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Background  High rates of musculoskeletal injuries such as plantar fasciitis and stress fractures have been observed among physically active military personnel. During service time, infantry soldiers use issued boots daily that should fit well and provide comfort to prevent injuries and decrease lower extremity pain effectively. The association of military boot comfort with overuse injuries remains unclear. This study investigates the relationship between the chosen military boot size, perceived boot comfort and lower leg overuse injury.    Methods  During the cross-sectional study, 227 (males, n = 213; females, n = 14) active-duty infantry soldiers at a mean age of 29.5 years old, and with an average service time of 7.2 years were assessed for a history of overuse injury, footprint length, appropriate shoe size, and footwear comfort. Males with a history of overuse injury (n = 32) and non-injured age-matched controls (n = 34) were selected for detailed testing and establishing the possible relationship between footwear comfort and lower leg overuse injury.    Results  No relationship was found between footwear comfort and a history of lower leg overuse injury.  N =  38 (57.6%) of study subjects were wearing an inappropriate shoe size daily. Inappropriate shoe size usage affected footwear comfort ratings significantly.    Conclusions  Study results showed that improper boot size was significantly related to comfort ratings but was not associated with a history of lower leg overuse injury.    Supplementary Information  The online version contains supplementary material available at 10.1186/s12891-021-04839-9.

Relationship of footwear comfort, selected size, and lower leg overuse injuries among infantry soldiers