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.

scholarly journals Longer Achilles tendon moment arm results in better running economy

2021 ◽  
Vol 107 (4) ◽  
pp. 527-541
Author(s):  
B. Kovács ◽  
I. Kóbor ◽  
Ö. Sebestyén ◽  
J. Tihanyi
Keyword(s):  
Electrical Activity ◽  
Achilles Tendon ◽  
Body Height ◽  
The Body ◽  
Running Economy ◽  
Medial Gastrocnemius ◽  
Moment Arm ◽  
Marathon Runners ◽  
The Right ◽  
Leg Kinematics

AbstractBased on the current literature, the link between Achilles tendon moment arm length and running economy is not well understood. Therefore, the aim of this study was to further investigate the connection between Achilles tendon moment arm and running economy and the influence of Achilles tendon moment arm on the function of the plantarflexor muscle-tendon unit during running.Ten male competitive marathon runners volunteered for this study. The participants ran on a treadmill at two running speeds: 3 and 3.5 m s−1. During running the oxygen consumption, lower leg kinematics, electrical activity of plantar flexor muscles, and fascicle behavior of the lateral gastrocnemius were measured simultaneously. On the second occasion, an MRI scan of the right leg was taken and used to estimate the Achilles tendon moment arm length.There was a negative correlation between running economy and the body height normalized moment arm length at both selected speeds (r = −0.68, P = 0.014 and r = −0.70, P = 0.01). In addition, Achilles tendon moment arm length correlated with the amplitude of the ankle flexion at both speeds (r = −0.59, P = 0.03 and r = −0.60, P = 0.03) and with the electrical activity of the medial gastrocnemius muscle at 3 m s−1 speed (r = −0.62, P = 0.02). Our finding supports the concept that a longer moment arm could be beneficial for distance runners.

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.

Quantification of Achilles Tendon Force Enhancement by Passively Induced Dorsiflexion Stretches

1999 ◽  
Vol 15 (3) ◽  
pp. 221-232 ◽  
Author(s):  
Caroline Nicol ◽  
Paavo V. Komi
Keyword(s):  
Achilles Tendon ◽  
Female Subject ◽  
Plateau Phase ◽  
Force Enhancement ◽  
Surface Electrodes ◽  
Twitch Response ◽  
Tendon Force ◽  
The Right ◽  
Passive Stretch

Magnitude of the reflex contribution to force enhancement was investigated in vivo during passive stretches of the Achilles tendon (AT) of one female subject. Thirty passive (5 × 6) dorsiflexions were induced by a motorized ankle ergometer. Achilles tendon force (ATF) was sensed by a buckle transducer applied surgically around the right AT. Single passive stretches resulted in a low but rather linear ATF increase in the absence of EMG (surface electrodes) activity. In the presence of reflexes, a clear ATF enhancement occurred 13–15 ms after the beginning of the EMG reflex responses. In double dorsiflexions at either 1.2 or 1.9 rad · s-1, which were separated by a maintained stretched position of either 40 or 90 ms, the first stretch resulted in initial linear ATF increase, followed by an additional force enhancement during the plateau phase. This reflexly induced increase represented 94 ± 4 N and 184 ± 1 N, respectively, for the 40 and the 90 ms plateaus, corresponding to 210 ± 85% and 486 ± 177% enhancements as compared to the first passive stretch effect. The results suggest further that timing of the stretch during the twitch response influences the magnitude and rate of force potentiation.

scholarly journals Can the Open Stance Forehand Increase the Risk of Hip Injuries in Tennis Players?

2020 ◽  
Vol 8 (12) ◽  
pp. 232596712096629
Author(s):  
Caroline Martin ◽  
Anthony Sorel ◽  
Pierre Touzard ◽  
Benoit Bideau ◽  
Ronan Gaborit ◽  
...  
Keyword(s):  
Hip Joint ◽  
Inverse Dynamics ◽  
External Rotation ◽  
Tennis Players ◽  
Flexion Extension ◽  
Hip Injuries ◽  
Hip Motion ◽  
Hip Kinematics ◽  
The Right ◽  
Hip Flexion

