Footwear in the United States Army Band: Injury incidence and risk factors associated with foot pain

BackgroundFootwear characteristics can influence, fatigue, comfort, injuries and energy cost. Members of the United States Army Band have hundreds of performances a year and these performances often include prolonged standing and marching in footwear.ObjectiveThe purposes of this paper are to: (1) determine injury rates before and after wearing a shoe with presumed greater cushioning and ventilation among US Army Band members, and (2) identify risk factors associated with foot pain/discomfort.MethodsTo potentially reduce injuries and improve comfort, 112 band members received shoes with an advertised increase in cushioning and ventilation.ResultsInjury incidence determined from medical records was 55% in the year before and 57% in the year during which band members wore the new shoes (p = 0.78). Higher risk of foot pain was associated with band unit (odds ratio (ORCeremonial unit/other units = 8.6), 95% confidence interval (CI): 1.2–60.2), shoe cushioning rating (ORpoor/good = 11.8, 95% CI: 1.5–89.7), orthotic use (ORyes/no = 18.5, 95% CI: 2.9–120.3), and how often band members replaced their shoes (OR≤1 year/>2 years = 11.5, 95% CI: 1.4–95.4).ConclusionsThe new shoes did not lower injury incidence, although specific risk factors associated with foot pain/discomfort were identified. To potentially increase the cushioning and comfort, insoles may be considered.