SLR - December 2012 - Zuska

Comparison of Pathway and Center of Gravity of the Calcaneus on Non-Involved and Involved Sides According to Eccentric and Concentric Strengthening in Patients with Achilles Tendinopathy

Reference: Lee, G and Yu J. Journal of Sports Science and Medicine. 2012 March; 11, 136-140.

Scientific Literature Review

Reviewed by: Matthew Zuska, DPM
Residency Program: Botsford Hospital, Farmington Hills, MI

Podiatric Relevance:
Patients with Achilles tendinopathy/tendinitis can respond poorly to conservative management. Eccentric and concentric strengthening exercises were examined in relation to center of gravity and pathways on the calcaneus in patients with unilateral Achilles tendinopathy.

Methods:
Eighteen patients with chronic Achilles tendinopathy were chosen for the study. A motion analysis marker was attached to the subjects' lower extremity. The subjects preformed strengthening exercises, and maximum dorsiflexion/plantarflexion range of motion was collected. A 3D motion analysis captured the calcaneal pathway while foot pressure was recorded with an AMTI force platform. Both the involved side and non-involved side data was collected.

Results:
The pathway of the calcaneus on the involved side increased significantly (p<0.05) during eccentric strengthening exercises. The path length of the center of gravity in the involved side decreased significantly during both eccentric and concentric strengthening exercises (p<0.05).

Conclusions:
There is increased movement of the calcaneus in patients that have Achilles tendinopathy since this reduces the stability of the foot when pressure is applied. Eccentric strengthening exercises reduce the forward and backward motion, thus helping to prevent Achilles tendinopathy. Furthermore, eccentric exercise is useful in rehabilitating these patients.

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