Influence Of Shoe Height On Lower Extremity Musculoskeletal Trauma In Collegiate Men’s Lacrosse

Lower extremity (LE) injuries are pervasive in men’s lacrosse athletes. With the various shoe types worn, the influence of shoe height on musculoskeletal trauma has not been properly addressed. PURPOSE: To quantify the incidence of LE injuries in men’s NCAA lacrosse athletes wearing low, medium, and high cut shoes. METHODS: Men’s collegiate lacrosse athletes from 29 universities were evaluated over 7 competitive seasons (2016-2022) on artificial turf across all NCAA D-I conferences. Outcomes of interest included injury severity, injury across skill position, imaging and surgical procedures, anatomical location of trauma, and specific musculoskeletal trauma. Injury incidence rates were calculated using injuries per 10 games = [(number of injuries ÷ number of games)x10]. RESULTS: Of the 1302 games, 327 (25.1%) injuries were documented with 167 (51.1%) athletes wearing low cut, 119 (36.4%) medium cut, and 41 (4.3%) high cut shoes. MANOVAs indicated a significant shoe height effect by skill position (F8,319 = 2.040; P = .008) and anatomical location of injury (F10,316 = 2.603; P < .001). No significant difference was found by injury severity (F2,.324= 1.740; P = .108), imaging and surgical procedures (F3,323= 1.074; P = .376), joint (F14,312= 0.981; P = .496), and muscle (F6,320= 0.943; P = .510). Post hoc analyses indicated a significantly lower (P = .05) incidence of LE trauma in athletes wearing high cut as opposed to medium and low cut shoes respectively, as observed in long pole midfielders [0.0 (95% confidence interval [CI], 0.0-0.1) vs 0.1 (95% CI, 0.0-0.2) vs 0.0 (95% CI, 0.0-0.1) (p = .009)], attackmen [0.0 (95% confidence interval [CI], 0.0-0.0) vs 0.2 (95% CI, 0.1-0.2) vs 0.2 (95% CI, 0.1-0.3) (p = .031)], and injury to the knee [0.1 (95% CI, 0.0-0.1) vs 0.2 (95% CI, 0.1-0.2) vs 0.3 (95% CI, 0.2-0.4) (p = .034)] lower leg [0.0 (95% CI, 0.0-0.1) vs 0.1 (95% CI, 0.1-0.2) vs 0.1 (95% CI, 0.1-0.2) (p < .001)], and heel/Achilles [0.0 (95% CI, 0.0-0.0) vs 0.0 (95% CI, 0.0-0.1) vs 0.0 (95% CI, 0.0-0.1) (p = .036)]. CONCLUSION: Findings indicated that there were significantly fewer injuries involving the knee, lower leg, and heel/Achilles in athletes wearing high cut shoes as opposed to medium and low cut. Therefore, it is recommended that male collegiate lacrosse athletes minimize the use of low cut shoes during play.