Effect of Foot and Ankle Immobilization on Leg and Thigh Muscles' Volume and Morphology: A Case Study Using Magnetic Resonance Imaging

Abstract

Our aim was to determine the time course of any changes in muscle volume and shape in the lower limbs following immobilization. A healthy young woman (29 years) had suffered a fracture of the fifth metatarsal of the right foot. MRI scanning of her right thigh and calf muscles had been performed 1 month before the injury (Pre) during a scan initially planned as a teaching tool, 2 days following a 4-week immobilization period (Post), and after a 2-month recovery period (Post12). The results show muscle volume decrements in the triceps surae (TS), quadriceps (Quad), and hamstring (Ham) of 21.9%, 24.1%, and 6.5%, respectively, between the Pre and Post measurements. At Post12, the Quad and TS muscle volumes were still 5.2% and 9.5% lower, compared with the Pre data. The Ham muscle volume, however, was 2.7% greater than at the Pre phase. Following recovery, the increase in individual TS muscles volume was limited to both proximal and medial (with respect to the knee joint) segments of the muscles. These results indicate very substantial and rapid losses in muscle volumes, both proximally and distally to the immobilization site. The results also show that recovery is far from complete up to 2 months post cast removal. The results have implications for the requirements for rehabilitation for orthopedic patients.

The Ankle Retinacula: Morphological Evidence of the Proprioceptive Role of the Fascial System

“…If a subject presents with incorrect walking, or if the anatomical dispositions of the bones and muscles of the foot are altered (i.e., in pes cavus or pes planus), traction inside the fasciae change and may alter the disposition of the fibrous bundles of the retinacula. Further confirmation of this hypothesis derives from evaluation of the subjects with outcomes of ankle sprain and of the amputated legs, which revealed new adherences between the retinacula and the subcutaneous tissue, and by the work of Grosset and Onambele-Pearson [2008]. In our anatomo-functional view of the retinacula, the formation of new fixed points anchoring the fasciae to the subcutaneous tissue, or interruption of the retinaculum after trauma, probably alters the distribution of force lines inside the fasciae, causing the formation of accessory fi-brous bundles, confirming the strong relation between mechanical function and molecular composition of the various fibrous connective tissue [Putz and Müller-Gerbl, 1995;Milz et al, 2005].…”

Nonsurgically induced disuse muscle atrophy and neuromuscular dysfunction upregulates alpha7 acetylcholine receptors

“…In pathological states or muscle-related genetic disorders, there is loss of muscle mass and decreased muscle strength (Elizabeth and Peter 2007). Muscle wasting can also occur in the absence of systemic or genetic disease states as in spaceflights, prolonged bed rest, limb unloading or plaster casting (Brunelli and Rovere-Querini 2008; Grosset and Onambele-Pearson 2008; Larsson 2007; Kortebein et al 2008; Ferrando et al 2006; Zhang et al 2007; Ferrando et al 1996; Frick et al 2008; Kong et al 2009). Immobilization changes the structure and function of the peripheral neuromuscular system and alters both protein synthesis and degradation (Robinson et al 1991).…”

Muscles Adaptation to Aging and Training: Architectural Changes – A Randomised Trial

“…To accurately estimate the entire muscle volume, the use of continuous transverse magnetic resonance imaging (MRI) scans has been validated [19] and widely used [12,13,20,21].…”