The Influence of Heel Lift Manipulation on Achilles Tendon Loading in Running

1998 ◽  
Vol 14 (4) ◽  
pp. 374-389 ◽  
Author(s):  
Sharon J. Dixon ◽  
David G. Kerwin
Keyword(s):  
Achilles Tendon ◽  
Ground Reaction Force ◽  
Reaction Force ◽  
Tendon Injury ◽  
Moment Arm ◽  
The Common ◽  
Tendon Force ◽  
The Moment ◽  
Joint Center ◽  
Heel Lift

In this study, a modeling method was developed to estimate Achilles tendon forces in running. Owing to the common use of heel lift devices in the treatment of Achilles tendon injury, we investigated the influence of increased heel lift on Achilles tendon loading. The hypothesis was that heel lift manipulation can influence maximum Achilles tendon force. Responses to heel lift variation were found to differ among 3 elite runners demonstrating distinct running styles. A rearfoot and a midfoot striker demonstrated significant increases in maximum Achilles tendon force with increased heel lift, whereas a forefoot striker demonstrated no changes in maximum Achilles tendon force values with heel lift manipulation (p < .05). Analysis of the factors contributing to the observed changes in maximum Achilles tendon force highlighted the influence of the moment arm of ground reaction force and the moment arm of the Achilles tendon about the ankle joint center. The finding that increased heel lift may increase maximum Achilles tendon force suggests that caution is advised in the routine use of this intervention. The different responses to heel lift increase between subjects highlight the importance of classifying subjects based on running style.

Effect of Foot Progression Angle and Lateral Wedge Insole on a Reduction in Knee Adduction Moment

2016 ◽  
Vol 32 (5) ◽  
pp. 454-461 ◽  
Author(s):  
Ken Tokunaga ◽  
Yuki Nakai ◽  
Ryo Matsumoto ◽  
Ryoji Kiyama ◽  
Masayuki Kawada ◽  
...  
Keyword(s):  
Ground Reaction Force ◽  
Reaction Force ◽  
Reduction Ratio ◽  
Knee Adduction Moment ◽  
Moment Arm ◽  
3 Dimensional ◽  
Foot Progression Angle ◽  
Close Relationship ◽  
The Moment ◽  
Joint Center

This study evaluated the effect of foot progression angle on the reduction in knee adduction moment caused by a lateral wedged insole during walking. Twenty healthy, young volunteers walked 10 m at their comfortable velocity wearing a lateral wedged insole or control flat insole in 3 foot progression angle conditions: natural, toe-out, and toe-in. A 3-dimensional rigid link model was used to calculate the external knee adduction moment, the moment arm of ground reaction force to knee joint center, and the reduction ratio of knee adduction moment and moment arm. The result indicated that the toe-out condition and lateral wedged insole decreased the knee adduction moment in the whole stance phase. The reduction ratio of the knee adduction moment and the moment arm exhibited a close relationship. Lateral wedged insoles decreased the knee adduction moment in various foot progression angle conditions due to decrease of the moment arm of the ground reaction force. Moreover, the knee adduction moment during the toe-out gait with lateral wedged insole was the smallest due to the synergistic effect of the lateral wedged insole and foot progression angle. Lateral wedged insoles may be a valid intervention for patients with knee osteoarthritis regardless of the foot progression angle.

scholarly journals A Hybrid Method for Computing Achilles Tendon Moment Arm Using Ultrasound and Motion Analysis

2010 ◽  
Vol 26 (2) ◽  
pp. 224-228 ◽  
Author(s):  
Kurt Manal ◽  
Justin D. Cowder ◽  
Thomas S. Buchanan
Keyword(s):  
Achilles Tendon ◽  
Motion Capture ◽  
Hybrid Method ◽  
Moment Arm ◽  
Measurement Instruments ◽  
Moment Arms ◽  
Perpendicular Distance ◽  
The Moment ◽  
Joint Center

