Insights on Biomechanics and Sport-Related Injuries in Fencing

Fencing is an ever-growing, high-intensity sport involving asymmetric stances with rapid dynamic movements, resulting in high-impact forces to the musculoskeletal system. These forces most commonly affect the lower extremity, which can then lead to injury. Understanding the mechanisms of these injuries, the importance of biomechanics, and the equipment involved can lead to effective treatment, and ultimately, prevent injuries in our patients.

Fencing involves a constant series of dynamic foot movements during competition. These movements are called advance, retreat, and lunging maneuvers. The advance is a step forward, pushing off the support leg, driving the opposite leg forward, and landing on the heel. The retreat is a step backward, pushing back from the lunge leg and retreating the support leg. The lunge involves attacking the opponent by kicking the front foot forward, extending the front leg from the knee, and moving the body forward by pushing off from the rear leg. The lunge maneuver itself requires greater joint motion and force output to perform, relying on propulsive force from ankle plantarflexors along with hip and knee extensors.¹

In addition to relying on force from the leg muscles, a significant amount of impact force transfers through the plantar foot. Trautmann and colleagues examined plantar pressure patterns during these 3 fencing moves in 29 experienced fencers.² They found that during the lunge and advance, the highest peak pressures were in the heel and hallux, and during retreat, the highest peak pressures were in the forefoot and hallux. An understanding of the characteristic loading patterns during different phases of competition can help identify areas of the foot that will require additional support to avoid excessive plantar pressures and strain, leading to injury.

What You Should Know About Fencing Shoe Gear

Footwear used during fencing is designed to protect the athlete’s foot during competition while also providing stability and grip on the piste, or fencing strip. Fencing shoes traditionally have a thin outsole with limited insole cushioning. Sinclair and colleagues examined 19 male fencers in traditional running and squash shoes versus fencing shoes and measured axial accelerations at the tibia.³ They found that the peak axial tibial shock was significantly lower in the running and squash shoes versus the fencing shoes. These reduced shock absorptive properties of the shoe gear may predispose fencers to overuse injuries.

However, according to a study by Geil, most fencers prefer this type of shoe to have a better “feel” of the fencing piste despite the reduced cushioning resulting in higher plantar pressures in the foot.⁴ The study also noted that increased cushion in the sole could lead to slower movement in the feet, which can in turn contribute to diminished velocity in the weapon hand. Fencing does require frequent movements such as the lunge, and shoe gear must allow for this along with providing adequate traction and stability.

Lin and colleagues examined shock absorption and rebound capacities of fencing shoes in a jump down test.⁵ They found that by adding an extra silicone heel support gasket, it provided for statistically significant shock absorption.

Along with shoe gear, the type of piste surface may also have an effect on overuse injuries. Greenhalgh and colleagues examined different surfaces typically used on the piste and the effect on tibial impact shock.⁶ They found that a sprung court surface reduces the magnitude of impact shock. Due to the high impact nature of the sport in regard to the lower extremity, proper shoe gear and competition surface are imperative to prevent overuse injuries.

What You Should Know About Common Fencing Injuries

Contrary to what one might think, fencing-related injuries are more commonly related to overuse and less commonly due to trauma. The asymmetrical stance required in fencing places an increased mechanical strain on the musculoskeletal structures.¹

Over a 5-year span, the United States Fencing Association recorded time loss injuries that occurred during a fencing match that were not related to an underlying condition, which forced the athlete to withdraw from competition.⁷ Out of 78,223 competitors over this span, 184 time loss injuries were recorded, for an overall injury rate of 0.3 per 1000. Fifty-two percent of all injuries were first- or second-degree sprains or strains, most commonly affecting the lower extremity (62% of all injuries). Penetrating wounds only accounted for about 2% of injuries.

Interestingly, the first metatarsophalangeal joint (MTPJ), particularly the sesamoids, seems to be a highly vulnerable and injury-prone location in fencers. A 2022 study by Lu and colleagues used computed tomography (CT) images from 10 elite fencers to construct finite element models to simulate stress distribution changes at the first MTPJ and ankle joint during lunging to examine foot and ankle structural injuries.⁸ The authors found that stress distributions at the sesamoids may contribute to the increased incidence of sesamoid fractures and injuries in fencers (11 fractures at the sesamoid from 7 participants), and with the sesamoids’ effect on the flexor hallucis longus (FHL) and flexor hallucis brevis (FHB), this may weaken the windlass mechanism. These sports injuries can be asymptomatic; however, damaged structures can leave the athlete more susceptible to further, more serious injury.

In Conclusion

In patients who present with fencing-related injuries to the lower extremity, in addition to treating the injury, one must fully appreciate all aspects of this intensive sport. If injury patterns correspond to specific maneuvers in the competition where peak pressures are encountered such as in the advance, retreat or lunge, one must consider the shoe gear and should employ proper padding or cushioning to prevent future injury. Athletes with chronic sport related injuries must also ensure adequate competition surfaces to reduce the strain and impact of force on the lower extremity.

Dr. David Haley is president of the Foot Care Group, PA with locations in Wilmington and Middletown, DE. In addition, Dr. Haley is Section Chief of Podiatric Surgery at Christiana Care Health System along with being an active teaching attending for the Podiatric Surgical Residency. He is board certified in Podiatric Surgery, Podiatric Sports Medicine and Podiatric Pediatrics. He is a Fellow of the American College of Foot & Ankle Surgeons, Fellow of the American Society of Podiatric Surgeons, Fellow of the American College of Podiatric Sport Medicine and a member of the American College of Foot & Ankle Pediatrics.

Dr. Kyle Wachala is a second-year resident (PGY-2) at Christiana Care Health System in Delaware.

References

1. Chen TL, Wong DW, Wang Y, Ren S, Yan F, Zhang M. Biomechanics of fencing sport: A scoping review. PLoS One. 2017;12(2):e0171578. Published 2017 Feb 10. doi:10.1371/journal.pone.0171578
2. Trautmann C, Martinelli N, Rosenbaum D. Foot loading characteristics during three fencing-specific movements. J Sports Sci. 2011;29(15):1585-1592. doi:10.1080/02640414.2011.605458
3. Sinclair J, Bottoms L, Taylor K, Greenhalgh A. Tibial shock measured during the fencing lunge: the influence of footwear. Sports Biomech. 2010;9(2):65-71. doi:10.1080/14763141.2010.491161
4. Geil MD. The role of footwear on kinematics and plantar foot pressure in fencing. J Appl Biomech. 2002; 18(2):155–162. https://doi.org/10.1123/jab.18.2.155
5. Lin CY. Human body dynamics detection of shock absorption and rebound ability of specialized athletic shoes. J Adv Computational Intelligence Intelligent Informatics. 2020; 24(3):293–298. https://doi.org/10.20965/jaciii.2020.p0293
6. Greenhalgh A, Bottoms L, Sinclair J. Influence of surface on impact shock experienced during a fencing lunge. J Appl Biomech. 2013;29(4):463-467. doi:10.1123/jab.29.4.463
7. Harmer PA. Incidence and characteristics of time-loss injuries in competitive fencing: a prospective, 5-year study of national competitions. Clin J Sport Med. 2008;18(2):137-142. doi:10.1097/JSM.0b013e318161548d
8. Lu C, Fan Y, Yu G, Chen H, Sinclair J, Fan Y. Asymptomatic foot and ankle structural injuries: a 3D imaging and finite element analysis of elite fencers. BMC Sports Sci Med Rehabil. 2022;14(1):50. Published 2022 Mar 27. doi:10.1186/s13102-022-00444-y