Soccer Shoes and Cleats and feet....

Is every kid in the country playing soccer, or is it my imagination?

The increased number of players has, not surprisingly, been accompanied by an increase in related foot injuries. Soccer coaches, trainers, players and parents of young players, as well as health care practitioners need to understand the roles soccer shoe construction and fit play in both causing and preventing injury.

To accommodate the spikes, the soccer shoe is constructed with a flat footbed. That means that there is no support for the 4 arches in the foot, which allows excess pronation or supination, and there is little or no cushioning to absorb shock. Players who have existing biomechanical problems find that the repetitive shock leads to injuries, heel pain, shin splints, knee pain, or plantar faciitis.

In addition, soccer shoes are "low profile"- they have insufficient depth at the heel to provide adequate support and stability for the ankle and heel. The result is an increased risk of twisted or sprained ankles and knees, given the quick turns and spins inherent in the sport.

High quality soccer shoes are usually made from kangaroo hide or other leathers, and less expensive versions are made from synthetic materials. Leather stretches substantially with wear, which allows for a better fit later - but it causes the buying of too-small shoes, increasing the risk of injury from the very beginning! Players also extend the buying of too-small shoes to the purchase of synthetic shoes, which do not stretch, and will always remain too tight. Some players buy too small shoes believing that the tightness will help hold the shoes on their feet during play.

A shoe - any shoe - worn too tight changes the functionality of the foot. The result can be hindered ball control during soccer play, and/or injury. Compounded by the lack of support in the shoe, common injuries from too-small shoes include "black toe", inflammation of the joints of the toes, "turf toe", even fractures! Buying shoes that are too large can also cause problems, and this has become common among parents of young players. Parents try to avoid the expense of frequent purchase of new shoes to accommodate children's rapidly growing feet by buying larger shoes the child can "grow into" Too- large shoes result in blisters from shearing, loss of ball control, and tripping.

Shoe fit affects spike placement, and proper placement is very important for foot health. A well-fitted shoe will have spikes placed above and below the big toe joint. A shoe worn too big or too small places a spike directly under that joint. This affects that joint as well as other bones in the foot. The constant shock experienced by the foot during soccer could result in serious injury and deformities that will last a lifetime.

According to Tom Engle, director of sports medicine and orthopedic rehabilitation at the Medical College of Wisconsin's Froedtert Hospital and also a soccer coach, attention should also be paid to how the shoe is laced. Players will wrap long shoelaces under the shoe to help hold the shoe around the heel and prevent slippage. Heel slippage, or shearing, causes the toes to hit the tip of the shoe, resulting in bruising. A properly fit shoe will not slip, and lacing in this manner should not be necessary.

What is proper fit for a soccer shoe? There should be a small amount of space, about the width of one's thumb, at the toe end. The foot should not be squeezed at the mid point. With this fit, the player will not feel the spikes under any of the metatarsal heads, and the shoe will not slip or feel as if it will come off during play.

Orthotics provide the support lacking in the shoe and moderate the effects of over-pronating or oversupinating. They may provide additional cushioning to absorb shock. The soccer shoe is a necessary tool in the game of soccer. When players, coaches, parents and health care providers understand the role of shoe construction, proper fit and support, the player's chances of avoiding injury and spending more time on the playing field increase.