Rugby World Cup: how an orthotist guides rugby players to the right boots, insoles and care for their prized feet
The 2019 Rugby World Cup knockout stages are here, with the world’s best teams battling it out for international glory.
Mr Nick Gallogly is a consultant orthotist who works with five premiership rugby teams, two Pro14 teams and currently has 19 players across nine nations competing in Japan.
We sat down with him to get an insight into what it is like to work with elite players, his role in the prescription of custom orthotics and boots in the prevention of injuries, and the management of those that crop up throughout the season.
Players have an amazing level of skill and raw talent to compete at that level. Professional athletes also have an incredible work ethic and attention to detail in everything they do. They work extremely hard to get where they are in the game and rarely have a day off.
All of these factors combined, along with years of coaching and experience in all aspects of the game, are often key ingredients for long-term success.
The trends in the type of injuries are surprisingly common across all levels of the game. Professional players are not immune to injuries, nor are they physically perfect.
Whatever level you play at, there are certain things you should watch out for.
Conditions such as ‘turf toe’ and syndesmosis (high ankle sprain), along with other ‘lower-limb’ injuries, are common across all levels of the game. As a contact sport, it’s not surprising that injuries from tackles and impacts with other players are a regular occurrence and to a large degree cannot be avoided.
My role is to work with the medical teams to help athletes prevent potential injuries related to their footwear and prescribe solutions to help manage them when they occur. I was an on-call orthotist at the 2015 Rugby World Cup and feel privileged to be involved with a large number of the players in Japan.
Preparations for all teams begin in pre-season, but as most of the players have been away in camp with their respective countries over the summer, it was important to make sure the players were up and running well before the start of the summer.
I meet with players individually to assess their history of injuries and the mechanics of their movement. This allows me to understand the reasons why they might be more susceptible to injury and then liaise with the medical team on what I feel might be the best course of action in relation to their foot and ankle issue.
Sometimes this will involve the prescription of custom orthotics and advice on the types of boots that might be better suited to them. Other times it will be reassurance that they are doing all the right things and there is nothing for me to do. Professional rugby players are very fortunate to have fantastic background support with a day-to-day team of physios and soft tissue therapists, and this is an influencing factor on their ability to play with on-going niggles.
If an injury occurs, I work closely with the orthopaedic surgeon treating the player and the medical team to ensure they are supported throughout their rehabilitation and they have the correct orthotic in place when they return to the field.
My advice would be to pay attention to any niggling injuries you have. Being specific to rugby, if you have pain in the big toe, or if you feel you need to tape your ankles for support, these are signs you should be seeking some advice from a physio initially and if required, an appointment with me.
You always want your preparation and training to be the best it can be. Core and lower-limb strengthening is invaluable for a lot of amateur players and a physiotherapist can personalise a treatment plan for you. Ultimately, if a minor injury progresses into something more serious then it is going to keep you away from playing the game you love for longer.
The short answer is, it depends.
The first thing to note is that not all professional rugby players wear rugby boots. They want different things depending on their position, so they may actually opt to wear football boots. Quite often, it’s simply down to player preference on the design and fit of the boot they choose.
Full backs and wingers sometimes choose football boots for speed, as they tend to have slightly more flexibility compared to rugby boots. Forwards tend to like stiffer and wider rugby boots.
Another factor for professional players is often the sponsor they have. They may have worn a particular type of boot for many years. If it is comfortable and works for them, it’s unlikely they’ll want to make regular changes. I work with players ensuring they have an orthotic device that fits comfortably within the boot they choose to use.
Trying on a boot that is your standard shoe size is a good place to start.
One trend I’ve noticed, which is perhaps more common in professional football players, is the tendency to wear boots that are a size too small. The idea is this will offer greater feel and feedback while playing, but I wouldn’t recommend doing this.
Instead, I would trust your gut instinct when trying on boots. If boots feel too small, then they probably are. If they feel too narrow, then you should probably try something else. This may sound condescending and obvious, but I see boots chosen regularly for appearance and not fit.
As a general rule, make sure you have at least ½ cm space at the end of the boot. Also make sure you are wearing the right type of studs for the surface you’re playing on and don’t wait too long before getting a new pair. Boots that are two years old are unlikely to be in the best condition to support you and you should be considering a replacement at this stage.
It’s very important, and an area both myself and players’ medical teams focus on for both rugby and football. Out of the boots and in day-to-day footwear is where I can do the most for them, as I do not have to contend with a lack of space inside the boots.
Certain types of footwear are “blacklisted” for players depending on their injury history. For example, those with achillies issues will be swayed against flat footwear and encouraged to ensure their trainers have a small heel. Players will in general take this advice on board because they treat their injuries with professionalism and the more they comply with rehab, the greater chance there is to a quick return to play.
Absolutely. I work with players at all levels of the game, from elite athletes to sports enthusiasts who aren’t sure why they’re suddenly getting foot or ankle pain. At Circle, I work with adults (including young people over 16) and those with neurological conditions, such as people who have had a stroke or diagnosis of MS.
I look at things from an engineering perspective. My role is to help you get from A to B with the least amount of effort, but with the maximum amount of output. If you need orthotics, I will prescribe these specifically for you to give you the best chance of reducing your foot pain and I will always work closely with other professionals involved in your treatment. I work with a fantastic team of physiotherapists and orthopaedic consultants, so we cover a wide range of treatment options to help you.