) compared with healthy matched control players during two football movements (kick and curved run) with the magnitude of these differences being very large. These findings may have important implications for manipulating regional load during rehabilitation or should a player report lateral forefoot prodromal symptoms.

KW - football

KW - metatarsal

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KW - Soccer

KW - stress fracture

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