Background: The open stance forehand has been hypothesized by tennis experts (coaches, scientists, and clinicians) to be more traumatic than the neutral stance forehand as regards hip injuries in tennis. However, the influence of the forehand stance (open or neutral) on hip kinematics and loading has not been assessed. Purpose: To compare the kinematics and kinetics at the hip joint during 3 common forehand stances (attacking neutral stance [ANS], attacking open stance [AOS], defensive open stance [DOS]) in advanced tennis players to determine whether the open stance forehand induces higher hip loading. Study Design: Descriptive laboratory study. Methods: The ANS, AOS, and DOS forehand strokes of 8 advanced right-handed tennis players were recorded with an optoelectronic motion capture system. The flexion-extension, abduction-adduction, and external-internal rotation angles as well as intersegmental forces and torques of the right hip were calculated using inverse dynamics. Results: The DOS demonstrated significantly higher values than both the ANS and AOS for anterior ( P < .001), medial ( P < .001), and distractive ( P < .001) forces as well as extension ( P = .004), abduction ( P < .001), and external rotation ( P < .001) torques. The AOS showed higher distractive forces than the ANS ( P = .048). The DOS showed more extreme angles of hip flexion ( P < .001), abduction ( P < .001), and external rotation ( P = .010). Conclusion: The findings of this study imply that the DOS increased hip joint angles and loading, thus potentially increasing the risk of hip overuse injuries. The DOS-induced hip motion could put players at a higher risk of posterior-superior hip impingement compared with the ANS and AOS. Clinical Relevance: Coaches and clinicians with players who have experienced hip pain or sustained injuries should encourage them to use a more neutral stance and develop a more aggressive playing style to avoid the DOS, during which hip motion and loading are more extreme.

Achilles Tendon Moment Arms Computed Using Ultrasound and Motion Analysis: In Vivo Estimates for Male Subjects

2008 ◽  
Author(s):  
Justin D. Cowder ◽  
Thomas S. Buchanan ◽  
Kurt T. Manal
Keyword(s):  
Achilles Tendon ◽  
Motion Capture ◽  
Hybrid Method ◽  
Lower Limb ◽  
Muscle Force ◽  
Average Weight ◽  
Moment Arm ◽  
Moment Arms ◽  
Male Subjects

Accurate estimates for Achilles tendon moment arm (MA) are essential when computing gastroc-soleus force from the net plantarflexion moment. Errors in approximating the Achilles tendon MA will adversely affect the muscle force estimate. We have noted that Achilles tendon MAs reported by Maganaris [1] and others are significantly greater (> 1 cm) than values used by Delp et al. computed using SIMM [2]. It is important to note that the stature of Delp’s lower limb model was almost identical to the average weight and height of the subjects in a study by Maganaris. This led us to question which MA profiles were more anatomically meaningful. To address this, we calculated Achilles tendon MAs for 10 male subjects using a previously described method. The method combines ultrasound and video-based motion capture, and referred to as the hybrid method. Subjects in our study were chosen to ensure they were of a similar stature to those tested by Maganaris, thereby minimizing confounding effects of subject anthropometrics.

scholarly journals Orthotic Heel Wedges Do Not Alter Hindfoot Kinematics and Achilles Tendon Force During Level and Inclined Walking in Healthy Individuals

2016 ◽  
Vol 32 (2) ◽  
pp. 160-170 ◽  
Author(s):  
Robert A. Weinert-Aplin ◽  
Anthony M.J. Bull ◽  
Alison H. McGregor
Keyword(s):  
Achilles Tendon ◽  
Plantar Flexion ◽  
Force Plate ◽  
The Body ◽  
Triceps Surae ◽  
Tibialis Posterior ◽  
Muscle Forces ◽  
Flexor Muscle ◽  
Optical Motion ◽  
Tendon Force

Conservative treatments such as in-shoe orthotic heel wedges to treat musculoskeletal injuries are not new. However, weak evidence supporting their use in the management of Achilles tendonitis suggests the mechanism by which these heel wedges works remains poorly understood. It was the aim of this study to test the underlying hypothesis that heel wedges can reduce Achilles tendon load. A musculoskeletal modeling approach was used to quantify changes in lower limb mechanics when walking due to the introduction of 12-mm orthotic heel wedges. Nineteen healthy volunteers walked on an inclinable walkway while optical motion, force plate, and plantar pressure data were recorded. Walking with heel wedges increased ankle dorsiflexion moments and reduced plantar flexion moments; this resulted in increased peak ankle dorsiflexor muscle forces during early stance and reduced tibialis posterior and toe flexor muscle forces during late stance. Heel wedges did not reduce overall Achilles tendon force during any walking condition, but did redistribute load from the medial to lateral triceps surae during inclined walking. These results add to the body of clinical evidence confirming that heel wedges do not reduce Achilles tendon load and our findings provide an explanation as to why this may be the case.

Reliability of Achilles Tendon Moment Arm Measured In Vivo Using Freehand Three-Dimensional Ultrasound

2017 ◽  
Vol 33 (4) ◽  
pp. 300-304 ◽  
Author(s):  
Steven J. Obst ◽  
Lee Barber ◽  
Ashton Miller ◽  
Rod S. Barrett
Keyword(s):  
Achilles Tendon ◽  
Plantar Flexion ◽  
Three Dimensional ◽  
Correlation Coefficients ◽  
Lateral Malleolus ◽  
Medial Malleolus ◽  
Minimal Detectable Change ◽  
Ultrasound Images ◽  
Moment Arm

