Abstract
BackgroundExcessive pronation (or eversion) at ankle joint in heel-toe running correlated with lower extremity overuse injuries. Orthotics and inserts are often prescribed to limit the pronation range to tackle the problem. Previous studies revealed that the effect is product-specific. This study investigated the effect of medial arch-heel support in inserts on reducing ankle eversion in standing, walking and running.MethodsThirteen pronators and 13 normal subjects participated in standing, walking and running trials in each of the following conditions: (1) barefoot, and shod condition with insert with (2) no, (3) low, (4) medium, and (5) high medial arch-heel support. Motions were captured and processed by an eight-camera motion capture system. Maximum ankle eversion was calculated by incorporating the raw coordinates of 15 anatomical positions to a self-compiled Matlab program with kinematics equations. Analysis of variance with repeated measures with post-hoc Tukey pairwise comparisons was performed on the data among the five walking conditions and the five running conditions separately.ResultsResults showed that the inserts with medial arch-heel support were effective in dynamics trials but not static trials. In walking, they successfully reduced the maximum eversion by 2.1 degrees in normal subjects and by 2.5–3.0 degrees in pronators. In running, the insert with low medial arch support significantly reduced maximum eversion angle by 3.6 and 3.1 degrees in normal subjects and pronators respectively.ConclusionMedial arch-heel support in inserts is effective in reducing ankle eversion in walking and running, but not in standing. In walking, there is a trend to bring the over-pronated feet of the pronators back to the normal eversion range. In running, it shows an effect to restore normal eversion range in 84% of the pronators.
Highlights
Excessive pronation at ankle joint in heel-toe running correlated with lower extremity overuse injuries
This study aims to evaluate the effect of orthotic inserts with different degree of medial arch-heel support in reducing maximum ankle eversion in standing, walking and running
analysis of variance (ANOVA) was performed for statistical analysis
Summary
Excessive pronation (or eversion) at ankle joint in heel-toe running correlated with lower extremity overuse injuries. This study investigated the effect of medial arch-heel support in inserts on reducing ankle eversion in standing, walking and running. Excessive pronation (or eversion in frontal plane) at ankle joint during repetitive impact in heel-toe running correlates with lower extremity overuse injuries and musculoskeletal pathologies, such as patellofemoral joint syndrome [1]. Ankle pronation (and its opposite, supination) refers to the calcaneal motion with respect to the talus orientation at the subtalar joint. Since the axis does not coincide with the human anatomical reference frame, the subtalar joint movement is often described as a tri-planar motion. The motion in frontal plane is often termed calcaneal or heel inversion/eversion [4], which describes the foot segment rotation about the anterior-posterior axis [5]
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