Dynamic foot function as a risk factor for lower limb overuse injury: a systematic review

Area of Science:

• Biomechanics
• Sports Medicine
• Clinical Research

Background:

• Dynamic foot function is a proposed risk factor for lower limb overuse injuries.
• Existing literature lacks a systematic appraisal of this relationship.
• Injuries include Achilles tendinopathy, shin pain, patellofemoral pain, and stress fractures.

Purpose of the Study:

• To systematically review and summarize the evidence linking dynamic foot function to lower limb overuse injuries.
• To evaluate the role of dynamic foot function as a risk factor for specific overuse injuries.

Main Methods:

• Systematic search of Medline, CINAHL, Embase, and SportDiscus databases.
• Inclusion of prospective cohort studies utilizing dynamic foot assessment methods.
• Methodological quality appraisal using an adapted Epidemiological Appraisal Instrument (EAI).

Main Results:

• Limited to moderate quality evidence from 12 studies (n=3,773).
• Evidence suggests plantar loading and rearfoot kinematics are risk factors for patellofemoral pain and Achilles tendinopathy.
• Conflicting evidence exists for non-specific lower limb overuse injuries; no evidence for iliotibial band syndrome or stress fractures.

Conclusions:

• Very limited evidence supports dynamic foot function as a risk factor for patellofemoral pain, Achilles tendinopathy, and non-specific lower limb overuse injuries.
• Clinical identification and modification of these risk factors remain unclear.
• Future studies require improved methodology and focus on clinically relevant measures.