Flatfoot Research Articles

Three-Plane Calcaneal Osteotomy With Joint Preservation vs Subtalar Arthrodesis to Treat Painful Calcaneal Fracture Malunions.

Calcaneal fracture malunion (CFM) commonly occurs with multiple pathologic changes and progressive pain and difficulty walking. The purpose of this study was to propose a modified 3-plane joint-preserving osteotomy for the treatment of CFM with subtalar joint incongruence, and to compare its efficacy to subtalar arthrodesis. A retrospective comparative analysis of the data of 56 patients with CFM admitted from January 2017 to December 2022 was performed. Twenty-six patients were in the osteotomy group and 30 in the arthrodesis group. Computed tomographic (CT) scans were used for measurement of the intraarticular steps. Radiologic parameters, visual analog scale (VAS) score for pain, 12-Item Short Form Health Survey (SF-12) mental component summary (MCS) and physical component summary (PCS) scores were compared between the 2 groups of patients to assess the outcome preoperatively and at last follow-up, which averaged 22.6 ± 3.6 months and 27.6 ± 3.6 months for the osteotomy and arthrodesis groups, respectively. Improvements in pain, function, and overall quality of life were obtained in both groups compared with the preoperative values at last follow-up. The VAS and SF-12 scores were similar between the groups at the last follow-up. In the osteotomy group, the average CT scan-measured intraarticular step-offs were significantly reduced from 3.7 ± 1.2 mm to 0.9 ± 0.3 mm. The osteotomy group showed improvement in pronation and supination range of motion (ROM) of the feet (P < .01). The correction of the ankle height and Meary angle were slightly better in the osteotomy group. In this short-term follow-up study, good results were achieved in both joint-preserving osteotomy and subtalar arthrodesis groups for the treatment of CFM with subtalar joint incongruence. The osteotomy group preserved the subtalar joint and achieved improvements in pronation and supination ROM.

Subtalar arthroereisis for simultaneous treatment of flexible pes planus during surgical correction of hallux valgus

BackgroundScarf osteotomy is a well-established procedure for hallux valgus, yet recurrence rates range from 3.6% to 10%. Pes planus, which often coexisting with hallux valgus, is a risk factor for recurrence. This study aimed to evaluate the effectiveness of simultaneous correction of hallux valgus and flexible pes planus.MethodsA total of 85 feet with hallux valgus associated with adult flexible pes planus were retrospectively reviewed. All patients were treated with scarf osteotomy (SO). Subtalar arthroereisis using a HyProCure implant (SOH) was performed to correct hindfoot valgus based on shared decision-making. We collected and compared pre- and at least 2 year postoperative clinical outcomes (American Orthopaedic Foot & Ankle Society (AOFAS) forefoot, hindfoot score, Visual Analog Scale (VAS) pain intensity) and radiographic outcomes (hallux valgus angle (HVA), intermetatarsal angle (IMA), Meary’s angle, talonavicular coverage angle (TNCA), and calcaneal pitch (CP) angle in both groups.ResultsOf the cases reviewed, 51 feet were allocated to SO group, and 34 feet were in SOH group. Recurrence frequency was 5 feet (9.8%) in the SO group, while no recurrences were reported in the SOH group. There was no significant difference in AOFAS forefoot and VAS scores between the groups, However, the SOH group demonstrated significant improvement in AOFAS hindfoot scores and CP angle, as well as a greater reduction in Meary’s angle and TNCA, compared to the SO group. Changes in HVA and IMA did not differ significantly between the groups. Three feet in the SOH group experienced sinus tarsi pain, which resolved after removal of the HyProCure implant.ConclusionsSubtalar arthroereisis with a HyProCure implant is an effective treatment option for adult flexible pes planus associated with scarf osteotomy for hallux valgus, leading to a steady improvement in the patients forefoot deformity and increased patient satisfaction at least 2 years postoperatively.

Optimizing the graft size in the Evans osteotomy to minimize the calcaneocuboid joint pressure by highly realistic in-silico analysis

This contribution details a new high-fidelity finite element analysis (FEA) methodology for the investigation of the effect of the graft size on the pressure distribution developing at the calcaneocuboid joint after the Evans osteotomy procedure. The FEA model includes all 28 bones of the foot up to the distal end of fibula and tibia as well as soft tissues, tendons, and muscles. The developed FEA model was validated by comparing the in-vivo pressure distribution on the foot plantar with the in-silico results, resulting in a low deviation equal to 7.8%, and with the deformed foot shape caused by the body weight in static standing position measured by a high-precision lidar scanning, for an average shape error of 5.3%. The developed FEA was then employed to investigate the effect of the graft size on the calcaneocuboid joint pressure and improvement in the medial-longitudinal arch for a flat foot patient, where the soft and hard tissues’ geometries were acquired by a CT scan. The results quantitatively demonstrated that the maximum pressure at the calcaneocuboid joint follows a quadratic trend where the minimum point also represents the best compromise to alleviate the flat foot condition while avoiding excessive pressure.

Endoscopic Treatment of Chronic Plantar Fasciitis with Plantar Heel Spur Pain: A Combined Suprafascial and Infrafascial Approach.

