Effect of Shoe Design and Gender on Valgus Angle

The purpose of this study was to determine the difference between genders in body position during jumping movements while wearing shoes with varying midsoles. Twenty-two apparently healthy female and seven males voluntarily participated in this study. Subjects were current or recently graduated NCAA division III athletes of weight bearing sports and familiar with plyometric jumping. Subjects performed plyometric jumps from three box heights (46 cm, 30.5 cm and 21.6 cm) while being filmed from both the front and side view. Each jump was completed wearing four different pairs of shoes. The subject was represented as digitized points designed to capture pertinent angles and velocities of the body. Females showed a greater valgus angle than males in all shoe. The Medial Post shoe resulted in subjects having the smallest degree of valgus. Discussion Previous studies have concluded that females show a greater amount of valgus than males when performing jumping tasks (Chappell et. al, 2002). Additionally, although there is suggestive research that shoe design can positively influence body position and movement during jumping motions, the appropriate shoe design has not been determined (Cornwall & McPoil, 1995). The aim of the current study was to determine an appropriate shoe design for women through differences in valgus between genders as well as the effect of shoe design on reducing valgus. This study found females to have a greater valgus angle than males for all shoes. Although valgus occurred while wearing all shoes, the Medial Post shoe showed the smallest degree of valgus. ConclusionGender differences were concluded with females having a greater degree ofvalgus than males. For females the degree of valgus was reduced while wearingthe Medial Post shoe. AcknowledgementsThis project was funded by a University ofPuget Sound Summer Research Grant.ReferencesChappell, J. D., Yu, B., Kirkendall, D. T., & Garrett, W. E. (2002). A comparison of knee kinetics between male and female recreational athletes in stop-jump tasks. American Journal of Sports Medicine, 30(2), 261-267.Cornwall, M. W., & McPoil, T. G. (1995). Footwear and foot orthotic effectiveness research: A new approach. Journal of Orthopaedic & Sports Physical Therapy, 21(6), 337-344.Harmon, K. G., & Ireland, M. L. (2000). Gender differences in noncontact anterior cruciate ligament injuries. Clinics in Sports Medicine, 19(2), 287-302.Haycock, C.E. & Gillette, J.V. (1976). Susceptibility of women athletes to injury. Journal of American Medical Association, 236, 163-165.Luethi, S.M., Frederick, M.R., & Nigg, B.M. (1986). Influence of shoe construction on lower extremity kinematics and load during lateral movements in tennis. International Journal of Sport Biomechanics, 2(3), 166-174.Orendurff, M. S., Rohr, E. S., Segal, A. D., Medley, J. W., Green III, J. R., & Kadel, N. J. (2008). Regional foot pressure during running, cutting, jumping, and landing. American Journal of Sports Medicine, 36(3), 566-571.BackgroundThere is evidence that females are more prone to knee injuries,specifically of the anterior cruciate ligament (ACL) than males (Haycock &Gillette, 1976). Females have gender-specific factors including looseness ofthe joints, hormonal influences and structural alignment that play a majorrole in the prevalence of injury (Harmon & Ireland, 2000). Valgus and varusare two structural alignments responsible for gender differences inconjunction with injury rate of the ACL (Figure 1). These terms refer to theposition of the knee in relation to the tibia which can result in either aknock kneed or bowlegged position. During specific landing and jumpingtasks, females have greater valgus angles whereas males have greater varusangles (Chappell, Yu, Kirkendall & Garrett, 2000). This can be attributed tothe ability of men to absorb the impact of a jump better than females(Chappell et. al, 2000). Limited research has suggested the use of orthoticsor specialized shoes in order to reduce the effects of the natural tendenciesof the body during jumping tasks (Luiethi, Frederick & Niggs, 1986;Orenduff, Rohr, Segal, Medley, Green & Kadel, 2008). The aim of this studywas to determine a more favorable shoe fit for women to reduce valgusmovement. PurposeThe purpose of this study was to determine the difference betweengenders in body position and during jumping movements while wearingshoes with varying midsoles. MethodTwenty two apparently healthy females with a mean body mass of(73.8+8.4 kg) and a mean height of (1.74+.06 m) and seven apparentlyhealthy males with a mean body mass of (73.5+5.3 kg) and a mean height of(1.68+.02 m) signed written consent forms from the University of PugetSound internal review board before participating in this study. Subjectswere current or recently graduated NCAA division III athletes familiar withplyometric jumping. Subjects completed all testing within one visit lastingapproximately one hour.Before testing, subjects were asked to warm up for five minutes at aself selected pace on a stationary bike. Subjects performed plyometricjumps from three box heights (46 cm, 30.5 cm and 21.6 cm) while beingfilmed from both the front and side view. While being filmed from the front,subjects stepped off the designated box, landed with both feet thenimmediately returned to a height of 46 cm. Subjects performed the jumpfrom each box height one time for each pair of shoes. From the side view,each subject stepped off the designated box, landed with both feet thenimmediately returned to a height of 46 cm. All jumps were completed as asingle motion without hesitation.Digital video files were recorded on the hard drive of the computerusing SIMI on MOTION (v6.2) with a JVC camera collecting at 60Hz. Thesubject was represented as points designed to capture pertinent angles andvelocities of the body. From the side view, the left elbow, shoulder, hip,knee, ankle, heel and toe were digitized (Figure 4). From this, ankle, hip andshoulder angles were calculated as relative angles. The trunk angle wascalculated as an absolute angle to the y-axis (Figure 4). The view of thesubject from the front yielded valgus angles (Figure 5). The valgus angle isthe relative angle from the hip to knee to ankle (Figure 5). Importantparameters that were collected include: maximal valgus, maximal hip, knee,trunk and ankle angles. Figure 4: Digitized points (side view)Figure 5: Digitized points (front view)Shoes:The shoes were made in a women’s ten (men’s size 8.5). Prototype shoes aretypically made in one size to reduce overhead before mass production of the shoe. Eachsubject performed all plyometric jumps in four different shoe designs:Control: a typical Nfinity volleyball shoe currently on the marketMedial Post: a shoe with a constructed mid-sole to reduce valgusD3O: a shoe with a mid-sole contructed to increase jumping capabilitiesCombo: a shoe with a combination of both the Medial Post and D3O shoes*Due to signing of non-disclosure agreement, specifications of shoes cannot be discussed Figure 1: Illustration of varus and valgus-15-10-5051015