Adolescent Football and Footwear Awareness: Association of Stud Configuration with Foot and Ankle Health Among Players Training on Artificial Turf

Abstract

Artificial turf is widely used in competitive football, yet players frequently train in boots designed for natural grass, creating a potentially important footwear–surface mismatch. This cross-sectional study examined associations of boot category and stud configuration with self-reported foot and ankle outcomes in 103 adolescent male football players training exclusively on artificial turf. Participants completed the Foot and Ankle Outcome Score (FAOS), and their routinely used boots were classified by two trained sports physiotherapists. Fifty-two players used artificial-turf (AT) boots and 51 used firm-ground (FG) boots. Overall FAOS was substantially higher in the AT group than in the FG group (85.4 ± 14.6 vs. 59.6 ± 24.1; mean difference 25.9, 95% CI 18.0–33.7; p < .001; Hedges’ g = 1.29), with consistently higher scores across all five domains. Exploratory analysis also showed higher overall FAOS among circular-stud than bladed-stud users (85.4 ± 14.6 vs. 64.5 ± 22.5; p < .001). Surface-appropriate AT-boot use was strongly associated with better foot and ankle symptoms, function, and quality of life. These findings support greater footwear–surface awareness while providing a clear rationale for prospective injury-surveillance and biomechanical studies.