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Sports Medicine and Biomechanics

Do the feet of male and female netball players differ in shape? Implications for shoe design

ORCID Icon, ORCID Icon, , &
Pages 483-489 | Received 19 Aug 2023, Accepted 27 Mar 2024, Published online: 09 Apr 2024

ABSTRACT

A large proportion of netball players suffer foot-related problems and pain and are dissatisfied with current netball-specific footwear. To improve the fit and functionality of netball-specific shoes, we must understand the shape of these players’ feet and determine whether any sex differences exist. Five hundred and two representative-level netball players (n = 251 male; n = 251 female) had their feet three-dimensionally scanned. We then used a validated MATLAB code to automatically extract 10 measurements to characterise each participant’s foot shape. Differences between men and women for the absolute values and those normalised to foot length and stature were identified using independent samples t-tests with a Bonferroni adjusted alpha level. The size and shape of male netball players’ feet differed significantly from their female counterparts. Males had significantly larger absolute and normalised foot measurements than females, notably at the ball of the foot, heel and instep (p < 0.001). Netball shoe manufacturers should develop unique lasts for each sex and foot size and should offer a more extensive range of shoe lengths and widths to netball players. Such considerations will help optimise shoe fit and comfort and, in turn, reduce foot-related problems and pain associated with ill-fitting footwear.

1. Introduction

Foot-related issues are highly prevalent in netball, with 84.3% of netball players reporting having suffered from at least one foot-related problem during their last netball season (Kirk et al., Citation2022). The most common foot-related problems netball players report are blisters, ankle sprains, calluses and bruised toenails (Kirk et al., Citation2022). Shoes are the primary interface between the foot and the ground for netball players, providing protection and support to the foot during high-impact and multi-directional movements characteristic of the sport (Kirk et al., Citation2022). Each time a player’s foot contacts the ground at landing, the player experiences a multi-directional ground reaction force (Steele, Citation1990). The vertical component of this force can be up to 4.3 times the player’s body weight, considerably higher than the 2 to 3 times body weight generated during running (Steele & Milburn, Citation1987). Thus, wearing correctly fitted shoes designed for the sport is essential for minimising injuries and optimising performance in netball (Steele, Citation1990).

Recent research, however, has revealed that male and female netball players are dissatisfied with the fit and functionality of current netball-specific shoes (Kirk et al., Citation2023a). Specifically, netball players report to be dissatisfied with the durability, cushioning and breathability of the shoes that they wear during netball – with significantly more men dissatisfied with the width fit and length fit compared to women (Kirk et al., Citation2023a). Shoes must properly fit an athlete’s feet to achieve their desired function. Proper shoe fit is essential because it affects comfort and can potentially prevent foot-related problems, pain and injury (Reinschmidt & Nigg, Citation2000; Witana et al., Citation2004). If footwear is to adequately support the foot, the shape and dimensions of the space inside a shoe must correspond to the shape of the human foot (Hawes & Sovak, Citation1994). The shape of the interior space within a shoe is created by a last, a three-dimensional mould that approximates the shape of the human foot, around which the upper of the shoe is shaped (Nácher et al., Citation2006). To ensure shoes cater for foot shape and are comfortable, the last must be based on the foot dimensions of the individuals likely to wear the shoes. Therefore, to design a comfortable, well-fitting shoe for netball players, we must first understand the shape of these players’ feet and the factors that can influence their foot morphology.

