Previous research examining footwear profiles and foot-related problems reported by netball players were conducted more than 30 years ago, in a female-only cohort [18]. With the recent increase in males participating in netball, as well as changes to the sport and footwear over time it was imperative to investigate what footwear netball players were wearing and whether footwear profiles and foot-related problems differed between sexes. The findings of our unique study established substantial differences in the footwear profiles of male and female netball players. Importantly, foot-related problems and pain were prevalent across all netball players, and the footwear profiles of male netball players differed relative to their female counterparts. The implications of these novel findings with respect to improving netball-specific footwear are discussed below.

Netball players in the present study reported wearing a diverse range of footwear types and brands when participating in netball (see Table 2). Although most participants (84%) indicated that they wore ASICS footwear during netball, Hopper et al. [18] reported that Adidas and Dunlop dominated 61% of the netball footwear market over three decades ago when the researchers surveyed 420 female representative netball players. The manufacturers of netball footwear have therefore changed greatly as netball has evolved as a sport, with ASICS and Mizuno being the current leading manufacturers of netball-specific shoes worldwide. Interestingly, males were significantly more likely to report wearing Nike, Adidas and Brooks shoe brands when playing netball, whereas a larger proportion of females reported wearing ASICS and Mizuno shoes for netball. This difference in shoe brand preference is likely because many of the male respondents reported that they preferred to wear other shoe types, in particular basketball and running shoes, with females 13.2 times more likely to wear netball-specific shoes compared to males (see Table 3). Brands such as Nike, are also known to be more popular among male athletes, with women’s products accounting for only 24% of the company’s revenue in 2021 [26]. This brand bias could possibly contribute to the differences between the male and female netball players in the choice of footwear brand. The large proportion of netball players, particularly men, who reported not wearing a shoe specifically designed for netball is alarming given that men’s netball is an emerging sport, and a high proportion of males are currently participating at the elite level. It is important that this problem is addressed because players must wear shoes that have been designed to cater for the demands of the game to minimise injuries and enhance their performance [14, 15].

Unlike running, netball is a game that demands rapid acceleration to ‘break free’ from an opponent, sudden and explosive changes in direction combined with elevating leaps to receive a high pass, intercept a ball or rebound after an attempted goal [6]. Sinclair et al. [15] investigated the effects of different footwear (netball-specific shoes—ASICS Gel-Netburner Professional 9 versus minimalist shoes—Nike Free run 5.0+) on the kinetics and kinematics of three netball specific movements (run, 45° cut and jump) performed by 12 experienced female netball players. Based on the study results, the researchers cautioned that netball players should not wear shoes designed for running during netball activities [15]. Minimalist shoes were shown to be associated with significant increases in impact-loading (average loading rate) for all three netball-specific movements, as well as increases in peak ankle joint eversion during the running condition, which may increase the risk of injury [15]. Instead, the researchers recommended players should use netball-specific footwear, which has additional midsole cushioning and a more pronounced medial support mechanism designed to control excessive ankle eversion [15]. Similarly, basketball also poses different demands than netball. That is, while basketball players can dribble the ball down a court, upon catching a ball netball players must not let their landing foot be re-grounded if it is lifted while they are in possession of the ball. That is, netball players are restricted to taking a maximum of one-and-half steps in any direction while holding the ball [19]. Netball footwork rules, therefore, greatly restrict the distance over which a player may move and, in turn, reduce the time over which a player’s forward progression can be halted [6]. Stopping rapidly after receiving a pass in netball is achieved by applying an opposing horizontal frictional force; the greater the desired deceleration the larger the frictional force must be [27]. Unlike basketball shoes, netball-specific shoes are designed with increased traction to withstand the frictional forces associated with the stop-start nature of netball and the harder outdoor netball playing surfaces such as asphalt. The reasons why netball players choose not to wear netball-specific shoes and instead prefer to wear basketball and running shoes remains unclear. This may in part be due to the lack of a men’s netball-specific shoe being available or a lack of knowledge of the importance of appropriate footwear to optimising netball performance and minimising the risk of injury [14, 15]. Not wearing netball-specific shoes also implies that netball players may be unsatisfied with the current netball-specific footwear on the market, although further research is required to confirm or refute this notion.