In this article, we outline a method for computing Achilles tendon moment arm. The moment arm is computed from data collected using two reliable measurement instruments: ultrasound and video-based motion capture. Ultrasound is used to measure the perpendicular distance from the surface of the skin to the midline of the tendon. Motion capture is used to determine the perpendicular distance from the bottom of the probe to the ankle joint center. The difference between these two measures is the Achilles tendon moment arm. Unlike other methods, which require an angular change in joint position to approximate the moment arm, the hybrid method can be used to compute the moment arm directly at a specific joint angle. As a result, the hybrid method involves fewer error-prone measurements and the moment arm can be computed at the limits of the joint range of motion. The method is easy to implement and uses modalities that are less costly and more accessible than MRI. Preliminary testing using a lamb shank as a surrogate for a human ankle revealed good accuracy (3.3% error). We believe the hybrid method outlined here can be used to measure subject-specific moment arms in vivo and thus will potentially benefit research projects investigating ankle mechanics.

scholarly journals A Forefoot Strike Requires the Highest Forces Applied to the Foot Among Foot Strike Patterns

2017 ◽  
Vol 01 (02) ◽  
pp. E37-E42 ◽  
Author(s):  
Satoru Hashizume ◽  
Toshio Yanagiya
Keyword(s):  
Achilles Tendon ◽  
Ground Reaction Force ◽  
Reaction Force ◽  
Moment Arm ◽  
Moment Arms ◽  
Joint Reaction Forces ◽  
Force Moment ◽  
Foot Strike ◽  
Reaction Forces ◽  
Joint Reaction

AbstractGround reaction force is often used to predict the potential risk of injuries but may not coincide with the forces applied to commonly injured regions of the foot. This study examined the forces applied to the foot, and the associated moment arms made by three foot strike patterns. 10 male runners ran barefoot along a runway at 3.3 m/s using forefoot, midfoot, and rearfoot strikes. The Achilles tendon and ground reaction force moment arms represented the shortest distance between the ankle joint axis and the line of action of each force. The Achilles tendon and joint reaction forces were calculated by solving equations of foot motion. The Achilles tendon and joint reaction forces were greatest for the forefoot strike (2 194 and 3 137 N), followed by the midfoot strike (1 929 and 2 853 N), and the rearfoot strike (1 526 and 2 394 N). The ground reaction force moment arm was greater for the forefoot strike than for the other foot strikes, and was greater for the midfoot strike than for the rearfoot strike. Meanwhile, there were no differences in the Achilles tendon moment arm among all foot strikes. These differences were attributed mainly to differences in the ground reaction force moment arm among the three foot strike patterns.

The Effects of a Lateral Wedge Insole on Knee and Ankle Joints During Slope Walking

2015 ◽  
Vol 31 (6) ◽  
pp. 476-483 ◽  
Author(s):  
Yuki Uto ◽  
Tetsuo Maeda ◽  
Ryoji Kiyama ◽  
Masayuki Kawada ◽  
Ken Tokunaga ◽  
...  
Keyword(s):  
Ground Reaction Force ◽  
Reaction Force ◽  
Force Plate ◽  
Three Dimensional ◽  
Frontal Plane ◽  
Knee Adduction Moment ◽  
Moment Arm ◽  
Level Walking ◽  
Ankle Valgus ◽  
The Moment

The purpose of this study was to determine whether a lateral wedge insole reduces the external knee adduction moment during slope walking. Twenty young, healthy subjects participated in this study. Subjects walked up and down a slope using 2 different insoles: a control flat insole and a 7° lateral wedge insole. A three-dimensional motion analysis system and force plate were used to examine the knee adduction moment, the ankle valgus moment, and the moment arm of the ground reaction force to the knee joint center in the frontal plane. The lateral wedge insole significantly decreased the moment arm of the ground reaction force, resulting in a reduction of the knee adduction moment during slope walking, similar to level walking. The reduction ratio of knee adduction moment by the lateral wedge insole during the early stance of up-slope walking was larger than that of level walking. Conversely, the lateral wedge insole increased the ankle valgus moment during slope walking, especially during the early stance phase of up-slope walking. Clinicians should examine the utilization of a lateral wedge insole for knee osteoarthritis patients who perform inclined walking during daily activity, in consideration of the load on the ankle joint.