To determine whether a combined endoscopic suprafascial and infrafascial approach with medial and lateral portals is a safe and effective technique for the endoscopic treatment of chronic plantar fasciitis with plantar heel spur pain. An interventional, prospective study was conducted. A total of 61 patients with plantar fasciitis with plantar heel spur pain underwent an endoscopic plantar fasciotomy with plantar heel spur resection, using a combined suprafascial and infrafascial approach between January 2018 and August 2022. Preoperative Foot and Ankle Ability Measure (FAAM), 36-Item Short Form Health Survey (SF-36), and visual analog scale (VAS) scores were measured. The measurements were repeated at 6 weeks, 3, 6, and 12 months postoperatively and at the final follow up. Preoperative and 1-year postoperative film parameters (Meary angle, calcaneal pitch angle, medial cuneiform-fifth metatarsal height) were compared.Complications were recorded at each encounter. The mean follow up time was 2.6 ± 1.1 years. At the 6-week postoperative visit, the mean change in FAAM-ADL, FAAM-Sport, SF-36 physical component summary, SF-36 mental component summary, and VAS were 26.0,19.0, 44.8, 61.2, and -5.8, respectively. These changes were statistically significant (P < .001). These findings were sustained and generally improved at all other follow-up points: 3, 6, and 12 months postoperatively and final follow-up. The average period until the recovery of activities of daily living and sport activities were 2.6 and 8.6 weeks, respectively. There were no significant differences between the pre- and 1-year postoperative radiographic values (P > .05). No cases resulted in medial arch collapse. Five cases (8%) had an injury to the first branch of lateral plantar nerve. Endoscopic plantar fascia release and plantar heel spur resection using a combined suprafascial and infrafascial approach resulted in the improvement of postoperative FAAM, SF-36, and VAS scores and involved a low incidence of postoperative complications.

The Effect of Flexible Flatfoot on the Running Function in School-Age Children.

Flexible flatfoot is common among school-age children and significantly affects walking efficiency, balance stability, and joint-movement coordination in children. The demands on the skeletal structure and muscle function are increased during running; however, the impact of a flexible flatfoot on children's running capabilities is unclear. In this study, we aimed to investigate the effects of flexible flatfoot on the running function of school-age children. Participants with flat feet (n = 28) and typical feet (n = 27) ran on a flat surface at their chosen maximum pace. At the same time, the kinematic and dynamic parameters of their lower limb joints were monitored. A two-sample statistical analysis assessed the differences in the lower limbs' three-dimensional kinematic and dynamic parameters during running. The findings revealed a significant reduction in running velocity, stride length, and frequency, and an increased proportion in the support phase (p < 0.05) in children with flexible flat feet. The navicular drop time decreased, whereas the dynamic navicular drop height increased (p < 0.05). A notable decrease in the maximum plantar flexion and eversion torque, power, and power absorption of the ankle joint was observed (p < 0.01). Furthermore, the maximum flexion torque of the knee and hip joints and hip joint power absorption decreased (p < 0.05). The peak ground reaction force in the anteroposterior directions was reduced (p < 0.01). These results indicate that flexible flatfoot can impair the running efficiency of school-age children and lead to diminished motor stability and reduced propulsive and braking capabilities.

Three-Dimensional Gait Analysis of School-Age Children With Angelman Syndrome: A Case-Control Study.

Gait disturbance is a common motor symptom in Angelman syndrome (AS), but its characteristics have been poorly studied quantitatively. This study aimed to analyze gait characteristics in school-age children with AS using three-dimensional gait analysis (3DGA). Patients with clinically and genetically confirmed AS and healthy children aged 6-15 years were included. For gait assessments, 3DGA was performed using an eight-camera motion analysis system and eight force plates. Gait metrics, including gait speed, step length, step width, gait variability, gait deviation index, and kinematic and kinetic data of lower extremity joints were compared between the groups. Eight children with AS and 24 healthy controls were evaluated. Seven children with AS had flat feet. While step length and gait speed were similar between groups, children with AS showed greater variability in these parameters and larger step widths. Their average gait deviation index was 74.5, indicating significant gait disturbance, and characteristic features included anterior pelvic tilt, insufficient hip extension, excessive knee flexion during early stance, and reduced ankle joint power. School-age children with AS exhibit unstable, prancing gait characterized by knee flexion in the early stance phase, quantifiable using 3DGA. These findings provide foundation for evaluating therapeutic interventions.

