Strain and loading of the second metatarsal during heel-lift.

Sharkey, Neil A.; Ferris, Linda; Smith, Tait S.; Matthews, Donald K.

doi:10.2106/00004623-199507000-00011

Cited by 87 publications

(44 citation statements)

References 13 publications

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“…Compared to the other metatarsals, the second carries the greatest loads during gait, 13,37 is the longest, and based on a diameter-to-length relationship, the least robust. 21,39 Ten subjects developed fracture while running track or cross-country. Gross and Bunch 21 collected data on runners using transducers placed beneath the forefoot and modeled the data to predict that the peak force and bending strain at the second metatarsal was 7 times that of the first.…”

Section: Discussionmentioning

confidence: 99%

“…29,35 Risk factors for development of fracture in women athletes include a history of menstrual disturbance caused by intensive physical activity, 6,10 low bone density, 10 less muscle mass 5 and mechanical dysfunction of the foot. 13,39,44 An unstable first ray and its resultant decreased capacity to carry weight has been theorized as a mechanical cause of a second or third metatarsal stress fracture. 32,33,44 Instability is described clinically as excessive dorsal excursion of the first metatarsal with a soft end point of motion.…”

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confidence: 99%

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Dorsal First Ray Mobility in Women Athletes With a History of Stress Fracture of the Second or Third Metatarsal

Glasoe¹,

Allen²,

Kepros³

et al. 2002

J Orthop Sports Phys Ther

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Study Design: Retrospective case-control study. Objective: To examine the amount of dorsal first ray mobility in subjects having a history of stress fracture of the second or third metatarsal as compared to control subjects, and to test the influence of navicular drop, length of the first ray, and generalized joint laxity on the measure of dorsal mobility. Background: Instability of the first ray may cause the lesser metatarsals to carry greater weight and contribute to the incidence of metatarsal stress fracture. Stability of the first ray is believed to be compromised when subtalar joint pronation continues into late stance, the first metatarsal is short, or an individual has generalized joint laxity. To date, no research has assessed the relationship of these etiological factors to the measure of first ray mobility. Methods and Measures: Fifteen women athletes having a history of a second or third metatarsal stress fracture were matched by age, body mass, and sport activity to women athletes without fracture. Dorsal first ray mobility was quantified by a device using a standard load of 55 N. Change in vertical height of the navicular during stance was the measure of foot pronation. Relative length of the first ray navicular segment compared to the length of the second ray navicular segment was measured by caliper. Generalized joint laxity was evaluated using the Beighton 9-point scale. Within-day repeated measures assessed reliability. Differences between groups were determined by independent t test. Multiple polynomial regression analysis assessed the relationship between dorsal mobility and navicular drop, length of the first ray, and joint laxity. Results: Interrater reliability coefficients ranged from 0.36 for metatarsal length to 0.71 for navicular drop. The intrarater reliability coefficient for dorsal first ray mobility was 0.93. Dorsal first ray mobility was not significantly different between the 2 groups. With regression analysis, the Beighton score was the only variable retained as a significant predictor of dorsal mobility (R 2 = 0.24). Conclusion: Results do not support the theory that describes the unstable first ray as a common cause of metatarsal stress fracture. In addition, this investigation found generalized joint laxity to be a significant predictor of dorsal first ray mobility.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Dorsal First Ray Mobility in Women Athletes With a History of Stress Fracture of the Second or Third Metatarsal

Glasoe¹,

Allen²,

Kepros³

et al. 2002

J Orthop Sports Phys Ther

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“…The observed peroneus longus muscle fatigue may have been the result of a greater contribution of the plantar flexor muscles while knee extensor moments were reduced. Plantar flexor muscle fatigue has previously been associated with both tibial (Milgrom et al 2007) and metatarsal (Arndt et al 2002;Sharkey et al 1995) stress fractures. Given its contributing role to ankle plantar flexion, peroneus longus muscle fatigue following a prolonged military load carriage activity may therefore be associated with the high rate of lower limb stress fracture in military populations.…”

Section: Effect Of Completing the Load Carriage Activitymentioning

confidence: 99%

“…These muscles act as plantar flexors during the push-off phase of walking, and play a protective role against increasing tibial (Milgrom et al 2007) and metatarsal (Arndt et al 2002;Sharkey et al 1995) strain. This protective ability may be impaired as a result of fatigue.…”

Section: Introductionmentioning

confidence: 99%

Influence of a 12.8-km military load carriage activity on lower limb gait mechanics and muscle activity

Rice

Fallowfield²,

Allsopp³

et al. 2016

Ergonomics

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The high stress fracture occurrence in military populations has been associated with frequent load carriage activities. This study aimed to assess the influence of load carriage and of completing a load carriage training activity on gait characteristics. Practitioner Summary:This study identified gait changes due to load carriage and after a military load carriage training activity. Such activities are associated with lower limb stress fractures. A prepost study design was used. Gait mechanics changed to a greater extent when carrying load, than after completion of the activity when assessed without load.

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“…However, the interrelationships among muscular control, internal joint movements, and plantar loading distributions have not been fully explored due to experimental difficulties. Sharkey et al (1995) simulated flexor muscle action in a cadaveric foot model and achieved a maximum GRF of 750N during heel-lift; strains in the second metatarsal bone were also measured. Similar loading conditions were applied by Ferris et al (1995) on the influence of extrinsic plantar flexors on loads borne by the toes, in which no variation of Achilles tendon forces was considered.…”

Section: Introductionmentioning

confidence: 99%

Role of gastrocnemius–soleus muscle in forefoot force transmission at heel rise — A 3D finite element analysis

Chen

Park

et al. 2012

Journal of Biomechanics

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Strain and loading of the second metatarsal during heel-lift.

Cited by 87 publications

References 13 publications

Dorsal First Ray Mobility in Women Athletes With a History of Stress Fracture of the Second or Third Metatarsal

Dorsal First Ray Mobility in Women Athletes With a History of Stress Fracture of the Second or Third Metatarsal

Influence of a 12.8-km military load carriage activity on lower limb gait mechanics and muscle activity

Role of gastrocnemius–soleus muscle in forefoot force transmission at heel rise — A 3D finite element analysis

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