Foot morphology, neuromuscular stability, performance, and injury risk: a multidimensional analysis in women football players

Background The neuromuscular stability and foot morphology are two critical biomechanical variables that can determine athletic performance and injury risk in football. Sex-specific characteristics (e.g., increased joint laxity and disrupted neuromuscular control) can also mediate these associations in female football athletes, but there is limited empirical evidence on this matter. Purpose To examine the correlation between foot arch morphology, neuromuscular stability, technical performance and regression-derived Injury Risk Index in university-level female football players and the cumulative predictive value of these factors. Methods Sixty-two female football players were evaluated in terms of foot structure using the Chippaux Smirak Index, neuromuscular stability using the YBalance Test, and performance using the measurement of kicking accuracy and maximal kicking distance. Regression modeling was used to build an injury risk index. The use of comparative analysis, correlation matrices, and multivariate regression would explain the relationship between variables. Findings The players with neutral arches showed better kicking performance, increased neuromuscular stability and lower scores on the theoretical Injury Risk Index derived from the regression model compared with those with flat or high arches. The foot measures were highly positively related to both the accuracy and distance measures, whereas the neuromuscular stability proved to be the strongest protective indicator of injury risk. Conclusion The combination of foot morphology and neuromuscular stability provides a multidimensional conceptual model of explaining performance dynamics and injury risk in female football athletes. These findings suggest the potential utility of specific screening guidelines and preventive measures to individualise performance and theoretical injury-related indices. However, prospective longitudinal studies incorporating actual injury surveillance are required before clinical application of screening or preventive strategies.