Acute Effects of Forefoot Wedges on Concentric Power Output During Loaded Back Squats in Elite Female Handball Players: A Randomized Crossover Study

The foot’s windlass mechanism (WM), engaged by hallux dorsiflexion, is a key determinant of lower-limb propulsive efficiency in explosive sports. This randomized within-subjects crossover study examined whether forefoot wedges of varying angulation, intended to facilitate the windlass mechanism, with or without real-time visual biofeedback, modify concentric power output during loaded back squats in elite female handball players. Seventeen professional athletes performed 3 × 3 back squats at 65% one-repetition maximum under six randomized conditions: three wedge angles (0°, 10°, and 30°) × biofeedback (present or absent). Peak concentric power (W) was the primary outcome; secondary outcomes included relative peak power (W·kg−1), concentric force (N), and concentric velocity (m·s−1), all recorded using dual force plates. The pre-specified two-way (3 × 2) repeated-measures ANOVA showed no significant main effects of wedge angle or biofeedback and no significant interaction for peak concentric power (all p > 0.05). A complementary exploratory Friedman analysis indicated an overall condition effect (χ2 = 14.01, p = 0.016; Kendall’s W = 0.165), with the highest descriptive values observed for the 30° wedge without biofeedback. However, pairwise comparisons did not remain significant after correction and did not isolate an independent wedge effect. Taken together, these findings are exploratory and hypothesis-generating and do not confirm that forefoot wedging acutely enhances power output in this population. Larger, pre-registered trials with direct biomechanical verification of windlass activation and longer-term performance outcomes are needed before specific wedge-based applications can be recommended in elite handball practice.