Multi-segment foot kinematics and plantar fascia strain during treadmill and overground running

Although physiologically beneficial, running is known to be associated with a high incidence of chronic injuries. Excessive coronal and transverse plane motions of the foot segments and strain experienced by the plantar fascia are linked to the development of a number of chronic injuries. This study examined differences in multi-segment foot kinematics and plantar fascia strain during treadmill and overground running. Twelve male recreational runners ran at 4.0 m.s-1 in both treadmill and overground conditions. Multi-segment foot kinematics and plantar fascia strain were measured using an eight-camera motion analysis system and contrasted using paired samples t-tests. The results showed that plantar fascia strain was significantly greater in the overground condition (8.23 ± 2.77) compared to the treadmill (5.53 ± 2.25). Given the proposed relationship between excessive plantar fascia strain and the etiology of injury, overground running may be associated with a higher incidence of injury although further work is necessary before causation can be confirmed

Retrospective analysis of chronic injuries in recreational and competitive surfers:Injury location, type, and mechanism

Only two studies have reported on chronic musculoskeletal surfing injuries. They found over half of the injuries were non-musculoskeletal, but did not consider mechanisms of injury. This study identified the location, type, and mechanisms of chronic injury in Australian recreational and competitive surfers using a crosssectional retrospective observational design. A total of 1,348 participants (91.3% males, 43.1% competitive surfers) reported 1,068 chronic injuries, 883 of which were classified as major. Lower back (23.2%), shoulder (22.4%), and knee (12.1%) regions had the most chronic injuries. Competitive surfers had significantly (p \u3c .05) more lower back, ankle/foot, and head/face injuries than recreational surfers. Injuries were mostly musculoskeletal with only 7.8% being of non-musculoskeletal origin. Prolonged paddling was the highest frequency (21.1%) for mechanism of injury followed by turning maneuvers (14.8%). The study results contribute to the limited research on chronic surfing injuries

Health care consumption and costs due to foot and ankle injuries in the Netherlands, 1986-2010

Background: Foot and ankle injuries account for a large proportion of Emergency Department attendance. The aim of this study was to assess population-based trends in attendances due to foot and ankle injuries in the Netherlands since 1986, and to provide a detailed analysis of health care costs in these patients. Methods. Age- and gender-standardized emergency attendance rates and incidence rates for hospital admission were calculated for each year of the study. Injury cases and hospital length of stay were extracted from the National Injury Surveillance System (non-hospitalized patients) and the National Medical Registration (hospitalized patients). Data were grouped into osseous and ligamentous injuries for foot and ankle separately. An incidence-based cost model was applied to calculate associated direct health care costs. Results: Since 1986 the overall emergency attendance rate decreased from 858 to 640 per 100,000 person years. In non-admitted patients (90% of cases), ligamentous injuries approximately halved, whereas osseous injuries increased by 28% (foot) and 25% (ankle). The incidence rate for hospital admission increased by 35%, mainly due to an almost doubling of osseous injuries. Attendance rates showed a peak in adolescents and adults until ∼45 years of age in males and (less pronounced) in females. The total number of hospital days decreased to 58,708 days in 2010. Hospital length of stay (HLOS) increased with age and was highest for osseous injuries. HLOS was unaffected by gender, apart for longer stay in elderly females with an osseous ankle injury. Health care costs per case were highest for osseous injuries of the ankle ( 3,461). Costs were higher for females and increased with age to 6,023 in elderly males and 10,949 in elderly females. Main cost determinants were in-hospital care (56% of total costs), rehabilitation/nursing care (15%), and physical therapy (12%). Conclusions: Since 1986, the emergency attendance rate of foot and ankle injuries in the Netherlands decreased by 25%. Throughout the years, the attendance rate of (relatively simple) ligamentous injuries strongly reduced, whereas osseous injuries nearly doubled. Attendance rates and health care costs were gender- and age-related. Main cost determinants were in-hospital care, rehabilitation/ nursing care, and physical therapy

