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Hayley Mick

Light and fast low-top shoes linked to climb in NBA player foot injuries Add to ...

The point guard was a seer, even as a rookie. Rajon Rondo joined the Boston Celtics in 2006 as a skinny, 6-foot-1 sophomore from Kentucky, but already knew his stunted stature could be conquered by nimble feet.

“I’ll never forget his first day,” recalled Celtics team physician Brian McKeon. “[Head coach] Doc Rivers is busting his chops a little bit. You know, Doc style: ‘You’re not going to be as good as I am as a guard. You’re too small.’”

“And Rondo turned and said, ‘You know what? Speed is everything now.’”

Quick, dynamic point guards such as Rondo, Chris Paul and Russell Westbrook have become vogue in the NBA, and the modern power forward position has also been redefined to favour lanky, athletic hybrids such as Kevin Durant. But with foot injuries on the rise, the question is whether this rush for speed is exacting a physical toll on the modern basketball player.

For decades, according to veteran league statistician Harvey Pollack, ankle injuries have alternated with knee injuries as the most common injury to NBA players. But new research shows the number of foot injuries has risen steadily over the past 21 NBA seasons. Only 80 players suffered foot injuries in 1988 compared to 130 in 2009.

Combined, foot injuries accounted for 13.5 per cent of all the 16,439 injuries suffered NBA players during those 21 NBA seasons. And researchers found that those injuries tend to be more devastating than ankle injuries, as Toronto Raptors fans learned this fall when Reggie Evans – then the league’s third-best rebounder – was sidelined for at least two months after fracturing the fifth metatarsal bone in his right foot.

“Compared to ankle injuries, foot injuries are much more severe [in terms of] lost return to play. That’s the bottom line. That’s what the coaches and the trainers and the GMs, and agents want to know, is how long is this player going to be out?” said McKeon, who presented the data to a gathering of elite team physicians for the American Orthopedic Society of Sports Medicine last month.

Experts say a combination of factors may be driving the trend: The game is faster, players are larger, and stress on the feet is compounded by an 82-game regular season, plus playoffs.

Team physicians also say they are concerned about the rise of the lightweight, low-top sneakers that are the latest rage in the NBA.

A growing number of pros – notably Steve Nash, Kobe Bryant, Westbrook, DeMar DeRozan and Rondo – are switching from traditional high-tops to more lightweight shoes resembling a traditional cross-trainer, which they say are less restrictive when they run.

“When I first brought it up in the meeting, everybody kind of looked at me and thought I had three heads or something,” Bryant said after Nike unveiled his new low-top shoe three years ago.

“I just feel like if I can have a lighter shoe, my ankle can move the way it was intended to move. I just feel like it could make me a better basketball player – minimize the seconds that I lose in changing directions and getting up off the floor.”

And while the smaller guards have led the charge, bigger players are getting in on the act as speed becomes more important to their role. Gone are the old back-to-the-basket big men who ruled the paint with brute force. They’ve been replaced by a hybrid epitomized by the league’s top scorer – Oklahoma City Thunder forward Kevin Durant – a big, lanky, ultra athletic player who can shirk his man getting up and down the floor and create his own shot off the dribble.

“Low-tops feel so much better than high-tops, I promise they do,” said 6-foot-11 forward-centre Joey Dorsey, who switched to low-tops this season despite his earlier concerns that he might be raising his risk of ankle injury.

“I think over time, the big guys are going to transition, wanting to be quicker, faster, like the Kevin Durants,” said Maurice Evans, a 6-foot-5 guard forward with the Atlanta Hawks, who began requesting low-tops from his shoe sponsor, Converse, four years ago.

The trend is also reaching the wider public. At their highest point, high-tops such as the Nike Air Jordans accounted for about 20 per cent of the U.S. market for basketball shoes, according to market-research firm NPD Group. Today, that number has sunk to about 8 per cent, while low-tops – the kind that Nash and Bryant wear – have grown to 29 per cent of the market from just 11 per cent in 2002.

“The feedback we've received from players at the NBA level all the way down to high schoolers is they want lighter footwear to be faster on the court. Speed is everything, and to make athletes faster our shoes are getting lighter,” said Lawrence Norman, vice-president of global basketball for Adidas.

Previous studies have shown that whether a player wears high or low-tops has no significant effect on their risk of ankle injury. But when it comes to foot injuries, experts say the low-tops may not provide the support players need to buffer their feet from constant pounding. Over time, lightweight shoes may also contribute to stress fractures and chronic injuries such as plantar fasciitis, Achilles tendinitis, and Achilles strain (the three most common foot injuries in the NBA) because they don’t have the same cushioning.

“They’re less protective. So you’ve got to try to work with the player a little bit and try to get a more sturdy shoe, more supportive [shoe],” McKeon said.

Convincing a player to do so can be easier said than done.

“Thirty years ago, they did what you said,” says Michael Lowe, a podiatrist and team doctor with the Utah Jazz for 31 years. “But it’s becoming less and less and less now, because they have the contracts, and if they’re seen wearing a shoes that’s not in their contract, then they lose the contract. ... They play more for the money than the wisdom of what that shoe’s going to do for their career.”

As a preventative measure and to account for genetic variation among their players (the shape of your foot also plays a role in your susceptibility to injury), many teams have begun outfitting their entire roster with custom orthotics.

“Half are floating in the Charles river after we give them to them,” McKeon said, chuckling.

The majority of basketball shoes sold in North America are worn for fashion, so it’s difficult to say accurately whether the trend has found it’s way to high school and college basketball.

But Lowe, former president of The American Academy of Podiatric Sports Medicine, recommends young basketball players avoid following heroes. Professionals have orthotics at their disposal – and trainers who can tape their ankles properly. Instead, he recommends high top sneaker with an ankle brace. He also says it’s important to get new shoes after every 60 hours of training or practice.

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