Controlled Trial to compare the Achilles Tendon load during running in flatfeet participants using a customized arch support orthoses vs an orthotic heel lift

Abstract

Achilles tendinopathy is one of the most common overuse injuries in running, and forefoot pronation, seen in flatfeet participants, has been proposed to cause additional loading across the Achilles tendon. Foot orthoses are one of the common and effective conservative treatment prescribed for Achilles tendinopathy, it works by correcting the biomechanical malalignment and reducing tendon load. Previous studies have shown reduction of Achilles Tendon load (ATL) during running by using customized arch support orthosis (CASO) or an orthotic heel lift (HL). However, there are still little biomechanical evidence and comparative studies to guide orthotic prescriptions for Achilles tendinopathy management. Therefore, this study seeks to investigate the two currently employed orthotic treatment options for Achilles tendinopathy: CASO and HL for the reduction of ATL and Achilles tendon loading rate (ATLR) in recreational runners with flatfeet. Methods: 12 participants were recruited and run along the runway in the laboratory for three conditions: (1) without orthoses, (2) with CASO (3) with HL. Kinematic and kinetic data were recorded by 3D motion capturing system and force platform. Ankle joint moments and ATL were computed and compared within the three conditions. Results: Participants who ran with CASO (p=0.001, d=0.43) or HL (p=0.001, d=0.48) associated with a significant reduction in ATL when compared to without orthotics. There was no difference between the two types of orthoses, the mean peak ATL of CASO was slightly lower than HL. Regarding the ATLR, both orthoses, CASO (p=0.003, d= 0.93) and HL (p=0.004, d= 0.78), exhibited significant lower value than the control but similarly, no significant difference was noted between them in which the use of CASO yielded a slightly lower loading rate than that of HL. Conclusion: Both CASO and HL were able to cause a significant reduction in peak ATL and ATLR comparing to without orthotics condition. There were subtle but no statistically significant differences in the biomechanical effects between the two types of orthoses. The findings help to quantify the effect of CASO and HL on load reduction of Achilles tendon and suggests that foot orthoses may serve to prevent the incidence of Achilles tendon pathologies.

Advanced Robotics to Address the Translational Gap in Tendon Engineering

“…By adjusting the current flow, a piston was electromagnetically moved back and forth and translated onto their collagen construct, resulting in the cells and the scaffold fibres aligning in the direction of loading [66]. The range of stress reported in this study, 1.5-4.5 N, is orders of magnitude lower than the load experienced by Achilles tendons in vivo, which can often experience loads of 6-8 times body weight (upwards of 3500 N) when running [76].…”

Möglichkeiten der Einlagenversorgungen im Sport – eine Übersicht

“…Es besteht eine Koinzidenz der Achillodynie zur lateralen Kapselbandinsuffizienz des Sprunggelenks, zum Knick-Senkfuß, zum Hohlfuß, zum Hallux rigidus und zu Knorpelschäden des oberen und unteren Sprunggelenks. Das Training mit "falschen" Sportschuhen, aber auch Trainingsfehler wie das Trainieren auf zu hartem Untergrund, zu hohe Trainingsintensität, zu wenig Regeneration und auch häufiges Training im anaeroben Bereich sind ursächlich für die Achillodynie [30]. Ursachen der Schmerzen können auch ein Impingement der Achillessehne und der darunterliegenden Bursae sein.…”