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	Institution: STANFORD Univ Med Center  | My Account | E-mail Alerts | Access Rights | Sign In Vol. 2 No. 7, July 1993   Archives  •  Online Features Original Contribution  This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal Foot Morphologic Characteristics and Risk of Exercise-Relatedn Injury David N. Cowan, PhD; Bruce H. Jones, MD, MPH; John R. Robinson, MS Arch Fam Med. 1993;2(7):773-777. Abstract Objective It is widely accepted that persons with flat or high-arched feet are at increased risk of exercise-associated injury, even though this purported association has not been scientifically evaluated. We evaluate the risk of exercise-associated injury among young men with flat, normal, and high-arched feet. Design A prospective study of 246 US Army Infantry trainees followed up over a rigorous 12-week training Program. All subjects were evaluated prior to onset of training. Evaluation included photographs of the right, weightbearing foot that were digitized and utilized to make several measures of arch height. Setting An army initial entry training center. Subjects All trainees beginning army training on 2 successive weeks were potential volunteers. There were no criteria for exclusion other than declining to participate (n=3). The subjects were healthy, active young men with a mean age of 20.3 years. Outcome Measure The occurrence of a lower-extremity musculoskeletal injury resulting in a visit to and a diagnosis by an army physician or physician assistant. Treating physicians and physician assistants were blind to participation status and were not study staff members. Results On univariate analysis, there was an association between arch height and risk of injury using several alternative operational definitions of foot type. The 20% with the flattest feet were at the lowest risk (reference group; odds ratio, 1.0), with adjusted odds ratios for any musculoskeletal injury of 3.0 (P<.05) for the middle 60% group and 6.1 (P<.05) for the highest 20% group. Conclusions These findings do not support the hypothesis that low-arched individuals are at increased risk of injury, and they have implications for runners, exercise enthusiasts, and clinicians. It may be possible to prevent substantial morbidity among active populations by identifying individuals at high risk and advising alternate activities. Author Affiliations From the Division of Preventive Medicine, Department of Epidemiology, Walter Reed Army Institute of Research, Washington, DC (Dr Cowan); the Division of Occupational Medicine, Army Research Institute for Environmental Medicine, Natick, Mass (Dr Jones); and the Department of Scientific Research, Nike Inc, Beaverton, Ore (Mr Robinson). THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES Effect of Running Shoe Type on the Distribution and Magnitude of Plantar Pressures in Individuals with Low- or High-Arched Feet Molloy et al. J. Am. Podiatr. Med. Assoc. 2009;99:330-338. ABSTRACT | FULL TEXT   Flat-Footedness Is Not a Disadvantage for Athletic Performance in Children Aged 11 to 15 Years Tudor et al. Pediatrics 2009;123:e386-e392. ABSTRACT | FULL TEXT   Arch Height Index Measurement System: Establishment of Reliability and Normative Values Butler et al. J. Am. Podiatr. Med. Assoc. 2008;98:102-106. ABSTRACT | FULL TEXT   Association between foot type and tibial stress injuries: a systematic review Barnes et al. Br. J. Sports. Med. 2008;42:93-98. ABSTRACT | FULL TEXT   Use of plantar contact area to predict medial longitudinal arch height during walking. McPoil and Cornwall J. Am. Podiatr. Med. Assoc. 2006;96:489-494. ABSTRACT | FULL TEXT   Foot Type and Overuse Injury in Triathletes Burns et al. J. Am. Podiatr. Med. Assoc. 2005;95:235-241. ABSTRACT | FULL TEXT   Differences in sole arch indices in various sports Aydog et al. Br. J. Sports. Med. 2005;39:e5-e5. ABSTRACT | FULL TEXT   Examining the Validity of Selected Measures of Foot Type: A Preliminary Study Mathieson et al. J. Am. Podiatr. Med. Assoc. 2004;94:275-281. ABSTRACT | FULL TEXT   Risk factors for lower extremity injury: a review of the literature Murphy et al. Br. J. Sports. Med. 2003;37:13-29. ABSTRACT | FULL TEXT   A Comparison of Four Methods of Obtaining a Negative Impression of the Foot Laughton et al. J. Am. Podiatr. Med. Assoc. 2002;92:261-268. ABSTRACT | FULL TEXT   Measurements Used to Characterize the Foot and the Medial Longitudinal Arch: Reliability and Validity Williams and McClay ptjournal 2000;80:864-871. ABSTRACT | FULL TEXT   The Effect of Foot Structure and Range of Motion on Musculoskeletal Overuse Injuries Kaufman et al. Am J Sports Med 1999;27:585-593. ABSTRACT | FULL TEXT   It's OK to Be Flat-Footed Journal Watch Dermatology 1993;1993:14-14. FULL TEXT   IT'S OK TO BE FLAT-FOOTED JWatch General 1993;1993:6-6. FULL TEXT   Flatfeet Become Respectable Fields Arch Fam Med 1993;2:723-724. ABSTRACT   HOME | CURRENT ISSUE | PAST ISSUES | TOPIC COLLECTIONS | CME | PHYSICIAN JOBS | HELP CONDITIONS OF USE | PRIVACY POLICY | CONTACT US | SITE MAP   © 1993 American Medical Association. All Rights Reserved.