Irrespective of whether footwear is designed correctly for a given sport, shoes must also properly fit the feet of athletes if the shoes are to achieve their desired function. To ensure shoes cater for foot shape and are comfortable to wear, it is imperative that the last upon which a shoe is constructed is based on the foot dimensions of individuals who are likely to wear the shoes [28]. Therefore, sex differences in foot shape must be considered. On average, men have longer and broader feet compared to women. The feet of men and women also differ in shape, especially in the angle formed by the axis of the metatarsal heads and the dimensions of the arch [22, 23, 28]. This size-difference in feet was supported by our findings, whereby male netball players reported wearing larger shoe sizes compared to the females (13.4 ± 2.7 vs 8.8 ± 1.6 US sizing, respectively). As male and female feet differ in size relative to stature and in shape [22, 23], it is concerning that 27.4% of male netball players indicated that they have previously worn netball-specific shoes that were specifically marketed for females. This is potentially problematic because footwear that is designed using foot dimensions unrelated to the individuals who are likely to wear the shoes can lead to ill-fitting footwear and, in turn, can lead to pain, discomfort and greater risk of foot-related problems and injury [24]. Developing netball-specific footwear for males based on the foot dimensions of men is necessary to ensure proper shoe fit and to prevent foot-related problems.

Foot-related problems such as blisters, ankle sprains, calluses and bruised toenails were very common amongst this cohort of netball players (see Fig. 2), with 84.3% of netball players reporting they suffered from at least one foot-related problem during their current netball season (see Table 3). These findings are substantially higher than previous research in which 47.5% of netball players reported experiencing problems with their feet, including 42% who required extra foot protection such as band-aids or an extra pair of socks [18]. Similarly, more recent research from Smyth et al. [9] found that lateral ankle ligament sprains and foot blisters had the highest incidence across injuries requiring medical attention during both the U17 and U19 age divisions at a national netball competition. Interestingly, in our survey females were 1.5 times more likely to suffer from foot-related problems compared to males (see Table 3). The reasons why females were more likely to suffer from foot-related problems is unclear and warrants further investigation. However, nearly 85% of netball players in the present study reported that they have previously experienced foot pain caused by their netball activity and 56.8% of these respondents were currently experiencing this pain during and/or after netball. Interestingly, sex was not related to the reporting of foot pain, whereby a large percentage of both male and female netball players reported experiencing foot pain caused by netball activity (see Table 3). Overall, the high prevalence of foot-related problems and pain reported by all netball players suggests that the shoes players are currently wearing for netball are not meeting the requirements of players, particularly regarding fit, comfort and functionality. Further research is therefore warranted to determine what factors associated with the shoes worn by both male and female netball players are contributing to this high prevalence of foot problems and pain.

Pain anywhere in the body has the potential to negatively affect muscle activity and, in turn, performance [29, 30]. Of concern, 57.7% of respondents who currently suffered from foot pain believed their pain was partially caused by the footwear they wore during netball activity, with 63.4% of these respondents reporting that their foot pain impacted their sporting performance. This percentage is much higher than three decades ago, where only 9% of the female players attributed their foot problems to their footwear [18], despite recent advancements in footwear design and methods used to manufacture netball-specific footwear. Importantly, males were significantly more likely to believe their foot pain was caused by the shoes that they wore for netball compared to females. This finding may be a consequence of male netball players wearing ill-fitting footwear and/or not wearing netball-specific shoes during their netball activity, although further research is required to confirm or refute this notion. As more men are not wearing netball-specific shoes, it is possible that men are more likely to blame their non-netball-specific footwear for their foot-related problems and pain due to how footwear type is marketed as a tool to prevent these problems in netball. Irrespective of the reason, it is vital that foot-related problems and pain are prevented so that the subsequent impacts on performance are minimised, particularly as maximising performance is necessary to increasing the professionalisation of netball for men.

Limitations

As the results of the present study are based on data collected from a survey, it is necessary to acknowledge the inherent limitations associated with subjective, self-reported data (e.g. frequency of foot pain) such as recall bias. Participant knowledge and personal beliefs must also be considered as a limitation when responding to questions related to footwear type and whether participants believe their shoes are causing their foot-related problems and pain. It is also important to acknowledge the multi-factorial nature of foot-related problems and pain, although many respondents reported that their netball activity caused these problems, there may be other factors that could contribute to the development of these problems (e.g. familial and biomechanical factors related to bunion development) [31]. Lack of questions related to training frequency must also be considered a limitation; it may be that male netball players train less frequently compared to their female counterparts at an equivalent level, which could influence the prevalence of foot-related problems and pain. The use of an online survey and indirect recruitment methods also prevented us from calculating an accurate response rate. A limited number of responses for certain categories, such as volleyball and basketball shoe types, are acknowledged, and future research that includes more responses in these categories is recommended to derive more accurate odds ratios. It is also important to acknowledge that the survey was distributed during the COVID-19 pandemic, which could have potentially impacted the recruitment process and influenced the participants responses, given that most netball competitions were abandoned in 2020.

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