Numerous factors can influence foot shape, including age, body mass index and sex (Wunderlich & Cavanagh, Citation2001; Zhao et al., Citation2017). Understanding differences in foot shape due to an athlete’s sex is therefore essential when designing shoe lasts for both male and female netball players. Traditionally, manufacturers have made women’s athletic shoes using a smaller version of a men’s last, with all dimensions proportionally scaled down according to foot length (Wunderlich & Cavanagh, Citation2001). However, if women’s feet differ in shape relative to men’s, this would be inappropriate and could lead to poorly fitted shoes for women. It would be equally inappropriate for a man’s shoe to be designed as a scaled-up version of a woman’s last. As netball has traditionally been a female-centric sport, a broad range of netball-specific shoes are manufactured for women (Kirk et al., Citation2022). However, despite the recent 88.4% increase in men playing netball, only one netball-specific shoe model is marketed explicitly for men (Kirk et al., Citation2023b). Unfortunately, this male netball-specific shoe is manufactured using a larger version of a women’s last, with all dimensions proportionally scaled according to foot length (Personal communications, Mark Doherty; ASICS Oceania Pty Ltd, June 2019). Researchers have consistently reported that male and female feet differ in size relative to stature and shape (Krauss et al., Citation2008, Citation2011; Mickle et al., Citation2010). Therefore, men’s feet are unlikely to simply be scaled-up versions of female feet but rather different in several shape characteristics, particularly at the arch, the lateral side of the foot, the first toe and the ball of the foot (Hawes & Sovak, Citation1994; Wunderlich & Cavanagh, Citation2001). There have been inconsistent results in values of ball-of-foot length between sexes (Krauss et al., Citation2011; Mickle et al., Citation2010), and the reported sex differences in foot morphology have been small in magnitude (<1% foot length) and of questionable practical relevance (Krauss et al., Citation2011). Differences in participant characteristics and experimental procedures such as, landmark identification may explain these inconsistent results between studies. There is no published research confirming that the scaled-up female lasts are matching the shape of the men’s feet. In fact, no previous studies have quantified the shape of the feet of male and female netball players and determined whether the foot shape of netball players differs between the two cohorts.

Given the high prevalence of foot-related problems reported by netball players and their dissatisfaction with current netball-specific shoes, exploratory research is required to better understand netball players’ foot shape. Such knowledge could inform recommendations to improve the fit, comfort and functionality of netball-specific footwear and, in turn, minimise foot-related problems and pain. Therefore, this study aimed to determine whether the dimensions and shape of netball players’ feet differed between men and women. Based on previous literature, we hypothesised that men would have longer and broader feet that differed in shape from their female counterparts.

2. Methods

2.1. Participants

A total of 502 representative-level Australian netball players volunteered to participate in this study. The inclusion criteria encompassed male and female netball players aged 16 years or above who had participated in at least one season of representative netball in the last 12 months. We excluded participants with current foot injuries. Netball players satisfying the inclusion criteria were recruited between November 2020 and August 2022 from netball training sessions and competitions within Australia, including the Men’s and Mixed Netball National Championships. The sample included 251 men (age: 26.1 ± 8.3 years; height: 183.3 ± 8.5 cm; mass: 87.7 ± 21.5 kg) and 251 women (age: 22.1 ± 6.7 years; height: 172.5 ± 13.8 cm; mass: 75.5 ± 14.4 kg). Although the men were significantly taller and heavier than the women, we matched the participants for competition level, whereby 85% of participants competed at a sub-elite (regional or state) level, and 15% competed at an elite (National or International) level. The Ethics Committee approved all testing procedures and the participant recruitment strategy (HREC 2019/326).

2.2. Experimental protocol

Each participant undertook a single 10-minute testing session held at their respective netball training or competition setting. First, we gave the participants a Participant Information Sheet outlining the details of the study. They then completed an Informed Consent Form and a Participant Characteristics Questionnaire with questions detailing their age, sex, level of netball competition, footwear habits and any exercise undertaken before the testing session (see supplementary material). Sixty-two per cent of participants stated they had exercised before their scanning session. We then asked the participants to remove any strapping tape or bandages from their feet and ankles. Finally, each participant had their height (cm) and body mass (kg) measured following standard procedures (International Standards for Anthropometric Procedures, 2001). Each measurement was taken three times, with the average value recorded to the nearest 0.1 cm and 0.1 kg, respectively, and used to characterise the cohort.

