Objective Foot injuries cause a significant absence from training and playing in the English rugby premiership. Pressure analysis gives information on how load is distributed, to give clinically relevant information this must be carried out in sports specific tasks. The aim of this study was to identify peak areas of pressure in the foot during three different positions related to the rugby scrum and their association to lower limb kinematics or stud formation.

Methods Twenty-four male athletes were recruited from an English Premiership Rugby Club. An inner sole was inserted into the rugby boot to collect information on plantar pressure, the foot was divided into eight sections which were used to determine loading patterns. Three positions considered to be functionally relevant were studied, standing, engaged with a scrum machine and maximally pushing against the scrum machine. The Foot Posture Index, the weight bearing lunge test, first metatarsal extension and the number of studs were assessed.

Results The medial forefoot showed the greatest load in the engaged and push positions (p<0.05). Foot Posture Index was negatively correlated to forefoot pressures in standing (p<0.05). Increase range of weight bearing lunge allowed for greater posterior lateral plantar loading during pushing (p<0.05). Stud number was positively correlated to medial plantar pressure in standing and pushing (p<0.05).

Conclusion The substantial load on the medial forefoot in the rugby scrum suggests potential mechanisms for metatarsalphalangeal injury. Stud placement, foot posture index and range of weight bearing lunge can all influence plantar pressure. Future research should investigate mechanisms to reduce load in peak regions during the rugby scrum.