El pie en el fútbol I: Elegir bien la bota ayuda a prevenir lesiones

Al fútbol se juega con la cabeza… y con los pies. Si para cualquier deportista los pies son una parte importantísima, en el caso del fútbol lo es todavía más ya que además de los gestos normales del desplazamiento (aceleraciones, frenadas, cambios de dirección, etc.), se da la circunstancia de que gracias a los pies el jugador conduce y dispara el balón precisando de una gran coordinación.

En este artículo hablaremos de la importancia de la bota de fútbol y cómo elegirla, de patologías frecuentes en este deporte como el Hallux limitus y la fascitis plantar, de las peculiaridades del futbol femenino en cuanto a la biomecánica, de cómo la tecnología puede prevenir lesiones, etc.

ELEGIR BIEN LA BOTA DE FÚTBOL PREVIENE LESIONES

La bota de fútbol es el principal agente externo que agrede al pie del futbolista. Hemos de entender que es un calzado que suele tener una horma bastante estrecha (cuando a veces los pies de los futbolistas son anchos) y además incorpora en la parte de debajo de la suela una serie de tacos que en función de su distribución, forma y tamaño pueden incidir de una u otra forma en el pie.

Respecto al hecho de jugar en césped natural o artificial no hay una relación directa con las lesiones, aunque habitualmente se han vinculado más al césped artificial (sin tener evidencia científica de ello). Lo que genera habitualmente las lesiones a este respecto es la mala adecuación entre la superficie de juego y la bota que estamos usando. Si jugamos en un césped artificial con una bota diseñada para jugar en césped natural, las posibilidades de sufrir una lesión de ligamento cruzado o de menisco aumentan significativamente ya que se puede dar el caso de que la bota se clave en el césped y al realizar el giro no se libere del terreno quedando la bota en una dirección y la rodilla en otra.

Cada tipo de bota está pensada para una superficie distinta de césped, no siendo válida la bota pensada para jugar en césped natural para jugar en césped artificial.

Incluso dentro del césped artificial, dependiendo de la calidad del mismo, habrá que elegir un modelo u otro de bota.

 

Si hablamos de césped artificial (que cada vez es más frecuente sobre todo en fútbol infantil) y de  cara a poder ayudar en la elección de la bota a los padres es importante tener el criterio de que cuanto peor calidad sea el césped, mayor número de tacos y más bajos necesitaremos para evitar lesiones.

 

Si hablamos de un césped tipo “moqueta”, de los que no tienen sustrato por debajo, se debe de jugar con una bota de futbol con suela tipo “turf”. Se trata de una suela que ni siquiera presenta tacos como tal sino que lo que tiene es una especie de rugosidades o surcos transversales. Este tipo de suela se agarra menos al suelo pero previene el mecanismo de lesión por torsión que comentábamos antes.

Si estamos jugando en una superficie de césped artificial de calidad media, lo ideal es usar una suela multitaco(muchos tacos pequeños) y si jugamos en un césped artificial de última generación podemos jugar con botas con menor número de tacos y mayor tamaño, pero siempre que sean botas para uso en césped artificial (es decir que siempre tendrán un número de tacos mayor que las que se aconsejan para césped natural).

 

Si un niño juega en césped de diferentes calidades debería de disponer de botas distintas para cada caso. En caso de elegir una única bota para jugar en todos los campos debemos de decidirnos por una bota que sea la indicada para la peor de las superficies en las que vaya a jugar (ante la duda, de muchos tacos pequeños).

Las botas con tacos de aluminio o mixtas deben de estar reservadas para jugar en césped natural que cuente con el mantenimiento adecuado.

Tanto el campo de césped artificial como el natural precisa de un mantenimiento importante para mantener las propiedades adecuadas en cuanto a amortiguación y agarre, manteniendo un equilibrio adecuado entre ambas.

Que parámetros hemos de evaluar en una bota para prevenir lesiones

1- Adecuación de la horma de la bota al pie del futbolista.

Es muy importante que el tamaño de la bota se ajuste al tamaño del pie. Esto que parece una cosa obvia es motivo de algunas lesiones (sobre todo del quinto metatarsiano) ya que puede darse la circunstancia de que el quinto metatarsiano (hueso que está en el lateral externo del pie)  quede fuera del apoyo estable de la horma de la bota y se generen momentos de tensión que pueden acabar en fractura.

Si el pie es muy ancho es necesario realizar una plantilla personalizada en un material con la consistencia necesaria para aumentar la superficie de apoyo plantar.

El hecho de que el jugador esté usando una horma demasiado ajustada para su pie también puede generar problemas en el dorso del pie y los dedos, así como en los laterales.

Es muy importante valorar la “altura de pala”. Esto es el espacio con el que cuenta la horma en la zona de los dedos. Tenemos que entender que cuando caminamos o corremos los dedos no se quedan paralelos al suelo sino que se dorsiflexionan (suben hacia arriba). Este es un mecanismo natural y necesario llamado mecanismo de Windlas. Si la altura de pala es muy baja impide este movimiento natural y puede provocar problemas como fascitis plantar y sobrecargas musculares así como lesiones en las uñas por traumatismo de repetición.