Three-dimensional foot scanning is frequently used in research to assess footwear fit systematically. Footwear manufacturers typically use algorithms produced by three-dimensional and mathematical modelling to accurately develop the shape of lasts, about which they mould their footwear. In this study, we took at least one three-dimensional foot scan (Tiger full foot 3D scanner, RS scan International NV, Paal, Belgium) of each participant’s left and right barefoot. The participants were instructed to stand with their body weight evenly distributed across their two feet, with one foot placed in the foot scanner. Each foot was scanned for 15 seconds, whereby the scanner projected two laser beams across the foot, and nine cameras recorded the resulting image. A single-foot scan provided a three-dimensional shape representing each participant’s left and right foot with a resolution of 0.5 mm. The scanner was calibrated before testing, and daily checks were performed before each testing session, following the manufacturer’s instructions (RS-scan, Belgium). After extensive calibration, the RS Tiger scanner had high accuracy (1 mm in the X, Y and Z axes; length, width and height measurements). It has also been shown to be a valid and reliable system when scanning the feet of 42 young adults (Lastovicka et al., Citation2022).

2.3. Foot measurements

Foot orientation and measurement extraction algorithms using a validated MATLAB code (Mathworks®, Natick, MA, USA) were adapted from Jurca et al. (Citation2019) to allow the extraction of 10 measurements from each foot scan automatically without needing to place anatomical landmarks on the participants’ feet before scanning (Jurca et al., Citation2019). We chose these measurements because they are the most relevant to netball-specific shoe design and have been commonly used in previous research (Krauss et al., Citation2008; Mickle et al., Citation2010; Wunderlich & Cavanagh, Citation2001). depicts the 10 measurements and the definition of each measurement. A quadratic Savitzky-Golay filter was applied to the scans to obtain accurate data (Savitzky & Golay, Citation1964). To verify the accuracy and reliability of the MATLAB code, we calculated the 10 measurements for a subset of scans (n = 6) using the code and generated renderings. These values were then compared to measurements we obtained directly from the participants’ feet using an anthropometer and measuring tape, and good concordance was found (ICC = 0.96–0.99). Ten measurements derived from one scan of each of the six participant’s right foot were then used for the analysis after we found intra-measurement reliability to be high for all variables (ICC = 0.94–0.98), excluding heel girth circumference (ICC = 0.51). This was due to the ankle angle adopted by each participant whilst being scanned between trials, which led to subtle changes to their heel girth circumference measurement. Furthermore, we then created foot length categories (i.e., 34–53 EU) according to the French Scaling System described by Blattner (Citation2003) to produce a standardised comparable unit (Blattner & Cityprint, Citation2003). No additional allowance space was included within the sizing system, as toe allowance space differs between shoe types, brands and manufacturers (Krauss et al., Citation2008).

Figure 1. The ten measurements and the definitions used to characterise the shape of each participant’s foot, adapted from (Jurca et al., Citation2019; Mickle et al., Citation2010).

Figure 1. The ten measurements and the definitions used to characterise the shape of each participant’s foot, adapted from (Jurca et al., Citation2019; Mickle et al., Citation2010).

2.4. Statistical analysis

Only data obtained for the right foot of each participant was included in the statistical analysis to meet the assumption of data independence (Menz et al., Citation2014). Previous research has found no statistically significant or practically relevant differences between the left and right feet of adolescents or adults (Xiong et al., Citation2009). Our preliminary analyses confirmed no significant within-subject differences between left and right foot measurements (p < 0.05). Wunderlich & Cavanagh (Citation2001) also reported that, for shoe design, an analysis of measures normalised to stature and foot length is warranted when comparing male and female feet (Wunderlich & Cavanagh, Citation2001). Thus, we normalised the foot measurements (excluding the first toe angle) to foot length (foot measurement/foot length) and stature (foot length and width/height*100) to enable us to compare values obtained for feet of different lengths (Mickle et al., Citation2010) and statures (Wunderlich & Cavanagh, Citation2001). We did not control for participant mass because mass did not have a strong positive correlation with any of the foot measurement variables. A series of independent t-tests were then used to identify any differences between men and women in the absolute foot measurements and the measurements normalised by height and foot length. The alpha level was set at p < 0.05, and all statistical analyses were conducted using IBM SPSS Statistics (Version 27.0, USA). A standard Bonferroni correction was used to account for the increasing likelihood of rejecting the null hypothesis with an increasing number of tests (Wunderlich & Cavanagh, Citation2001).

