Effectiveness of Gastrocnemius Stretching

NCT ID: NCT05015088

Last Updated: 2023-10-10

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 20 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2022-05-01
• Study Completion Date: 2023-04-15

Brief Summary

The aims of this study are to: (1) determine muscle activation of the tibialis posterior muscle during different common gastrocnemius stretches and (2) radiographically quantify the tibial-calcaneal angle during the common stretching positions. We hypothesize that stretching over the edge of a step with the arch supported will minimize the activation of the tibialis posterior muscle in addition to increasing the tibial-calcaneal angle.

Detailed Description

Many studies have assessed the effect of dynamic and passive support of the medial longitudinal arch. The posterior tibial tendon is the main dynamic stabilizer of the medial longitudinal arch, although peroneus/fibularis longus, flexor digitorum longus, and flexor hallucis longus also contribute to a lesser degree. Passive structures also a play role in supporting the arch and include the plantar fascia, plantar ligaments and spring ligament. These plantar structures aid in preventing collapse of the arch during weight bearing.

Several studies have demonstrated that increased tension from the triceps surae can lead to flattening of the arch. Gastrocnemius muscle tightness in particular is thought to be partially responsible for many forefoot and midfoot conditions in non-neurologically impaired patients. Therefore, identifying effective ways to stretch the gastrocnemius muscle without creating increased stress through dynamic structures that support the longitudinal arch may be important for the management of individuals with limited gastrocnemius flexibility.

Common ways to stretch the gastrocnemius include a runner's stretch, stretching with the foot fully supported on a ramp, stretching with the arch of the foot supported on the edge of step and the heel dropping down toward the ground and lastly, stretching with the ball of the foot supported on the edge of a step and the heel dropping down toward the ground. To our knowledge no other studies have assessed the muscle activation of the tibialis posterior muscle via indwelling EMG activation in addition to radiographic measurements to determine the effectiveness of common gastrocnemius stretches. Therefore, the aims of this study are to determine muscle activation of the tibialis posterior muscle during different common gastrocnemius stretches and to radiographically quantify the tibial-calcaneal angle. We hypothesize that stretching over the edge of a step with the arch supported will minimize the activation of the tibialis posterior muscle in addition to increasing the tibial-calcaneal angle more than the other stretching positions.

Conditions

Gastrocnemius Tightness

Study Design

• Observational Model Type: OTHER
• Study Time Perspective: PROSPECTIVE

Study Groups

Gastrocnemius Stretching Group

The study will enroll 20 healthy subjects between the ages of 18 to 65 years old. Individuals will be recruited from multiple locations. Exclusion criteria include: any boney or tendinous foot/ankle operative procedure, diagnosis of neuromuscular disorder, any previous ankle fracture or degenerative changes that would limit dorsiflexion range of motion. Participants must have no obvious gait asymmetries demonstrated through observation. In addition, participants who are pregnant will be excluded from participation in the study.

No interventions will be performed in this study

Intervention Type: OTHER

This study will not include any intervention

Interventions

No interventions will be performed in this study

This study will not include any intervention

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• 20 healthy subjects between the ages of 18 to 65 years old.

Exclusion Criteria

• any boney or tendinous foot/ankle operative procedure
• diagnosis of neuromuscular disorder
• any previous ankle fracture or degenerative changes that would limit dorsiflexion range of motion
• no obvious gait asymmetries demonstrated through observation
• participants who are pregnant will be excluded from participation in the study

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

University of Colorado, Denver

OTHER

Sponsor Role: collaborator

Regis University

OTHER

Sponsor Role: lead

Responsible Party

Stephanie Albin

Principal Investigator

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Stephanie Albin, PhD

Role: PRINCIPAL_INVESTIGATOR

Regis University

Locations

Regis University

Denver, Colorado, United States

Countries

United States

References

Mueller TJ. Acquired flatfoot secondary to tibialis posterior dysfunction: biomechanical aspects. J Foot Surg. 1991 Jan-Feb;30(1):2-11.

Reference Type: BACKGROUND

PMID: 2002182 (View on PubMed)

Thordarson DB, Schmotzer H, Chon J, Peters J. Dynamic support of the human longitudinal arch. A biomechanical evaluation. Clin Orthop Relat Res. 1995 Jul;(316):165-72.

Reference Type: BACKGROUND

PMID: 7634700 (View on PubMed)

Huang CK, Kitaoka HB, An KN, Chao EY. Biomechanical evaluation of longitudinal arch stability. Foot Ankle. 1993 Jul-Aug;14(6):353-7. doi: 10.1177/107110079301400609.

Reference Type: BACKGROUND

PMID: 8406252 (View on PubMed)

DiGiovanni CW, Kuo R, Tejwani N, Price R, Hansen ST Jr, Cziernecki J, Sangeorzan BJ. Isolated gastrocnemius tightness. J Bone Joint Surg Am. 2002 Jun;84(6):962-70. doi: 10.2106/00004623-200206000-00010.

Reference Type: BACKGROUND

PMID: 12063330 (View on PubMed)

Maeda N, Komiya M, Nishikawa Y, Morikawa M, Tsutsumi S, Tashiro T, Fukui K, Kimura H, Urabe Y. Effect of Acute Static Stretching on the Activation Patterns Using High-Density Surface Electromyography of the Gastrocnemius Muscle during Ramp-Up Task. Sensors (Basel). 2021 Jul 15;21(14):4841. doi: 10.3390/s21144841.

Reference Type: BACKGROUND

PMID: 34300581 (View on PubMed)

Other Identifiers

COMIRB

Identifier Type: -

Identifier Source: org_study_id