Are static foot posture and ankle dorsiflexion range of motion associated with Achilles tendinopathy? A cross-sectional study
Date
2022-12-02
Journal Title
Journal ISSN
Volume Title
Publisher
Brazilian Journal of Physical Therapy
Abstract
Background
Subtalar hyperpronation and ankle dorsiflexion restriction have been theoretically associated with Achilles tendinopathy (AT). However, evidence to support these associations is lacking.
Objectives
To compare foot alignment and ankle dorsiflexion range of motion (ROM) between the symptomatic and non-symptomatic limbs of individuals with unilateral AT. And to verify whether differences exist between individuals with symptomatic pronated feet and individuals with symptomatic neutral/supinated feet in terms of tendon pain, structure, and symptom severity.
Methods
Sixty-three participants with unilateral AT underwent a bilateral evaluation of pain during tendon palpation, symptom severity, tendon thickening, tendon neovascularization, ankle dorsiflexion ROM, and foot posture alignment [foot posture index (FPI), navicular drop, navicular drift, and longitudinal arch angle (LAA)]. Side and group comparisons were made using t-tests and correlations were evaluated using the Pearson test.
Results
There were no differences between the symptomatic and non-symptomatic limbs regarding foot posture alignment. Specifically, non-significant negligible differences were observed between limbs regarding FPI [mean difference (MD)=-0.23; 95% confidence interval (CI)=-0.70, 0.25), navicular drop (MD=0.58 mm; 95%CI=-0.25, 1.43), navicular drift (MD=0.16 mm; 95%CI=-0.77, 1.09), and LAA (MD=0.30º; 95%CI=-1.74, 2.34). There was no difference between limbs regarding ankle dorsiflexion ROM. However, lower ankle dorsiflexion was associated with worse symptom severity (r = 0.223). Finally, no difference was observed between individuals with symptomatic pronated feet and individuals with symptomatic neutral/supinated feet in terms of tendon pain or structure.
Conclusions
Static foot alignment measures do not seem to be clinically relevant in patients with AT. Smaller ankle dorsiflexion ROM, however, was associated with greater symptom severity in this population.
Description
This article was originally published in Brazilian Journal of Physical Therapy. The version of record is available at: https://doi.org/10.1016/j.bjpt.2022.100466. This article will be embargoed until 12/02/2023.
Keywords
calcaneal, pronation, supination, tendinitis, tendinosis, tendon
Citation
Scattone Silva, Rodrigo, Hayley Powell Smitheman, Andy K. Smith, and Karin Grävare Silbernagel. “Are Static Foot Posture and Ankle Dorsiflexion Range of Motion Associated with Achilles Tendinopathy? A Cross-Sectional Study.” Brazilian Journal of Physical Therapy 26, no. 6 (December 2, 2022): 100466. https://doi.org/10.1016/j.bjpt.2022.100466.