Una solución que hemos implementado para estos casos recientemente es la generación de una horma personalizada que nos permita “domar” la bota al pie antes de que la use el jugador. El proceso para la realización de esa horma es escanear tanto el pie del futbolista como la bota y diseñar en el departamento de ingeniería una horma personaliza que se imprime en 3D para dicha bota. Esto que a priori puede parecer un remedio exclusivo para futbolistas profesionales, puede ser una muy buena solución para cualquier aficionado al que le cueste mucho adaptarse a una bota nueva.  El coste de una de estas hormas es de unos 150€ y tiene una duración muy larga en el tiempo por lo que puede ser una interesante inversión en salud.

2- Análisis de la estabilidad de la suela. Este es uno de los puntos más importantes.

Hay una maniobra muy sencilla que consiste en sujetar la bota con las dos manos, como aparece en la fotografía y realizar una fuerza de compresión hasta que flexe la bota. Si la bota es correcta deberá de doblarse por la zona metatarsal (justo por donde nacen los dedos del pie). Si la bota se dobla por la mitad de la suela no la consideraremos una bota adecuada y genera un alto riesgo de fractura de quinto metatarsiano por estrés.

3- Tamaño y posición de los tacos.

La longitud tanto de los huesos metatarsales como de los propios dedos del pie es distinta entre distintos jugadores. Puede darse la circunstancia de que una determinada distribución de tacos sea adecuada para un jugador y dañina para otro.Si el taco coincide justo debajo de las articulaciones metatarsales (detrás de los dedos) puede generar una mayor carga en dichas estructuras produciendo dolor en inflamación a corto plazo y procesos artrósicos a medio y largo plazo.

Si después de comenzar a usar una bota comienza a aparecer un dolor selectivo en una articulación metatarsal, debemos de dejar de usar la bota cuanto antes y analizar la posición del taco. Una prueba válida para esto es hacer una radiografía lateral del pie con la bota puesta en la que podremos valorar si el problema puede venir por la posición del taco.

Los que tenemos la suerte de trabajar con futbolistas de élite podemos hablar con las casas comerciales y realizar una distribución de tacos a medida. Para todo el resto de jugadores de fútbol lo que aconsejamos es cambiar de bota hasta encontrar una distribución de tacos que no genere molestias.

Respecto a la forma de los tacos sigue habiendo defensores  y detractores de los tacos redondos y los laminados. Habitualmente el argumento de quien defiende el taco redondo suele ser que al ser circular es más fácil realizar el movimiento de “pivotación” o sea de rotación cuando gira el pie sobre el campo. Este argumento sólo sería válido si la bota contase sólo con un único taco en la parte anterior de la bota. En el momento que contamos con 4 o más tacos, este argumento deja de tener sentido ya que si la bota se clava en el suelo mediante cuatro puntos, esa pivotación ya no es efectiva.

Se supone que la aparición de los tacos laminados era entre otras cuestiones porque facilitaban la salida del terreno ante una rotación importante (intentando evitar el mecanismo lesional de que se quede el pie en una dirección y la rodilla en otro).

Las marcas innovan permanentemente cambiando la forma, situación y tamaño de los tacos.

Mi consejo es que cuando el jugador encuentra una disposición de tacos y modelo de bota en la que se siente cómodo, intente realizar los menos cambios posibles. Es verdad que a veces resulta imposible mantener la distribución de tacos porque las marcas dejan de fabricar determinados modelos. El problema fundamental  en mi opinión es que a veces prima más la estética que la salud por lo que hemos de intentar no basar la compra de la bota en la moda o en que la use uno u otro jugador profesional sino en la que realmente nos va bien.

Son pocos los modelos de botas que perduran en el tiempo. Un caso muy representativo es la “Copa Mundial” de Adidas. Una bota que estéticamente no es de las más atractivas pero que se ha mantenido desde hace muchos años porque sigue habiendo un gran número de futbolistas que se sienten cómodos con ella. Tiene una horma razonable, una distribución de tacos lógica y se fabrica en piel (lo que mejora bastante tanto la trasnpiración como la capacidad de adaptación al pie).

Es importante conocer las peculiaridades del pie de cada futbolista  ya que datos como por ejemplo la longitud de nuestros metatarsianos son determinantes a la hora de elegir una distribución de tacos u otra. Si por ejemplo el tamaño del quinto metatarsiano es sustancialmente más corto, esto hace la que quinta cabeza metatarsal esté mucho más retrasada y en una distribución de tacos “normal”, un taco coincida justo debajo de la articulación y nos genere un problema.

Como siempre aconsejamos acudir a un podólogo deportivo que esté especializado en fútbol y pueda asesorarnos sobre el tipo de horma, distribución de tacos, etc. De una forma tan sencilla como elegir bien la bota de fútbol, estaremos previniendo un número importante de lesiones.

 

Víctor Alfaro

Podólogo experto en Biomecánica

Responsable podología Real Madrid CF

Director General Podoactiva

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