scholarly journals Variations in Achilles Tendon Loading with Heel Lift Intervention in Heel-Toe Runners

2002 ◽  
Vol 18 (4) ◽  
pp. 321-331 ◽  
Author(s):  
Sharon J. Dixon ◽  
David G. Kerwin
Keyword(s):  
Achilles Tendon ◽  
Inverse Dynamics ◽  
Sagittal Plane ◽  
Average Rate ◽  
Moment Arm ◽  
Peak Rate ◽  
Individual Participant ◽  
Tendon Force ◽  
Heel Lift ◽  
Rate Of Loading

This study investigated the influence of heel lift interventions on the loading of the Achilles tendon for heel-toe runners. It was hypothesized that the peak Achilles tendon force and peak rate of loading would be reduced by the increase in heel lift, and that the peak Achilles tendon force would occur significantly later in stance. Achilles tendon forces were determined by calculating sagittal-plane ankle joint moments using inverse-dynamics techniques and dividing these moments by Achilles tendon moment arm lengths. Methods for estimating Achilles tendon moment arm length using skin markers were justified via MRI data for one participant. Seven participants underwent running trials under three heel lift conditions: zero, 7.5-mm, and 15-mm heel lift. Average magnitude and occurrence time of peak Achilles tendon force and peak rate of loading were determined for each condition over the 7 participants. Despite group reductions in peak Achilles tendon force and peak rate of loading for the increased heel lift conditions, statistical analysis (ANOVA) revealed no significant differences for these variables, p > 0.05. Individual participant observations highlighted varied responses to heel lift; both increases and decreases in peak Achilles tendon force were observed. For the group data, the time of peak impact force occurred significantly later in the 15-mm heel lift condition than in the zero heel lift, p < 0.05. It is suggested that the success of increased heel lift in treating Achilles tendon injury may be due to a later occurrence of peak Achilles tendon force in response to this intervention, reducing Achilles tendon average rate of loading. In addition, the individuality of Achilles tendon peak force changes with heel lift intervention highlights the need for individual participant analysis.

Identification of subclinical tendon injury from ground reaction force analysis

1991 ◽  
Vol 23 (4) ◽  
pp. 266-272 ◽  
Author(s):  
S. M. DOW ◽  
J. A. LEENDERTZ ◽  
I. A. SILVER ◽  
A. E. GOODSHIP
Keyword(s):  
Ground Reaction Force ◽  
Reaction Force ◽  
Tendon Injury ◽  
Force Analysis

scholarly journals Effects of Achilles Tendon Moment Arm Length on Insertional Achilles Tendinopathy

2020 ◽  
Vol 10 (19) ◽  
pp. 6631
Author(s):  
Takuma Miyamoto ◽  
Yasushi Shinohara ◽  
Tomohiro Matsui ◽  
Hiroaki Kurokawa ◽  
Akira Taniguchi ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Achilles Tendinopathy ◽  
Control Group ◽  
Moment Arm ◽  
Healthy Individuals ◽  
Suture Bridge ◽  
Significant Difference ◽  
The Moment ◽  
Insertional Achilles Tendinopathy ◽  
Suture Bridge Technique

Insertional Achilles tendinopathy (IAT) is caused by traction force of the tendon. The effectiveness of the suture bridge technique in correcting it is unknown. We examined the moment arm in patients with IAT before and after surgery using the suture bridge technique, in comparison to that of healthy individuals. We hypothesized that the suture bridge method influences the moment arm length. An IAT group comprising 10 feet belonging to 8 patients requiring surgical treatment for IAT were followed up postoperatively and compared with a control group comprising 15 feet of 15 healthy individuals with no ankle complaints or history of trauma or surgery. The ratio of the moment arm (MA) length/foot length was found to be statistically significant between the control group, the IAT group preoperatively and the IAT group postoperatively (p < 0.01). Despite no significant difference in the force between the control and preoperative IAT groups, a significantly higher force to the Achilles tendon was observed in the IAT group postoperatively compared to the other groups (p < 0.05). This study demonstrates that a long moment arm may be one of the causes of IAT, and the suture bridge technique may reduce the Achilles tendon moment arm.

