Persons with acquired flatfoot deformity demonstrate impaired walking performance, as indicated by slower walking speed and frequent reports of foot pain during activity and at rest. 25,29 There is no doubt that acquired flatfoot deformity is accompanied by some level of tibialis posterior tendon dysfunction. The tibialis posterior functions to create a rigid foot segment by stabilizing the midfoot 37 and assists in generating energy, by the plantar flexors in terminal stance, to produce successful propulsion. 41 Laboratory studies confirm that persons with acquired flatfoot deformity demonstrate T T STUDY DESIGN: Controlled laboratory study using a cross-sectional design. T T OBJECTIVES:To characterize ankle and hip muscle performance in women with posterior tibial tendon dysfunction (PTTD) and compare them to matched controls. We hypothesized that ankle plantar flexor strength, and hip extensor and abductor strength and endurance, would be diminished in women with PTTD and this impairment would be on the side of dysfunction. T T BACKGROUND:Individuals with PTTD demonstrate impaired walking abilities. Walking gait is strongly dependent on the performance of calf and hip musculature. T T METHODS:Thirty-four middle-aged women (17 with PTTD) participated. Ankle plantar flexor strength was assessed with the single-leg heel raise test. Hip muscle performance, including strength and endurance, were dynamometrically measured. Differences between groups and sides were assessed with a mixed-model analysis of variance. T T RESULTS:Females with PTTD performed significantly fewer single-leg heel raises and repeated sagittal and frontal plane non-weight-bearing leg lifts, and also had lower hip extensor and abductor torques than age-matched controls. There were no differences between sides for hip strength and endurance measures for either group, but differences between sides in ankle strength measures were noted in both groups. T T CONCLUSION:Women with PTTD demonstrated decreased ankle and hip muscle performance bilaterally.

Level III, case control study.

Patellar tendinopathy is highly prevalent in all ages and skill levels of volleyball athletes. To illustrate this, we discuss the clinical, biomechanical, and ultrasound imaging presentation and the intervention strategies of three volleyball athletes at different stages of their athletic career: youth, middle-aged, and collegiate. We present our examination strategies and interpret the data collected, including visual movement analysis and dynamics, relating these findings to the probable causes of their pain and dysfunction. Using the framework of the EdUReP concept, incorporating Education, Unloading, Reloading, and Prevention, we propose intervention strategies that target each athlete's specific issues in terms of education, rehabilitation, training, and return to sport. This framework can be generalized to manage patellar tendinopathy in other sports requiring jumping, from youth to middle age, and from recreational to elite competitive levels.