“One of the reasons I was not able to collect pressure data for the full cohort of military recruits in previous projects is because it would have taken too long. With Footscan 9, I can collect the information of one person in less than three minutes. Now, we can collect data from up to 60 recruits in two-and-a-half to three hours on a regular basis. I wouldn't have managed a fraction of that with the old system."

 

Naturally, being user-friendly is just one requirement for software like this. It also needs to provide results that can be acted upon and corroborated. For Dr. Dixon, Footscan has proven to be as effective in the field as it is in the classroom, particularly in the case of her research with the Royal Marines. In 2011, she began to use Footscan in research projects demonstrating aspects of barefoot pressure data that were predictive of lower limb stress fracture risk. These results have helped to support changes in footwear and have provided evidence to support later research.

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“Between 2010 and 2012, metatarsal stress fractures were the main problem, and we found that high forefoot pressure increased risk of this injury. But since then, the footwear has changed, and the new boot seems to protect against this injury by lowering the localised load on the forefoot. So we can say, look, we’ve demonstrated this, and so we can provide an explanation for the reduction in this injury.” Those findings laid the groundwork for the project she began in 2018, collecting data from the roughly 800 soldiers who begin training each year. “The medical team is very much on board with trying to utilise this information,” she tells us. “This is only possible with the evidence base we have developed over many years. “They say, OK, you’ve provided us with evidence that these measures have been linked with increased risk, so let’s collect data for everyone that starts the program. Now we routinely collect barefoot walking and running pressure data at the start of Royal Marine training.”

 

With a sizeable evidence base taken from a conveniently homogenous group — a researcher’s dream from a scientific point of view — Dr. Dixon began to identify patterns, particularly with the number of tibial stress fractures or other overuse injuries and the potential relationship with pressure patterns. And while she says that much more data is required to confidently act in a preventative manner, previous studies have shown that the potential to do so is there.

 

While it may be some time before this latest round of data can inspire preventative change, the Royal Marines are already benefitting when it comes to recovering from injury. “What's really been nice is by doing this collection and working with the clinical team, we've found that this information can support treatment and rehabilitation. So, in addition to using research evidence, we've found that having baseline measurements when they start training has been really useful from a rehabilitation perspective. “So knowing what this person's foot strike and pressure pattern looked like before they were injured can be used to know what we're trying to get back to, or to identify possible factors influencing the injury occurrence. It's there straight away, as long as you've created that baseline data.”