This article is provided exclusivelyto Podiatry Management by the Ameri-can Academy of Podiatric SportsMedicine. The AAPSM serves to ad-vance the understanding, preventionand management of lower extremitysports and fitness injuries. The Acade-my believes that providing such knowl-edge to the profession and the publicwill optimize enjoyment and safe par-ticipation in sports and fitness activi-ties. The Academy accomplishes thismission through professional educa-tion, scientific research, public aware-ness and membership support. For ad-ditional information on becoming amember of the AAPSM please visit ourwebsite at www.aapsm.org or circle#151 on the reader service card.

Soccer is constantly immersedin a dynamicof strategic

change and physi-cal demand asplayers becomestronger, faster,more agile, and fitat younger ages.All this is evidentto the observer ofprofessional soc-cer, but especiallyso for those whofollow and partici-pate in youth soc-cer globally. Soc-cer’s public face isthe focus of bil-

around the world, manufacturers ofsoccer shoes/boots are now morecommitted than ever to meeting theneeds of youth, adolescent, and ad-

vanced players. Byintegrating con-cepts previouslyreserved for theelite and profes-sional player, inconjunction withevidence-baseddesign and bio-compatible com-ponents, soccerboots are reachingconsumers with aquality and func-tional capacity

that has never been seen before.As a profession and as individual

practitioners, we now more thanever have the responsibility to em-brace soccer as part of our cultureand professional landscape (Figure2). The millions of beginning, inter-mediate, and advanced players wholive near our clinics require the high-est level of care from sports podia-trists and members of the multidisci-plinary sports team to meet theirgrowing clinical needs. Having abasic introduction into the biody-namics of soccer and a sophisticatedunderstanding of the functionalcomponents of soccer boots can putthe clinician in good stead with thechallenges that he or she will facewhen the next soccer injury or podi-atric-related soccer malady presents.

By Howard Liebeskind, DPM

Continued on page 190

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C U R R E N T T O P I C S I N S P O R T S P O D I A T R Y

lions of fans and participantsaround the world, and more recent-ly its popularity has unquestion-ably taken a foothold in the UnitedStates. It nowfinds itself em-bedded withinour culture (Fig-ure 1), be it onthe street, beach,playground, orthe uncountablesoccer fields thatdot our country,and one is nowhard pressed tofind a momentwhere the game isnot being played.

As a result of the exponentialgrowth of soccer in the UnitedStates and continued growth and so-phistication of soccer/football

Figure 1: Global soccer icon David Beckham of the Los Ange-les Galaxy in a “friendly match” versus FC Barcelona).

A quality and

biodynamically sound

soccer shoe must

allow for complete

freedom of function

and movement.

Different field conditions require different patternsand types of cleats.

The Biodynamicsof Soccer andSoccer Cleat Design

movements, there isa change of speedevery five to six sec-onds. Such activityrequires a most sup-portive and com-fortable cleat con-struction (Figure 3).

Although youthsoccer players mightnot come within afraction of runningas much as or asforcefully as thosein the professionalgame, soccer shoedevelopment teamsnow incorporatethe most importantcharacteristics of pro-fessional cleats forproportionate play.

Functional Requirements of Soccer BootsA quality and biodynamically sound soccer shoe must

allow for complete freedom of function and movement.It must also provide total comfort and support.2 Unfortu-nately, the principles governing control and comfort willoften be at odds with each other. The more control acleat exhibits, the less flexible and more sturdy and con-trolling its structure will be. The opposite is true of thecomfort scenario. One will find the more comfortablecleat to have a more flexible and somewhat less stable en-vironment. Both present with advantages and disadvan-tages. Developing a hybrid cleat that provides ergonomicperformance and the best combination of comfort andcontrol should be a guiding principle for manufacturers.

Basic Structural and FunctionalCharacteristics of Soccer Boots

The goal of today’s product development teams is toadequately address flexibil-ity and stability within theconfines of a lightweightboot. Incorporating theseelements in conjunctionwith a clean functionalkicking surface will yieldlonger periods of grip, in-creased friction betweenthe boot and ball, greaterball control, increasedpower and swerve, alongwith biomechanical sta-bilities (Figure 4).

Excessive motion ofthe foot during play haslong plagued boot manu-facturers and develop-ment teams. This has been addressed vigorously overthe past several years. Numerous improvements arenow part of the boot’s environment; these include bet-

Movement DynamicsSoccer is characterized by sprinting, stopping, cut-

ting, and pivoting situations where shoe relations are es-sential and frictional resistance must be within an opti-mal range.1 During the progressions of a typical 90-minute professional or international match a player willfrequently cover 8,000 to 11,000 meters. Two-thirds ofthe total distance covered is generally associated withwalking and jogging and one-third is associated cruising,sprinting, and backing. Approximately 800 meters ofeach game requires bursts of 10-40 meters. Within these

Soccer...

