Context: Stress fractures are one of the most common injuries in sports, accounting for approximately 10% of all overuse injuries. Treatment of fifth metatarsal stress fractures involves both surgical and nonsurgical interventions. Fifth metatarsal stress fractures are difficult to treat because of the risks of delayed union, nonunion, and recurrent injuries. Most of these injuries occur during agility tasks, such as those performed in soccer, basketball, and lacrosse.Objective: To examine the effect of a rigid carbon graphite footplate on plantar loading during 2 agility tasks.Design: Crossover study. Setting: Laboratory. Patients or Other Participants: A total of 19 recreational male athletes with no history of lower extremity injury in the past 6 months and no previous metatarsal stress fractures were tested.Main Outcome Measure(s): Seven 458 side-cut and crossover-cut tasks were completed in a shoe with or without a fulllength rigid carbon plate. Testing order between the shoe conditions and the 2 cutting tasks was randomized. Plantarloading data were recorded using instrumented insoles. Peak pressure, maximum force, force-time integral, and contact area beneath the total foot, the medial and lateral midfoot, and the medial, middle, and lateral forefoot were analyzed. A series of paired t tests was used to examine differences between the footwear conditions (carbon graphite footplate, shod) for both cutting tasks independently (a ¼ .05).Results: During the side-cut task, the footplate increased total foot and lateral midfoot peak pressures while decreasing contact area and lateral midfoot force-time integral. During the crossover-cut task, the footplate increased total foot and lateral midfoot peak pressure and lateral forefoot force-time integral while decreasing total and lateral forefoot contact area.Conclusions: Although a rigid carbon graphite footplate altered some aspects of the plantar-pressure profile during cutting in uninjured participants, it was ineffective in reducing plantar loading beneath the fifth metatarsal.Key Words: soccer, cross-cutting, side cutting, plantar pressure, fifth metatarsal fracture, rigid carbon graphite footplate
Key PointsFifth metatarsal stress fractures can be difficult to treat because of the risks of delayed union, nonunion, and recurrent injury. In combination with a custom orthotic and foot brace, modifying footwear with the use of a carbon graphic footplate has been proposed to allow athletes to safely return to sport while the stress fracture is healing. Plantar loading beneath the fifth metatarsal increased in healthy participants who wore a carbon graphite footplate while performing agility tasks. Plantar loading with and without the footplate should be studied in patients with metatarsal fractures. W hile athletes compete in sports, the risk of injury depends upon the sport and position being played.1 Age, sex, competition level, bone density, and shoe type are all risk factors for injuries related to the foot and ankle.2-4 Stress fractures are one of the most ...
