Effect of toe box space on metatarsal stress and lower limb biomechanics: insights from an integrated finite element model

During stop-jumping landings, variations in toe box space (TBS) may influence lower limb movement strategies. This study aimed to investigate the effects of TBS on metatarsal (MT) stress distribution and lower limb biomechanics. Twenty-eight basketball players participated, wearing tight-fitting (TF) and loose-fitting (LF) shoes. An integrated foot-ankle-shoe-knee finite element model (FEM) was established to obtain MT1−MT5 stress. The peak metatarsophalangeal joint dorsiflexion angle (PMDA) was measured and its relationships with peak MT stress and 13 ankle and knee parameters were analyzed. TF shoes significantly restricted metatarsophalangeal joint (MPJ) dorsiflexion (P < 0.001), and PMDA was correlated with all variables except peak ankle inversion angle (PAIA) (R2 = 0.209). MT stress was more concentrated in the central region. These findings suggest that restricted TBS limits MPJ mobility, and lower PMDA is linked to central MT2 stress distribution and compensatory loading at proximal joints, potentially increasing injury risk. This study provides biomechanical insights for basketball shoe selection and injury prevention in high-impact sports.