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190 www.podiatrym.comPODIATRY MANAGEMENT • MARCH 2011

Jiri Dvorak, MD, FIFA Chief Medical Officer; Howard F Liebe-skind, DPM, Team Podiatrist US National Team; Bob Bradley,Head Coach, US Men's National Team; Bert Mandelbaum,MD, Team Physician, US National Team

Figure 3: U.S. Soccer Star LandonDonovan in action.

Figure 4: Under Armour Boots

192 www.podiatrym.comPODIATRY MANAGEMENT • MARCH 2011

ter lining materials, softer/more conforming construc-tions, and more effective lacing systems.

Excessive motion can lead to a multitude of issuesranging from simple blistering to severely debilitatingtendinopathies and stress injuries. Many soccer-specif-ic functional and stabilizing components are nowcombined to provide the control and comfort neededfor youth, adolescent and advanced play.

Lasting Characteristics of Soccer Boots

External Last DynamicsLasts are forms on which boots are constructed.

The global three-dimensional shape of a boot mimicsthe design form of the last and gives the upper itsshape and volume. Anatomical lasts are more con-toured to match the shape of the foot, while genericlasts are based on morphological averages.

Individuals with rectus or moderately pronated foottypes will likely find themselves most comfortable inboots fabricated from a somewhat straight or slightlycurved last. Those with an adducted forefoot or a clini-cally supinated foot type will find a slightly curved lastedor a more significantly curve lasted boot to their liking.

Internal Last DynamicsA boot’s footbed can have a profound impact on play-

er performance. Foot-bed construction delivers the opti-mal blend of stability and flexibility and lends personalityto the shoe. It is the functional interface between the play-er’s foot and the studs found on the exterior of the outsoleplate. The internal last refers to the structure of the foot-bed found under the sockliner of the boot. A quality inter-nal last construction, along with a well-designed sockliner,can help provide proper midfoot support, torsional con-trol, and forefoot flexibility for the user.

Despite best attempts, supportive adjuncts found inmany boots may not always provide the needed con-trol for the foot and might need to be replaced by aprescriptive insert or functional orthotic appliance. Or-thotic control in soccer boots is a constantly evolvingscience due to the myriad of seasonal manufacturingchanges in boot design. Boots should be submitted to asoccer-specific orthotics laboratory, along with the pa-tient’s casts and/or digital data to properly accommo-date the player’s foot, chosen footplate design, and in-ternal/external lasting dynamic.

Elite and professional soccer players are known to occa-sionally wear their cleated shoes one to one and a half sizes(U.S.) smaller than their known Brannock measurements.For this reason, it is essential to follow the boot submissionguidelines for proper orthotic fabrication and fit.

A properly advised internal and external supportiveboot structure can minimize common soccer maladiessuch as calcaneal apophysitis, plantar fasciitis, shinsplints/anterior tibial tendinitis, posterior tibial ten-dinitis, and turf toe, just to name a few.

The UpperThe upper is that portion of the cleat visualized from

Soccer...

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MARCH 2011 • PODIATRY MANAGEMENTwww.podiatrym.com 193

ferences in stability between the vari-ous versions of lightweight shoes.

The External Heel CounterThe heel counter is a structure that

anatomically cradles the back of theheel. It must be bonded strongly to theoutsole plate as well as the remainderof the upper (the soft portion of thecleat that surrounds the foot). Higherheel counters tend to yield greater rear-foot control to the vigorously trainingplayer. A well-constructed counter willnot bend out of alignment with varusor valgus game force and will maintaina parallel, vertical position whenviewed from the posterior of the cleat,even after long-term use. If the counter“gives” to either side or a parallelo-gram appears, then the cleat is at afunctional deficit. A quality externalheel counter should be rigid. It mustalso be accompanied by comfortablepadding on the internal surface to pre-vent friction, irritation, and blistering.

SocklinerThe sockliner is a dynamically

fabricated insole that offers cush-

dorsal, medial and lateral views. Itcovers all but the contacting plantarsurface of the boot. More than just aplace for advertising, it acts as a pro-tective functional foot covering. It isfirmly bonded to the outsole plate.The upper contributes significantlytoward medial to lateral stabilitywithin the boot and is also of impor-tance in controlling the ball duringplay. It has unique and distinct fea-tures as determined by the fabrica-tor; the upper may be synthetic orleather. Synthetics don’t over-stretch and don’t absorb water. Inaddition, they are gaining populari-ty because of their ability to influ-ence swerve on the ball.

