Effects of Soccer Cleat Stud Patterns Worn Versus Lower Extremity Injuries in the English Premier League

Background: Soccer has driven increased player physical demands, resulting in elevated levels of lower extremity injuries, especially among elite players. Purpose: To analyze the potential effects of soccer cleat stud patterns worn by players who sustained lower extremity injuries in the English Premier League (EPL). Study Design: Cohort study; Level of evidence, 3. Methods: Cleat models, 510 players, and 221 injuries were analyzed from the EPL 2021-2022 season. The injured player cohort was established using Transfermarkt.com, and cleat stud patterns—categorized as very aggressive (VA), mildly aggressive (MA), and nonaggressive (NA)— were obtained from footballbootsdb.com, product websites, and online reviews. Odds ratios (ORs) and 95% CIs were used to assess the risk of lower extremity injury. Poisson regression, multinomial linear regression, chi-square tests, and t tests were used to assess the relationships between age, position, cleat type, and injuries. Results: VA stud patterns had significantly higher injury odds compared with other models (OR_VA, 1.362 [95% CI, 1.008-1.842]; P = .023), while MA stud patterns had significantly lower injury odds (OR_MA, 0.579 [95% CI, 0.352-0.952]; P = .016). NA stud patterns were not significantly associated with the odds of injury. Cleat type and player position together were significantly associated with differences in observed versus expected injuries (χ² = 37.89; P < .0001; df = 6). Players aged between 23 and 30 years had a significantly higher incidence of injury compared with players aged 18 to 22 years (β_{23-26-year-olds} = 0.4205; P = .03; β_{27-30-year-olds} = 0.5199; P = .006). Conclusions: EPL players wearing VA stud patterns may have a higher risk of lower extremity injuries compared with those with MA or NA patterns. Older age and player position, combined with cleat type, were associated with increased risk of injury.