Subtalar Joint Pronation and Energy Absorption Requirements During Walking are Related to Tibialis Posterior Tendinous Tissue Strain

Abstract

During human walking, the tibialis posterior (TP) tendon absorbs energy in early stance as the subtalar joint (STJ) pronates. However, it remains unclear whether an increase in energy absorption between individuals, possibly a result of larger STJ pronation displacement, is fulfilled by greater magnitudes of TP tendon or muscle fascicle strain. By collecting direct measurements of muscle fascicle length (ultrasound), MTU length (3D motion capture and musculoskeletal modelling), and TP muscle activation (intramuscular electromyography) we endeavoured to illustrate that the TP tendinous tissue fulfils the requirements for energy absorption at the STJ as a result of an increase in muscle force production. While a significant relationship between TP tendon strain, energy absorption at the STJ (R2 = 0.53, P = < 0.01) and STJ pronation (R2 = 0.53, P = < 0.01) was evident, we failed to find any significant associations between tendon strain and surrogate measure of TP muscle force (TP muscle activation together with ankle and subtalar joint moments). These results suggest that TP tendon compliance may explain the variance in pronation and energy absorption at the STJ. Therefore, as the tendinous tissue of the TP is accountable for the absorption of energy at the STJ it may be predisposed to strain-induced injury.

Paediatric patients with blood‐induced ankle joint arthritis demonstrate physiological foot joint mechanics and energetics during walking

“…Through an inverse dynamic approach in which total ground reaction forces are distributed over different foot segments, fundamental insights into the joint dynamics of the ankle‐, Chopart‐, Lisfranc and hallux joint can be obtained 14 . Nowadays, we have come to a point in which research groups are looking for correlations between these kinetic measures and other clinical measures such as foot posture, supination resistance test and muscle fascicle length 16,17 …”

Increasing step width reduces the requirements for subtalar joint moments and powers

“…The STJ generally functions to maintain frontal plane stability as it absorbs energy during pronation following heel strike and generates power for STJ supination at push-off (Piazza, 2005), with the tibialis posterior (TP) muscle and tendon considered a key muscle in recycling energy across the stance phase (Maharaj et al, 2016). Numerous factors influence the dynamics of the STJ during walking, including the properties of the TP tendinous tissue (Maharaj et al, 2017a), footwear (Maharaj et al, 2018), foot structure (Maharaj et al, 2017b) and gait parameters (Maharaj et al, 2017b;. Deviations in step width may alter frontal plane mechanics and hence the function of its constituting structures such as the STJ.…”

Improvement of Mobility, Strength, Stability and Pain in Soccer Players with Recurrent Ankle Sprains Through Myofascial Release, Strength Exercises and Taping: A Randomized Controlled Trial.

“…The term myofascial refers to an interconnected three-dimensional network, which surrounds and connects the musculoskeletal system [23]. During gait, the tendon of the tibialis posterior muscle absorbs energy when the subastragaline joint is in pronation and can cause strain injury [24]. Long-term improvements in postural control and plantar fascia mobility has been observed using myofascial techniques [25].…”