3. Results

illustrates the distribution of the male and female netball players according to their foot length in EU sizing. The most frequent foot size for men was EU 42, with sizes ranging from EU 37 to EU 53 (247.5 mm − 329.6 mm). For women, EU 39 was the most frequent foot size, with sizes ranging from EU 34 to EU 45 (228.2 mm − 297.7 mm). All foot measurements, except for the first toe angle, were significantly larger for the men than the women. As men had significantly longer feet (280.4 ± 14.4 mm vs 260.6 ± 12.2 mm; p < 0.001) than their female counterparts, we directly compared the absolute foot measurements of men and women whose foot lengths were the same; that is, EU 40 (263–270 mm) and EU 41 (271–276 mm). We selected these foot sizes because there were enough participants in each sex group to enable a valid statistical comparison between men and women (Krauss et al., Citation2008). The male measurements, excluding toe angle, were still larger than the female measurements, despite the two cohorts having the same foot length (see ). These differences between the men and women were significant (p < 0.001) in both sizes for foot width, heel width, instep height, ball circumference and instep circumference.

Figure 2. Distribution of foot length for the male (n = 251) and female (n = 251) netball players.

Figure 2. Distribution of foot length for the male (n = 251) and female (n = 251) netball players.

Table 1. Mean and standard deviations for the absolute foot measurements of the male and female netball players with a foot length of EU 40 and EU 41.

When the foot measurements, excluding angles, were normalised to foot length, men also had a significantly (p < 0.001) larger foot width, heel width, ball circumference and instep circumference compared to their female counterparts (see ). As male netball players were significantly taller than their female counterparts (p < 0.001), we normalised foot length and width by stature and found significant differences between men and women (p < 0.001; see ). Men had longer feet by approximately 0.24% of height and wider feet by 0.22% of height than women. For a male and female netball player, both 170 cm tall, the male netball player would have a foot approximately 4.1 mm longer and 3.7 mm wider than the female netball player (see ).

Figure 3. The estimated foot length (a) and foot width (b) normalised by stature for common participant heights −170 cm, 180 cm and 190 cm.

Figure 3. The estimated foot length (a) and foot width (b) normalised by stature for common participant heights −170 cm, 180 cm and 190 cm.

Table 2. Mean, standard deviations and p-values for the foot measurements, normalised by foot length of the male (n = 251) and female (n = 251) netball players.

Table 3. Foot length and width normalised by stature, grouped by sex.

4. Discussion

Over 20 million people across approximately 117 countries currently play netball (World Netball, Citation2023). Despite these high participation rates, there are limited footwear options for male netball players. Unfortunately, only one male netball shoe is available but it is a scaled-up version of the women’s netball-specific shoes. Consequently, a large proportion of netball players, particularly men, are dissatisfied with current netball-specific footwear and report a high prevalence of foot-related problems and pain. This is the first study to comprehensively compare the foot shape of male and female netball players to help inform recommendations to footwear manufacturers and researchers to help improve the fit and functionality of netball-specific footwear. The findings of our study identified the size and shape of the feet of male netball players differed significantly from their female counterparts. Specifically, male netball players had significantly larger absolute and normalised foot measurements than female netball players, notably at the ball of the foot, heel and instep. The practical implications of these findings for designing sex-specific netball shoes are discussed below.