This study investigated reliability of freehand three-dimensional ultrasound (3DUS) measurement of in vivo human Achilles tendon (AT) moment arm. Sixteen healthy adults were scanned on 2 separate occasions by a single investigator. 3DUS scans were performed over the free AT, medial malleolus, and lateral malleolus with the ankle passively positioned in maximal dorsiflexion, mid dorsiflexion, neutral, mid plantar flexion and maximal plantar flexion. 3D reconstructions of the AT, medial malleolus, and lateral malleolus were created from manual segmentation of the ultrasound images and used to geometrically determine the AT moment arm using both a straight (straight ATMA) and curved (curved ATMA) tendon line-of-action. Both methods were reliable within- and between-session (intra-class correlation coefficients > 0.92; coefficient of variation < 2.5 %) and revealed that AT moment arm increased by ∼ 7 mm from maximal dorsiflexion (∼ 41mm) to maximal plantar flexion (∼ 48 mm). Failing to account for tendon curvature led to a small overestimation (< 2 mm) of AT moment arm that was most pronounced in ankle plantar flexion, but was less than the minimal detectable change of the method and could be disregarded.

scholarly journals Achilles Tendon Structure Differs Between Runners And Non-Runners Despite No Clinical Signs Or Symptoms Of Mid-Substance Tendinopathy

2018 ◽  
Author(s):  
Todd J. Hullfish ◽  
Kenton L. Hagan ◽  
Ellen Casey ◽  
Josh R. Baxter
Keyword(s):  
Young Adults ◽  
Achilles Tendon ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Achilles Tendinopathy ◽  
Ultrasound Images ◽  
Distance Running ◽  
Distance Runners ◽  
Structural Differences ◽  
The Right

AbstractAchilles tendinopathy affects many running athletes and often leads to chronic pain and functional deficits. While changes in tendon structure have been linked with tendinopathy, the effects of distance running on tendon structure is not well understood. Therefore, the purpose of this study was to characterize structural differences in the Achilles tendons in healthy young adults and competitive distance runners using quantitative ultrasound analyses. We hypothesized that competitive distance runners with no clinical signs or symptoms of tendinopathy would have quantitative signs of tendon damage, characterized by decreased collagen alignment and echogenicity, in addition to previous reports of thicker tendons. Longitudinal ultrasound images of the right Achilles tendon mid-substance were acquired in competitive distance runners and recreationally-active adults. Collagen organization, mean echogenicity, and tendon thickness were quantified using image processing techniques. Clinical assessments confirmed that runners had no signs or symptoms of tendinopathy and controls were only included if they had no history of Achilles tendon pain or injuries. Runner tendons were 40% less organized, 48% thicker, and 41% less echogenic compared to the control tendons (p < 0.001). Young adults engaged in competitive distance-running have structurally different tendons than recreationally-active young adults. While these structural differences have been associated with tendon damage, the lack of clinical symptoms of tendinopathy may suggest that these detected differences may either be precursors of tendinopathy development or protective adaptations to cyclic tendon loading experienced during running.

scholarly journals Quantifying Achilles tendon force in vivo from ultrasound images

2016 ◽  
Vol 49 (14) ◽  
pp. 3200-3207 ◽  
Author(s):  
Taylor J.M. Dick ◽  
Allison S. Arnold ◽  
James M. Wakeling
Keyword(s):  
Achilles Tendon ◽  
Ultrasound Images ◽  
Tendon Force

scholarly journals Muscle Fatigue Assesment of the Lower Limb in Young Hurdlers Using Isokinetic Dynamometry

GYMNASIUM ◽  
2019 ◽  
Vol XIX (2) ◽  
pp. 145
Author(s):  
Gheorghe-Adrian Onea ◽  
Lorand Balint ◽  
Ștefan Alecu ◽  
Doru Oprea
Keyword(s):  
Muscle Fatigue ◽  
Lower Limb ◽  
Knee Flexion ◽  
Total Work ◽  
Isokinetic Dynamometry ◽  
Lower Limb Muscles ◽  
Flexion Extension ◽  
Hip Abduction ◽  
The Right ◽  
Work First

This research study aim was to assess muscle fatigue of the dominant and non-dominant lower limb (knee flexion/extension, hip abduction/adduction and ankle plantar/dorsoflexion), using Biodex System 4 ProTM. This investigation tested the lower limb muscles during isokinetic concentric/concentric mode at 60o /sec,120o /sec, 300o /sec,450o /sec. Hip abduction/adduction of the right and left side values range for total work from 101.6 J to 528.1 J ; work first third from 32.7 J to 164.7 J; work last third from 25.2 J to 183.7 J. Knee flexion/extension of the right and left side values range for total work from 443.2 J to 792.2 J; work first third from 135.7 J to 258.7 J; work last third from 124.1 J to 249.2 J. The present study suggests that as we change the velocity, muscle fatigue can affect the kinetic lower limb chain.

Sign in / Sign up

Export Citation Format

Share Document