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

Background: Footwear 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.

Objective: The 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.

Methods: To potentially reduce injuries and improve comfort, 112 band members received shoes with an advertised increase in cushioning and ventilation.

Results: Injury 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 (OR(Ceremonial unit/other units) = 8.6), 95% confidence interval (CI): 1.2-60.2), shoe cushioning rating (OR(poor/good) = 11.8, 95% CI: 1.5-89.7), orthotic use (OR(yes/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).

Conclusions: The 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.