Self-selected Foot Strike Patterns in Runners when Transitioning from the Shod to Barefoot Condition: A Systematic Review of the Literature

Purpose and Background: Recent research has begun to focus on foot strike patterns as they relate to injuries in runners. Runners who employ a rear-foot strike (RFS) pattern (in which the heel lands before the ball of the foot) are more likely to experience repetitive stress injuries such as tibial stress fractures, patellofemoral pain syndrome (PFPS), and plantar fasciitis. Conversely, runners demonstrating a forefoot strike (FFS) pattern (defined as the ball of the foot-usually the 4th and 5th metatarsal heads-landing before the heel) are more susceptible to Achilles tendon, plantarflexor, and metatarsal injuries. Several systematic studies have concluded that barefoot runners employed a FFS pattern while shod runners used a RFS pattern. The purpose of this systematic review was to determine the effects of transitioning from traditionally shod running to barefoot running on self-selected initial contact patterns in long distance runners.https://jdc.jefferson.edu/dptcapstones/1010/thumbnail.jp

Gender differences in multi-segment foot kinematics and plantar fascia strain during running

This study aimed to determine whether there are gender differences in multi-segment foot kinematics and plantar fascia strain during running. Fifteen male and fifteen female participants ran at 4.0- m.s-1. Multi-segment foot kinematics and plantar fascia strain were quantified using a motion capture system and compared between genders using independent samples t-tests. The results showed that plantar fascia strain was significantly greater in males (0.09 ± 0.04) compared to females (0.06 ± 0.03). Furthermore male runners (-9.72 ± 3.09) were also associated with a significantly larger peak calcaneal eversion angle compared to females (-6.03 ± 2.33). Given the proposed relationship between high levels of plantar fascia strain as well as excessive coronal plane rotations of the foot segments and the etiology of injury, it is likely that the potential risk of the developing running injuries in relation to these mechanisms is higher in males

The influence of great toe valgus on pronation and frontal plane knee motion during running

Injury rates in running range from 19.4‐79.3%, with injuries at the knee comprising 42.1%. Pronation and altered frontal plane knee joint range of motion have been linked to such injuries. The influence of foot structure on pronation and knee kinematics has not been examined in running. This study examined associations between great toe valgus angle, peak pronation angle and frontal plane range of movement at the knee joint during overground running while barefoot. Great toe valgus angle while standing, and peak pronation angle and frontal plane range of motion of the dominant leg during stance while running barefoot on an indoor track were recorded in fifteen recreational runners. There was a large, negative association between great toe valgus angle and peak pronation angle (r = -0.52, p = 0.04), and a strong positive association between great toe valgus angle and frontal plane range of motion at the knee joint (r = 0.67, p = 0.006). The results suggest that great toe position plays an important role in foot stability and upstream knee-joint motion. The role of forefoot structure as a factor for knee-joint injury has received little attention and could be a fruitful line of enquiry in the exploration of factors underpinning running-related knee injuries

Audit on the use of radiography and the management of ankle sprains in A&E

Objective: To determine the need for a local implementation strategy of the Ottawa Ankle and Foot rule in the A& E Department of St. Luke' s Hospital, Malta and to examine the current management practices of ankle sprains. Methods: A prospective study was conducted on all patients aged 16 years and over presenting to the A& E department of St. Luke’s Hospital, Malta over a six week period with ankle and midfoot injuries. Data collected included time and mechanism of injury, clinical examination findings, radiographic investigations ordered, management and disposal of patient. Results: Sixty nine (95%) of the 73 patients presenting with ankle injuries underwent x-ray investigation. In total 90 x-ray series (i.e. AP and lateral) were performed, 62 of which were ankle x-rays and 28 were foot x-rays. Clinical application of the Ottawa ankle rules (OAR) would have resulted in a reduction of ankle x-rays by 19.4% and foot x-rays by 32.1%. Management of severe ankle sprains included written discharge instructions in 54% and referrals to physiotherapy in 31%. One patient out of the 13 with severe ankle sprains was given a follow up appointment at Fresh Trauma Clinic (FTC). Conclusion: A local implementation strategy for the OAR in the A& E department may result in an overall reduction in radiographic requests by 21%. An appropriate guideline for management of ankle injuries incorporating the OAR is needed and should be developed using the available evidence base.peer-reviewedpeer-reviewe

