Dynamic Support of the Human Longitudinal Arch

Thordarson, David B.; Schmotzer, H.; Chon, Jae; Peters, John J.

doi:10.1097/00003086-199507000-00022

Cited by 232 publications

(139 citation statements)

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“…Talonavicular abduction with Achilles tendon overpull was documented previously. 12 These changes highlight the importance of a tight Achilles tendon in flatfoot deformity. However, the differences were relatively small (due to small applied loads, limited time to create the deformity, nondynamic simulations).…”

Section: Discussionmentioning

confidence: 99%

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Cadaveric flatfoot model: Ligament attenuation and Achilles tendon overpull

Blackman

Blevins

Sangeorzan

et al. 2009

Journal Orthopaedic Research

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Flatfoot deformity is characterized by loss of the medial longitudinal arch, forefoot abduction, hindfoot eversion, and often Achilles tendon contracture. Our objectives were to validate a cadaveric flatfoot model that involves selective ligament attenuation and to determine if Achilles tendon overpull is associated with increased pes planus severity. We measured the three-dimensional (3D) orientation of the bones of interest in the unloaded, loaded, and Achilles tendon overpull conditions. A flatfoot model was created by attenuating ligaments involved in the pes planus deformity followed by cyclic axial loading, and bone orientations were acquired in the three conditions. Significant differences seen between normal feet and flat feet were consistent with those seen with the pes planus deformity. The first metatarsal dorsiflexed and abducted relative to the talus. The navicular abducted relative to the talus. The calcaneus everted relative to the tibia. The talus plantar flexed and adducted. Achilles overpull resulted in first metatarsal-to-talus dorsiflexion and navicular-to-talus abduction. Thus, selective ligament attenuation followed by cyclic axial loading can create a cadaveric flatfoot model consistent with the in vivo deformity. Longitudinal arch depression, hindfoot eversion, talonavicular joint abduction, forefoot abduction, and talar plantar flexion were seen. Simulated Achilles tendon contracture increased the severity of the deformity, particularly in arch depression and forefoot abduction.

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Section: Discussionmentioning

confidence: 99%

“…The triceps surae has the most significant arch-flattening and forefootabducting effect of the extrinsic muscles of the foot. 12 Much research has been devoted to creating and testing cadaveric flatfoot models. 5,6,[13][14][15][16] However, we are unaware of any models that have examined the effects of Achilles tendon contracture.…”

mentioning

confidence: 99%

Cadaveric flatfoot model: Ligament attenuation and Achilles tendon overpull

Blackman

Blevins

Sangeorzan

et al. 2009

Journal Orthopaedic Research

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“…While weight-bearing, the bony structures, ligaments, and extrinsic/intrinsic foot muscles contribute to maintaining the MLA of the foot to control excessive pronation [10][11][12][13] . Of the midfoot bones, the navicular supports the structures of the MLA 14,15) .…”

Section: Introductionmentioning

confidence: 99%

The Relationship between Activity of Abductor Hallucis and Navicular Drop in the One-leg Standing Position

Nam¹,

Kwon

2012

J Phys Ther Sci

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Abstract. [Purpose] This study examined whether abductor hallucis (AH) activity in the one-leg-standing position can be used to predict the navicular drop (ND) when it is or is not actively supporting the medial longitudinal arch.[Subjects] Forty healthy subjects without foot or ankle problems were recruited.[Methods] For all subjects, the ND was measured as the difference in navicular height between the subtalar joint resting (STJR) and subtalar joint neutral (STJN) positions while standing. AH activity was measured in both positions during one-leg standing.[Results] AH muscle activity in the STJR position was significantly negatively correlated with the ND, while AH muscle activity in the STJN position was not. Using a simple regression model, AH activity predicted the ND based on the STJR position.[Conclusion] The results suggest that AH activity is a good predictor of the ND. Therefore, intervention that activates the AH in the one-leg standing position could be used to correct the ND.

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“…36 Several authors have suggested that the plantar fascia provides the primary truss support for the longitudinal arch. 27,28,42 The plantar fascia attaches proximally at the calcaneus and distally on the proximal phalanges by connections to the fibrous flexor sheaths of the 5 toes. 27 The plantar fascia provides additional support to the longitudinal arch via the ''windlass effect,'' 16 and is placed under greater tension with extension of the great toe compared with extension of the lateral 4 toes.…”

mentioning

confidence: 99%

“…Numerous authors have concurred that the role of the dynamic arch supporters is to stabilize the longitudinal arch of the foot during the weight-bearing phase of gait. 29,30,42,43 Kibler et al 22 also have suggested that fatigue or weakness of the dynamic arch supporters diminishes their ability to attenuate ground reaction forces effectively and to provide truss support to the longitudinal arch of the foot, thereby imposing additional stress on passive supporting structures, especially the plantar fascia.…”

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confidence: 99%

Toe Flexors Strength and Passive Extension Range of Motion of the First Metatarsophalangeal Joint in Individuals With Plantar Fasciitis

Allen

Gross

2003

J Orthop Sports Phys Ther

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Study Design: Cross-sectional study. Objective: To determine if a difference exists in toe flexors strength and passive extension range of motion of the first metatarsophalangeal joint between individuals with unilateral plantar fasciitis and control subjects. Background: Weakness of the dynamic longitudinal arch supporters and shortening of the plantar fascia have been suggested as etiologic factors for plantar fasciitis. Methods and Measures: Twenty subjects with unilateral plantar fasciitis participated in the study. Subjects had had symptoms for an average (±SD) of 19.9 ± 33.2 months prior to participating in the study. Twenty control subjects matched for sex and age were also tested. Each subject was measured bilaterally for passive extension range of motion of the first metatarsophalangeal joint and peak resistance force observed during an isometric test of toe flexors strength. Results: Subjects with unilateral plantar fasciitis demonstrated weaker toe flexors (PϽ.05) than the control subjects. A significant main effect for feet also indicated that the toe flexors for the involved feet were significantly weaker than the uninvolved feet (PϽ.05) of subjects with unilateral plantar fasciitis. Passive extension range of motion of the first metatarsophalangeal joint was not significantly different between the involved and the uninvolved feet for subjects with plantar fasciitis. Conclusion: Results for our subjects indicate that the extensibility of soft tissues influencing extension of the first metatarsophalangeal joint was not related to the presence of plantar fasciitis. Additional research is needed to determine if toe flexors weakness is a cause or a result of plantar fasciitis and if strengthening regimes for the toe flexors are effective interventions for plantar fasciitis. J Orthop Sports Phys Ther 2003;33:468-478.

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Dynamic Support of the Human Longitudinal Arch

Cited by 232 publications

References 0 publications

Cadaveric flatfoot model: Ligament attenuation and Achilles tendon overpull

Cadaveric flatfoot model: Ligament attenuation and Achilles tendon overpull

The Relationship between Activity of Abductor Hallucis and Navicular Drop in the One-leg Standing Position

Toe Flexors Strength and Passive Extension Range of Motion of the First Metatarsophalangeal Joint in Individuals With Plantar Fasciitis

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