The Effects of Orthotic Heel Lifts on Achilles Tendon Force and Strain During Running

2012 ◽  
Vol 28 (5) ◽  
pp. 511-519 ◽  
Author(s):  
Dominic James Farris ◽  
Erica Buckeridge ◽  
Grant Trewartha ◽  
Miranda Polly McGuigan
Keyword(s):  
Achilles Tendon ◽  
Lower Limb ◽  
Inverse Dynamics ◽  
Force Plate ◽  
Medial Gastrocnemius ◽  
Ultrasound Images ◽  
Moment Arm ◽  
Flexion Extension ◽  
Tendon Force ◽  
The Right

This study assessed the effects of orthotic heel lifts on Achilles tendon (AT) force and strain during running. Ten females ran barefoot over a force plate in three conditions: no heel lifts (NHL), with 12 mm heel lifts (12HL) and with 18 mm heel lifts (18HL). Kinematics for the right lower limb were collected (200 Hz). AT force was calculated from inverse dynamics. AT strain was determined from kinematics and ultrasound images of medial gastrocnemius (50 Hz). Peak AT strain was less for 18HL (5.5 ± 4.4%) than for NHL (7.4 ± 4.2%) (p = .029, effect size [ES] = 0.44) but not for 12HL (5.8 ± 4.8%) versus NHL (ES = 0.35). Peak AT force was significantly (p = .024, ES = 0.42) less for 18HL (2382 ± 717 N) than for NHL (2710 ± 830 N) but not for 12HL (2538 ± 823 N, ES = 0.21). The 18HL reduced ankle dorsiflexion but not flexion-extension ankle moments and increased the AT moment arm compared with NHL. Thus, 18HL reduced force and strain on the AT during running via a reduction in dorsiflexion, which lengthened the AT moment arm. Therefore, heel lifts could be used to reduce AT loading and strain during the rehabilitation of AT injuries.

A Robotic Ankle–Foot Prosthesis With Active Alignment

2016 ◽  
Vol 10 (2) ◽  
Author(s):  
Andrew Kennedy LaPrè ◽  
Brian R. Umberger ◽  
Frank C. Sup
Keyword(s):  
Center Of Pressure ◽  
Reaction Force ◽  
Residual Limb ◽  
Moment Arm ◽  
Ankle Prosthesis ◽  
Socket Connection ◽  
The Moment ◽  
Socket Interface ◽  
Configuration Changes ◽  
Large Moment

An ankle–foot prosthesis designed to mimic the missing physiological limb generates a large sagittal moment during push off which must be transferred to the residual limb through the socket connection. The large moment is correlated with high internal socket pressures that are often a source of discomfort for the person with amputation, limiting prosthesis use. In this paper, the concept of active alignment is developed. Active alignment realigns the affected residual limb toward the center of pressure (CoP) during stance. During gait, the prosthesis configuration changes to shorten the moment arm between the ground reaction force (GRF) and the residual limb. This reduces the peak moment transferred through the socket interface during late stance. A tethered robotic ankle prosthesis has been developed, and evaluation results are presented for active alignment during normal walking in a laboratory setting. Preliminary testing was performed with a subject without amputation walking with able-bodied adapters at a constant speed. The results show a 33% reduction in the peak resultant moment transferred at the socket limb interface.

Estimation of ground reaction force from joint center positions during balance exergaming

2021 ◽  
Vol 90 ◽  
pp. 124
Author(s):  
E. Klæbo Vonstad ◽  
B. Vereijken ◽  
K. Bach ◽  
X. Su ◽  
J.H. Nilsen
Keyword(s):  
Ground Reaction Force ◽  
Reaction Force ◽  
Joint Center
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