Our study revealed that sex differences in foot shape exist in netball players. Men had larger values than women for all the foot measurements except for the first toe angle, even for the same foot length. We confirmed that when the measurements were normalised to either stature or foot length, the men’s feet still significantly differed from the women’s feet (see ). These results are similar to those recorded in U.S. Army personnel (Wunderlich & Cavanagh, Citation2001) and older adults (Mickle et al., Citation2010). When comparing differences in the foot shape of 293 men and 491 women from the U.S. Army, Wunderlich & Cavanagh (Citation2001) found men had longer and broader feet than women even when values were normalised to a common foot length of 257 mm (Wunderlich & Cavanagh, Citation2001). Specifically, women had a higher arch, a shallower first toe and a shorter ankle, outside ball of foot length and instep circumference than a man’s foot (Wunderlich & Cavanagh, Citation2001). When foot length and foot width were normalised to stature, for a man and woman of the same height, the man would have a foot that was approximately 5 mm longer and 2 mm wider than the woman (Wunderlich & Cavanagh, Citation2001). In older adults, Mickle et al. (Citation2010) also found that when normalised to foot length, the feet of men (n = 158; age: 71.1 ± 6.3 years) and women (n = 154; age: 71.7 ± 7.0 years) differed in several shape characteristics, particularly at the ball of the foot and at the first toe (Mickle et al., Citation2010). Mickle et al. (Citation2010) suggested that due to the longer medial ball of foot length exhibited by women in their study that the medial side of a women’s shoe should expand for the first metatarsal head at a more distal location than on a men’s shoe of the same length (Mickle et al., Citation2010). It is important, however, to acknowledge that foot shape differs with age. Age-related morphological changes to feet might explain why there are some differences between the results of our study and previous cohorts, whereby, in contrast to Mickle et al. (Citation2010), our female participants displayed lower instep heights than men. Irrespective of subtle between-study differences, given the sex differences in foot shape reported in our study and previous research, netball-specific shoes designed for women are unlikely to fit the feet of male netball players. Therefore, the results of this study provide practical evidence to support that the last design of men’s and women’s netball-specific footwear should reflect the differences in foot size and shape highlighted in this study.

4.1. Implications for netball-specific shoe design

Foot anthropometrics are a fundamental prerequisite for shoe design, whereby shoes should be based on the foot shape of the individuals who are likely to wear them (Krauss et al., Citation2010). Regarding foot length, our results revealed that female netball players’ shoe sizes ranged from EU 34 to EU 45, and male netball players’ shoe sizes ranged from EU 37 to EU 53. However, the largest netball-specific shoe size currently available to men is an EU 50.5 (US 15), suggesting that the available sizes do not cater for all men’s feet (ASICS Australia, Citation2023; Australia, Citation2023). This result may explain why previous research has found that the most common reason men are not wearing netball-specific footwear is due to a lack of available sizing (Kirk et al., Citation2023). This result is concerning as ill-fitting footwear has been previously shown to lead to pain, discomfort and foot-related problems (Branthwaite & Chockalingam, Citation2019). Therefore, the lack of appropriately sized shoes available to netball players could be causing improper fit and ultimately contributing to the 84.3% and 56.8% of netball players who reported suffering from foot-related problems and pain during their last netball season, respectively (Kirk et al., Citation2022). Thus, we recommend that netball-specific shoes, particularly those manufactured for men, are available in larger sizes to reflect the foot length of this cohort.

A central finding from this current study was that male netball players have significantly broader foot and heel widths than their female counterparts. For a given foot length, foot width varied up to 5.9 mm between men and women. Furthermore, the large standard deviations identified within each sex group suggests that a range of widths are required for each foot length (see ). Foot width can be classified as one of nine levels from AAA to EEE, of which the increment is about 4.8 mm (Cheskin, Citation2013). One width size cannot accommodate all male and female feet (Jeyeon et al., Citation2022). This finding is concerning, as netball-specific shoes available on the market today are only manufactured in two width sizes – “B – standard” or “D – wide”, with the one netball-specific shoe designed explicitly for men available only in standard width (ASICS Australia, Citation2023; Australia, Citation2023). In contrast, running shoes from the same brands as netball-specific shoes are offered in “AA – narrow”, “2E – wide”, and “4E – extra wide” sizes (ASICS Australia, Citation2023; Australia, Citation2023). This lack of shoe widths may explain why netball players have previously expressed dissatisfaction with the width fit of their shoes (Kirk et al., Citation2023a). Female netball players often complain that netball-specific shoes are too wide. In contrast, some netball players, particularly men who wear women’s netball-specific shoes, find their netball-specific shoes to be too narrow, specifically at the forefoot (Kirk et al., Citation2023a). Interestingly, Kirk et al. (Citation2023) have previously reported significant differences between male and female netball players in their level of satisfaction with the width fit of netball-specific footwear (Kirk et al., Citation2023a). That is, significantly more men were dissatisfied with the width fit of their netball-specific shoes (18.8% vs 6.6%, p < 0.001) (Kirk et al., Citation2023a). Given the variability in width sizes and dissatisfaction with the width fit of current netball-specific shoes, we recommend that a range of shoe models with varying widths, including narrow and extra wide options, be available to both male and female netball players.

