[pct-l] Boots and ankle sprains

Tue Mar 1 16:36:05 CST 2011

Dear Ellen

There is a practical study.
There is no difference between boots and shoes concerning injury.

Wilderness Environ Med. 2009 Fall;20(3):250-6.
The impact of footwear and packweight on injury and illness among
long-distance hikers.
Anderson LS Jr, Rebholz CM, White LF, Mitchell P, Curcio EP 3rd,
Feldman JA, Kahn JH.

Boston Medical Center, Department of Emergency Medicine, Boston,
Massachusetts, USA. andersonstew at gmail.com
Comment in:

Wilderness Environ Med. 2010 Jun;21(2):178-9; author reply 179.
Abstract
OBJECTIVE: To determine the prevalence and predictors of injury and
illness among long-distance hikers.

METHODS: This was a cross-sectional study of long-distance hikers (>
500 miles [805 km]) along the Appalachian Trail and Pacific Crest
Trails between August and October of 2006. An 8-page survey instrument
was made available to hikers at a designated station near the northern
terminus of the respective trails. The survey questions were yes/no or
multiple choice. Independent variables included packweight, footwear,
and type and frequency of water purification. chi(2) tests to compare
categorical data and the Cochran-Armitage test for trend were used (P
< .05 significant). We used logistic regression to compare the
variables concurrently, and significance was determined using
likelihood ratio tests. Profile likelihood confidence intervals for
the odds ratios are reported.

RESULTS: Of the 128 hikers completing surveys that met inclusion
criteria, the mean age was 33 years (range = 18-65 years), 94% walked
>1500 miles (2400 km), and 70% were male. Using univariate analysis,
trends were noted in the proportion of hikers reporting paresthesias
and increasing packweight (35% with 10-20 pound [4.5-9 kg] packs, 50%
with 21-30 pound [9.5-13.5 kg] packs, and 69% with >31 pound [14 kg]
packs [P < .002]), as well as in the proportion of hikers reporting
paresthesias and increasing footwear rigidity (29% sandals, 36%
running shoes, 42% hiking shoes, and 68% hiking boots [P < .001]). In
multivariate analysis compared to sandals, the odds ratio of suffering
from paresthesias with running shoes was 1.57 (95% CI 0.3, 12.2),
hiking shoes 1.73 (95% CI 0.3, 13.9), and hiking boots 3.9 (95% CI
0.7, 32.1) (P = .16). Compared to 10 to 20 pound (4.5-9 kg) packs, the
odds ratios of suffering from paresthesias with 21 to 30 pound
(9.5-13.5 kg) packs was 1.5 (95% CI 0.6, 3.9), and for > 31 pounds (14
kg) was 2.2 (CI 0.7, 7.1) (P = .03). Adjusting for footwear and pack
weight, only pack weight was significantly associated with
paresthesias. Packweight and footwear were not significantly
associated with other musculoskeletal injuries, such as joint sprains
or chronic pain, and muscle injuries.

CONCLUSIONS: There is an association between packweight and the
prevalence of paresthesias among long-distance hikers. The association
between type of footwear and the prevalence of paresthesias is
significant when analyzed independently, but loses its significance
when the variables are examined together. This suggests that there is
confounding between footwear and packweight.

2011/3/2 Ellen Shopes <igellenig at gmail.com>:
> OK, I'll bite on the 'boots don't really prevent ankle sprains'.
> Obviously, the stiffer the boot and the higher it goes, the less likely one
> is to sprain an ankle.  At one extreme would be a downhill ski boot, so
> stiff that one breaks the tib/fib rather than spraining the ankle.  At the
> other extreme, a sneaker or trail runner that offers NO support.  Boots,
> while not preventing all injuries, will fall in between the 2.  They do help
> some.
> For years I wore running shoes on the trails at Grand Canyon.  What I
> noticed was the development of a neuroma from foot impact, which I
> attributed to the thinner soles that offerred less protection.
> I am sceptical of the whole barefoot arguement.  I've seen a lot of bare
> feet in 3rd world countries and they are not pretty.  The altered walking
> technique might have caused fewer knee or hip injuries, but it was at the
> sacrifice of their foot health.
> I would be interested in seeing any study that actually compares the
> incidence of problems between shoe/boot.  Not a theoretical comparison of
> the physics and physiology of walking.
> The important thing is to find a shoe/boot that works for you.
> Elderly Ellen
> _______________________________________________
> Pct-L mailing list
> Pct-L at backcountry.net
> To unsubcribe, or change options visit:
> http://mailman.backcountry.net/mailman/listinfo/pct-l
>
> List Archives:
> http://mailman.backcountry.net/pipermail/pct-l/
>

-- 
Sincerely
--------------- --------------------------------------
Hiro    ( Yoshihiro Murakami )
Blogs http://completewalker.blogspot.com/
Photo http://picasaweb.google.co.jp/CompleteWalker/
Backpacking since about 1980 in Japan
2009 JMT, the first America.
2010 JMT, the second America.
------------------------------------------------------