Subjective skeletal discomfort measured using a comfort questionnaire following a load carriage exercise

Objective: Limited research has been conducted into the effect of load carriage on discomfort and injuries. This study aimed to determine the skeletal discomfort for part-time soldiers who completed a 1-hour field march carrying 24 kg. Methods: A postmarch comfort questionnaire was completed by 127 participants, with exercise withdrawals and postmarch injuries also recorded. Results: The foot was subjectively rated as the most uncomfortable skeletal region. Females reported hip discomfort to be significantly greater than males. The military experience of participants had no difference on the mean perceived comfort ratings of any of the measured regions. Finally, only one participant withdrew from the exercise, with no participants reporting a load carriage injury in the 2 to 3 days proceeding the exercise Conclusions: This study concludes that although a 1-hour period of load carriage causes noteworthy discomfort it is not sufficient to result in noncompletion of a military exercise or cause injury

Comparison of lower body segment alignment of elite level hockey players to age-matched non-hockey players

Master's Project (M.A.) University of Alaska Fairbanks, 2015Lower body overuse and insidious onset injuries are thought to have an underlying biomechanical component which may be predisposing to injury. The purpose of this study was to compare lower body biomechanical characteristics for elite hockey players to matched controls. I hypothesize that elite hockey players have a greater degree of anterior pelvic tilt, greater varus knee angle, a higher foot arch and feet held in parallel more during gait than a matched non-skating population. Measures were taken of elite level, college aged, male hockey players and compared to cross country runners (ten subjects in each group) who served as controls for trunk angle, pelvic tilt angle, knee alignment, (varus/valgus angle), foot angle, arch index (arch height), hip, center of range of motion, hip external rotation, hip internal rotation, hip total range of motion (ROM), knee transverse plane ROM, and step width. The results obtained support the hypothesis for anterior pelvic tilt and foot angle during gait. Although knee angle was in the expected varus direction it was not significant and no differences were observed in the foot arch between the groups. All other measurements not directly related to the hypothesis were not significantly different with the exception of mean step width. The obtained results are important as recent literature describes a lower body posture of medial collapse into "dynamic valgus" as being predisposing to injury. Results show, on the spectrum from lower body varus to lower body valgus, hockey players are on the varus side of the spectrum in all attributes except arch height, which was similar in both populations. Since lower body alignment is thought to be coupled, this inconsistency appears contrary to the "medial collapse into dynamic valgus" model and may explain why foot orthotics and athletic shoes used as an injury intervention often fail

Material properties of the heel fat pad across strain rates

The complex structural and material behaviour of the human heel fat pad determines the transmission of plantar loading to the lower limb across a wide range of loading scenarios; from locomotion to injurious incidents. The aim of this study was to quantify the hyper-viscoelastic material properties of the human heel fat pad across strains and strain rates. An inverse finite element (FE) optimisation algorithm was developed and used, in conjunction with quasi-static and dynamic tests performed to five cadaveric heel specimens, to derive specimen-specific and mean hyper-viscoelastic material models able to predict accurately the response of the tissue at compressive loading of strain rates up to 150 s−1. The mean behaviour was expressed by the quasi-linear viscoelastic (QLV) material formulation, combining the Yeoh material model (C10=0.1MPa, C30=7MPa, K=2GPa) and Prony׳s terms (A1=0.06, A2=0.77, A3=0.02 for τ1=1ms, τ2=10ms, τ3=10s). These new data help to understand better the functional anatomy and pathophysiology of the foot and ankle, develop biomimetic materials for tissue reconstruction, design of shoe, insole, and foot and ankle orthoses, and improve the predictive ability of computational models of the foot and ankle used to simulate daily activities or predict injuries at high rate injurious incidents such as road traffic accidents and underbody blast