Notably, the sex differences in foot length and width measurements identified between men and women do not imply that male netball players can simply wear a longer and broader version of female netball-specific shoes. As the male cohort had a unique distribution of foot dimensions, such as at the heel and instep, manufacturers should develop lengths and widths of netball-specific shoes exclusively for each sex and shoe size separately (Jeyeon et al., Citation2022; Krauss et al., Citation2010). Feet should be classified into different foot types and lasts should be created for each foot shape to ensure a proper fit for netball players (Krauss et al., Citation2008). For example, based on a foot index characterised by foot length and width, Jung et al. (Citation2001) classified three foot types; slender, normal and wide (Jung et al., Citation2001). Moreover, Krauss et al. (Citation2008) classified men’s and women’s feet into voluminous, flat and pointed (narrow) and slender groups (Krauss et al., Citation2008). Specifically, when participants were grouped into the same shoe size (EU 39), most of the women’s feet were flat and pointed (narrow) or slender, whereas most of the men’s feet were voluminous (Krauss et al., Citation2008). Further research to classify the shape of the feet of netball players into groups is required to better understand the range of shoe models needed to cater for each sex. Research using other methods, such as three-dimensional shape modelling that converts the foot models into last models, should also be used in the future. This method will help to compare the foot measurements of netball players to that of current netball-specific shoe lasts to determine whether their foot dimensions match the internal dimensions of the shoes. Doing so will help improve netball-specific footwear’s overall fit and functionality and minimise foot-related problems and pain associated with ill-fitting footwear.

4.2. Limitations

The foot measurements in this study may not fully represent the entire set of three-dimensional shape differences between men and women. Previous research has analysed up to 17 measurements per foot (Mickle et al., Citation2010). Thus, future studies should expand the measurements used to characterise the feet of netball players, focusing on areas identified as functionally important in this study. Other factors such as competition level, ethnicity, age and geographical location could potentially affect foot shape; these factors were not controlled for in this study. Thus future research should investigate age and ethnicity differences in netball player’s foot shape. We also only recruited representative netball players and future research needs to build on our findings by investigating the foot shape of recreational netball players. In addition, over half of the participants in this study were scanned following netball training sessions and games. Exercise can contribute to swelling and slight changes to foot morphology, with foot volume change dependent on the type of exercise undertaken by the individual (McWhorter et al., Citation2008), which could have affected the foot scans. Similarly, although we instructed the participants to distribute their body weight equally, subtle changes to their posture may have affected their foot morphology, particularly at the heel and ankle, while being scanned.

5. Conclusion

With the high prevalence of foot-related problems and pain in netball, researchers and footwear manufacturers must better understand the shape of netball players’ feet to improve the fit and functionality of current netball-specific shoes. This study revealed significant differences in male and female netball players’ absolute and normalised foot measurements. Men have significantly larger and broader feet than women, notably at the ball of the foot, heel and instep. Footwear manufacturers should prioritise developing unique lasts for netball-specific shoes for each sex and foot size. A more extensive range of shoe sizes and widths should also be considered to cater for more netball players’ feet. Such considerations will help optimise shoe fit and comfort and, in turn, reduce foot-related problems and pain associated with ill-fitting footwear.

Availability of data and material

All data generated or analysed during this study are included in this published article.

Consent

Tacit consent was obtained from all individual participants included in the study regarding participation in the study and publishing their data.

Ethics approval

The Ethics Committee (HREC 2019/326) approved all of the procedures for this study.

Supplemental material

Participant characteristics survey 311223.pdf

Download PDF (163.8 KB)

Acknowledgments

The first author was supported by an Australian Research Training Program Scholarship when undertaking her research. The authors thank all the participants who volunteered to participate in this study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Supplementary material

Supplemental data for this article can be accessed online https://doi.org/10.1080/02640414.2024.2338335.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.

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