Football Cleats and Injury Patterns in 14- to 19-Year-Old Female Football Players: The Effect of Surface, Gender-Specific Shoe Gear and Cleat Pattern

Background: Female football (soccer) players are at increased risk for lower extremity injuries, yet prevention strategies remain based mostly on male athlete data. Modifiable extrinsic factors including footwear design and playing surface have not been well defined in youth female athletes. The Protect our Players (POP) pilot survey examined links between lower extremity injuries, footwear, and playing surfaces among youth female football players to guide future large-scale research. Hypothesis: Modifiable factors, including footwear design and playing surface, are associated with lower extremity injury exposure in youth female football players and may inform targeted injury prevention strategies. Study Design: Retrospective cross-sectional survey. Level of Evidence: Level 4. Methods: The POP pilot study surveyed 99 United States female football players (age, 14 to 19 years; mean ± SD, 16.54 ± 1.16 years) via an anonymous online platform. The study included both injured and noninjured participants and achieved a 100% completion rate. Results: Of the 99 participants who completed the survey, 60% reported injuries, ankle sprains (36.7%) and anterior cruciate ligament (ACL) tears (20%). Players wearing men’s cleats faced 2 times higher odds of injury than those wearing women’s cleats. Participants wearing women’s cleats reported improved comfort and fit. Similarly, firm ground surfaces were linked to nearly double the injury odds, regardless of cleat pattern. Overall, the use of women’s footwear appeared to confer a protective benefit. Conclusion: Footwear was associated with injury occurrence in female athletes, suggesting that gender-specific gear may be a protective factor. These results warrant a larger-scale investigation to confirm these associations and inform evidence-based, female-player-specific equipment design. Clinical Relevance: Modifiable factors, including footwear design and playing surface, may inform injury prevention strategies and female-player-specific equipment development in youth female football players.