Effects of a 9-weeks arch support intervention on foot morphology in young soccer players: a crossover study

Abstract

Background: A flat foot is a common cause of chronic sports injuries and therefore many opportunities for arch support interventions exist. However, young athletes change their foot morphology due to developmental influences even without intervention. Therefore, developmental influences need to be considered when examining the effects of arch support, but there have not been sufficient longitudinal studies to date. This study aimed to determine the effect of the arch support intervention by performing a 9-weeks arch support intervention on the foot morphology and cross-sectional area of the foot muscles in flat-footed young athletes. Thirty-one elementary school boys (Age 11.4 ± 0.5 years, Height 145.2 ± 7.4 cm, Weight 38.8 ± 8.3 kg, BMI 18.2 ± 2.2 kg/m2) with a decreased medial longitudinal arch in the foot posture index were selected as participants from a local soccer club and randomly divided into two groups. Methods: In one group, in the intervention period, an existing arch supporter was used to provide arch support, while in the other group, no special intervention was provided in the observation period. To account for developmental effects, the intervention study was conducted as an 18-weeks crossover study in which the intervention and observational phases were switched at 9 weeks after the intervention. Foot morphology was assessed using a three-dimensional foot measuring machine, and the cross-sectional area (CSA) of the internal and external muscles of the foot was assessed using an ultrasound imaging device. We examined the effect of the intervention by comparing the amount of change in the measurement results between the intervention and observation periods using corresponding t-tests and Wilcoxon signed-rank sum test, analysis of covariance methods. Results: After adapting the exclusion criteria, 14 patients (28 feet) were included in the final analysis. The CSA of the abductor hallucis muscle (ABH) increased 9.7% during the intervention period and 3.0% during the observation period (p = 0.01). The CSA of the flexor digitorum longus muscle (FDL) increased 7.7% during the intervention period and 4.2% during the observation period (p = 0.02). Conclusion: A 9-weeks arch supporter intervention may promote the development of the ABH and FDL CSA in young flat-footed soccer players.