Are static foot posture and ankle dorsiflexion range of motion associated with Achilles tendinopathy? A cross-sectional study

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Author(s)Scattone Silva, Rodrigo
Author(s)Powell Smitheman, Hayley Powell
Author(s)Smith, Andy K.
Author(s)Silbernagel, Karin Grävare
Date Accessioned2023-02-02T19:24:18Z
Date Available2023-02-02T19:24:18Z
Publication Date2022-12-02
DescriptionThis 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.
AbstractBackground 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.
SponsorResearch reported in this publication was supported by the National Institute Of Arthritis And Musculoskeletal And Skin Diseases of the National Institutes of Health under Award Number R01AR072034. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors would like to thank past and current members of the Delaware Tendon Research Group who have assisted in the data collections.
CitationScattone 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.
ISSN1809-9246
URLhttps://udspace.udel.edu/handle/19716/32204
Languageen_US
PublisherBrazilian Journal of Physical Therapy
Keywordscalcaneal
Keywordspronation
Keywordssupination
Keywordstendinitis
Keywordstendinosis
Keywordstendon
TitleAre static foot posture and ankle dorsiflexion range of motion associated with Achilles tendinopathy? A cross-sectional study
TypeArticle
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