Some synthetically manufacturedboots now weigh less than sixounces. Despite the perceived bene-fits of lightweight boot technology,studies are now beginning to indicatethat weight reduced versions shouldnot take precedence at the expense ofpedal stability. There also appears tobe evolving evidence validating dif-

ioning to the foot, disperses studpressure, and reduces foot-to-bootslip (that can lead to blisters andfrictional conditions).

Field Conditions and CleatAssortment

Field conditions frequently dic-tate the need for variation andchange in one’s cleat pattern andcleat type. We generally breakdown pitch conditions and cleattypes into various categories foroutdoor play:

Turf Fields (TF)Hard Ground (HG)Firm Ground (FG)Soft Ground (SG)Regardless of environmental con-

ditions, the outsole and cleat patternmust communicate with the pitch andyieldmaximum grab and traction.

Cleat, Blade, and StudPatterns for Outdoor Play

Cleat, blade, and stud patterns,as well as their placement and de-sign, are an art and a science. Re-

Soccer...

Continued on page 194

search and development in conjunction with field-test-ing have provided the playing public with a myriad ofexcellent choices. Studs are firmly bonded or optional-ly screwed into the outsole plate depending on prefer-ence, functional need, and pitch conditions.

• Turf Field (TF)—for play on extreme-ly hard and/or original synthetic surfaces

These cleats have been designed for harshand/or extreme field conditions as well asolder original synthetic surfaces. These finelystudded shoes are most helpful where thefield is balanced or when natural grass maynot be available or in its best form. They aregrippy and can provide maneuverability.

• Hard Ground (HG)—for play onhard unforgiving field conditions

These cleats generally have short studsand appear in fairly uniform patterns acrossthe outsole plate. In this grouping of cleats,the studs are prepared from thermal plastic orrubber-like materials. They are very effective for grab in dif-ficult-to-penetrate field surfaces and conditions. They canprovide adequate traction and simultaneous comfort with-out significant loss of mechanical control. Studs tend to beshorter and softer than the FirmGround (FG) variety.

Soccer...

194 www.podiatrym.comPODIATRY MANAGEMENT • MARCH 2011

Dr. Liebeskind has been team podia-trist to the U.S. Men’s and Women’sNational soccer teams for the past 19years, serving the United States SoccerFederation through a combined sevenFIFA World Cups. He currently sits onthe Medical Advisory Board of theUSSF and is a member of the Ameri-can Academy of Podiatric SportsMedicine. Dr. Liebeskind also serves asteam podiatrist to the Los AngelesGalaxy and Chivas USA of Major League Soccer in addition tothe UCLA and Pepperdine University Athletic Departments.

• Firm Ground (FG)—for playing on the firm tomoderately forgiving field

Firm ground cleats are perhaps the most commonlyused cleat type; they generally vary from 10-14 on theoutsole plate. Firm ground blades and studs provide andaddress pivot points, impact points, and stability inorder to maintain control and comfort for the average

player. Blades and round studs are equallypreferred in today’s market place. In addi-tion, firm ground cleats help each playerkeep a low center of gravity on a field thathas been fairly well manicured (Figure 5).

• Soft Ground (SG)—for playing on softfieldSoccer shoes for rain-soaked or soft field

conditions occasionally require longer, de-tachable studs. Replaceable studs are foundin various shapes and forms, generally num-bering six, and are used most frequently bythe most advanced and competitive player.They are fabricated in different lengths(12mm-19mm), so one can adjust his or hersoccer shoes based on the condition of the

field at the time of play. Soft ground studs should not beused on firm fields because they can lead to a higher in-jury rate. Detachable studs are declining in popularitydue to the fact that today’s fields have better drainage.Many professional soccer players now use a mixedSG/FG system for standard field conditions.

SummaryBiomechanical design concepts, once reserved for

cleats worn only by professional athletes, are now foundin numerous models used by youth players. Choosingthe proper soccer boot based on the athlete’s foot typewill lead to improved performance and will reduce thefrequency of injury. With a fundamental understandingof the biodynamics of soccer and soccer cleats, podia-trists can advise and protect those athletes who seek ad-vice and guidance. By embracing soccer as part of ournew cultural sports landscape, the “beautiful game” or“jogo bonito” can bring you the same enjoyment expe-rienced by those who have sought your services. �

References1 Ekstrand J., Nigg B.M.: Surface Related Injuries in Soccer.

Am J Sports Med., 1998.2 Lees, A and Nolan, L., The Biomechanics of Soccer: A Re-

view. Journal of Sports Sciences, (1998) 16, 211-234.

Figure 5: Typical FG cleatpattern