Effect of Ankle and Knee Position on Tension in the Achilles                Tendon

Davis, William L.; Singerman, Robert; Labropoulos, Panagiotis A.; Victoroff, Brian N.

doi:10.1177/107110079902000210

Cited by 29 publications

(29 citation statements)

References 5 publications

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“…Thus, PF of the ankle alone appears to loosen the Achilles-tendon complex, and any further loosening produced by flexing the knee may not have resulted in any additional effect. This finding is supported by Davis et al, 20 who measured the passive tension forces in the Achilles tendon at various knee and ankle positions and reported that positioning the hindfoot in at least 156 of PF effectively eliminated tension in the Achilles tendon. When examined with the knee in full extension, tension within the Achilles tendon was eliminated at 306 of PF.…”

Section: Effects Of Knee Positioningsupporting

confidence: 75%

“…When examined with the knee in full extension, tension within the Achilles tendon was eliminated at 306 of PF. 20 …”

Section: Effects Of Knee Positioningmentioning

confidence: 99%

“…Because the muscle crosses the knee, ankle, and subtalar joint, placing the gastrocnemius in a shortened position could reduce the passive tension effects (tightness) of the muscle acting through the Achilles tendon on the ankle complex. 5,19,20 When anterior drawer loading of the ankle is performed with the knee extended, ankle complex laxity and stiffness are more likely to be affected by the noncontractile components of the gastrocnemius-Achilles tendon complex, which could be under increased tension due to musculotendinous unit elongation. 21 In biological tissues, the elasticity of the tissue is quantified by its stiffness and is calculated as the change in applied force divided by the resulting change in length.…”

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confidence: 99%

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Knee and Ankle Position, Anterior Drawer Laxity, and Stiffness of the Ankle Complex

Kovaleski

Norrell

Heitman

et al. 2008

Journal of Athletic Training

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Context: Anterior drawer testing of the ankle is commonly used to diagnose lateral ligamentous instability. Our hypothesis was that changing knee and ankle positions would change the stability of the ankle complex during anterior drawer testing.Objectives: To assess the effects of knee and ankle position on anterior drawer laxity and stiffness of the ankle complex.Design: A repeated-measures design with knee and ankle position as independent variables.Setting: University research laboratory.Patients or Other Participants: Bilateral ankles of 10 female (age 5 19.8 6 1.1 years) and 10 male (age 5 20.8 6 1.2 years) collegiate athletes were tested.Intervention ( Results: Anterior laxity of the ankle complex was maximal with the knee positioned at 906 of flexion and the ankle at 106 of PF when compared with the knee positioned at 06 of flexion and the ankle at 106 or 06 of PF (P , .001), whereas ankle complex stiffness was greatest with the knee positioned at 06 of flexion and the ankle at 06 of PF (P , .009).Conclusions: Anterior drawer testing of the ankle complex with the knee positioned at 906 of flexion and the ankle at 106 of PF produced the most laxity and the least stiffness. These findings indicate that anterior drawer testing with the knee at 906 of flexion and the ankle at 106 of PF may permit better isolation of the ankle capsuloligamentous structures.Key Words: lateral ankle sprains, physical examination Key PointsN Differences in ankle laxity and stiffness during anterior drawer loading of the ankle complex were found in various knee and ankle positions.N Alterations in the passive tension characteristics acting through the Achilles tendon complex and the ankle capsuloligamentous structures should be considered when assessing ankle ligament laxity.

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Section: Effects Of Knee Positioningsupporting

confidence: 75%

“…When examined with the knee in full extension, tension within the Achilles tendon was eliminated at 306 of PF. 20 …”

Section: Effects Of Knee Positioningmentioning

confidence: 99%

mentioning

confidence: 99%

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Knee and Ankle Position, Anterior Drawer Laxity, and Stiffness of the Ankle Complex

Kovaleski

Norrell

Heitman

et al. 2008

Journal of Athletic Training

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“…The soleus muscle has a stabilizing effect on the foot and is continuously active during erect standing (Norkin and Levangie, 1983). Various positions of the knee and ankle joints can affect the forces along the Achilles tendon (Arndt et al, 1998, Davis et al, 1999. The Achilles tendon is broad and flat where it originates and becomes more narrow and rounded distally before it fans out at the insertion (Józsa and Kannus, 1997).…”

Section: Anatomymentioning

confidence: 99%

Iontophoresis with or without dexamethazone in the treatment of acute Achilles tendon pain

Neeter

Thomeé

Silbernagel

et al. 2003

Scandinavian Med Sci Sports

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The purpose of this double‐blind study was to evaluate the effects of iontophoresis with dexamethazone to iontophoresis with saline solution on patients who had acute (less than 3 months) pain from the Achilles tendon, in terms of range of motion, muscular endurance, pain and symptoms. Twenty‐five patients (15 men and 10 women), aged between 18 and 76 years (mean = 38), were evaluated before and after 2 weeks of treatment with iontophoresis, as well as after 6 weeks, 3 and 6 months and 1 year. Two groups were treated for 2 weeks with iontophoresis for each treatment. Three ml of dexamethazone were used for the experiment group (n = 14) and 3 ml of saline solution for the control group (n = 11). Both groups then followed the same rehabilitation programme for 10 weeks. Good reliability was found for the toe‐raise and range of motion tests. Poor reliability was, however, found for the pain on palpation test, which was therefore excluded. No difference was found between or within groups for the toe‐raise test. Several significant improvements were seen in the experiment group but not in the control group, in the range of motion test, pain during and after physical activity, pain during walking and walking up and down stairs, morning stiffness and tendon swelling. Even though the small sample size limits the possibilities to draw definite conclusions, we conclude from the present study, using a double‐blind, randomised approach and a 1‐year follow‐up period, that positive effects from using iontophoresis with dexamethazone were found in the treatment of patients with acute Achilles tendon pain.

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“…On the other hand, Davis et al [26] stated that positioning the hindfoot in 20-25 degrees of plantarflexion effectively eliminates tension in the Achilles tendon, regardless of knee position.…”

Section: Discussionmentioning

confidence: 99%