Pilot Study on Midfoot Pressure Analysis in Individuals with Flat Feet While Climbing Stairs Using a Pressure Sensing System

Flat feet, or pes planus, present a prevalent condition impacting mobility and quality of life, warranting an understanding of its biomechanical implications. This study aimed to quantify pressure differentials in the midfoot region between individuals with flat feet and those without during stair ascent. The pilot study evaluated one individual with clinically diagnosed flat feet and one healthy individual, both meeting specific inclusion criteria. The participants ascended stairs while a pressure-sensing system consisting of force-sensitive resistors (FSRs) recorded midfoot pressures. The results showed that individuals with flat feet exhibited lower pressure along the medial longitudinal arch and higher pressure along the lateral longitudinal arch compared to normal feet participants. Statistical analysis revealed significant differences in pressure for FSRs placed on the medial and lateral arches (p &lt; 0.05). These results suggest a compensatory shift in pressure distributions, highlighting the altered loading patterns associated with flat feet. These findings have significant implications for physical therapy, underscoring the importance of arch-strengthening exercises to improve foot stability and redistribute pressure more effectively. By integrating pressure mapping into rehabilitation strategies, therapists can create personalized treatment plans, ultimately improving outcomes for individuals with flat feet. Future studies with larger participant groups and advanced pressure-sensing technologies are needed to validate these findings and refine therapeutic approaches.

Impact of preoperative pes planus on orthopaedic implant removal following first metatarsophalangeal joint arthrodesis: A retrospective analysis.

First metatarsophalangeal (MTP) joint fusion is a frequently employed surgical treatment option for hallux rigidus and hallux valgus. Implant-related complications are common, necessitating further investigation into predisposing factors. The altered mechanics of pes planus may influence surgical outcomes; however, its direct impact on implant removal rates post-fusion remains unclear. We retrospectively analyzed the TriNetX US Collaborative Network database to identify patients undergoing first MTP joint arthrodesis by ICD-10 and CPT coding, the data was stratified by preoperative pes planus status. Implant removal rates were compared between pes planus (PP) and non-pes planus (noPP) cohorts. Odds ratios (OR) were calculated to assess associations. Patients in the PP cohort exhibited significantly higher rates of subsequent hardware irritation (OR 1.30, 95 % CI 1.010-1.675), and hardware removal (OR 1.27, 95 % CI 1.007-1.604) compared to patients in the noPP cohort. Our findings highlight patients with preoperative pes planus have significantly increased likelihood of implant irritation, removal, and reoperation following first MTP joint arthrodesis surgery. Biomechanical alterations associated with pes planus likely contribute to accelerated implant wear and compromise fusion stability leading to higher rates of future surgery.

Surgical Correction of Cavus Foot May Promote Quality of Life in Patients with Charcot-Marie-Tooth Disease: A Retrospective Study.

Charcot-Marie-Tooth disease (CMT) is a hereditary peripheral neuropathy leading to neuromuscular impairments, muscle atrophy, and functional limitations. Currently, no specific treatment exists to restore muscle strength in patients with CMT, and the disease can be severely disabling. Surgical correction of cavus foot has been suggested as a potential intervention to alleviate pain and improve gait in selected patients. This study aimed to evaluate the therapeutic effects and analyze the subsequent improvement in quality of life. A retrospective analysis was conducted on 45 patients (57 feet) who underwent surgical correction of cavus foot due to CMT. Annual follow-up assessments involved clinical symptoms, and patient-reported outcomes, including the Foot and Ankle Disability Index (FADI) and the Short-Form 12 (SF-12). Radiological evaluation was performed using the Meary angle, calcaneal pitch angle, talocalcaneal angle, talo-first metatarsal angle, and calcaneal-fifth metatarsal angle. After 2 years of follow-up, most radiographic and symptomatic outcomes improved significantly. Functional scales showed a significant increase (P < .001) in median FADI (23 vs. 40) and physical component score of the SF-12 (26 vs. 41). Therefore, surgical correction of cavus foot should be considered an effective intervention for patients with CMT, leading to sustained improvements in function and quality of life. LEVEL OF CLINICAL EVIDENCE: 4.

Lateral column lengthening using Z osteotomy of calcaneus for adolescents with symptomatic flexible flat foot

Lateral column lengthening using Z osteotomy of calcaneus for adolescents with symptomatic flexible flat foot

The immediate Effect of Treatment on Muscle Tension in Pediatric Adolescents with Tiptoe Walking and Flat Foot

The immediate Effect of Treatment on Muscle Tension in Pediatric Adolescents with Tiptoe Walking and Flat Foot

Plantar Pressure Topography Based Sports Branch Prediction System Modeling in 7-11 Years Old Athletes

Objective: The sole of foot plays a crucial role in sports movements, as it applies pressure to the ground and transfers loads. The foot pressing types vary depending on the sport played by the athlete. The aim of this study is to develop a model that can predict sports branches from the plantar pressure types of athletes. Methods: A total of 80 athletes, 54 athletics and 26 combat athletes, between the ages of 7-11 were included in the study where static pedobarographic measurements of the participants were collected. First we applied conventional statistical analysis on the featured obtained from the measurements of the data using Fisher Freeman Halton Exact test. Then, we implemented sports branch prediction based on the data obtained from these measurements using advanced machine learning and deep learning techniques. Results: There was no statistically significant difference between the plantar compression types of the participants according to the branches (p &gt; .05). In the machine learning classification based on foot plantar compression, the best success was found to be 56.9% with Linear Support Vector Machine. When the branch prediction successes made with deep learning were examined, it was found that the average branch prediction was 82.58±7.62% in the foot with pes planus, 87.84±17.56% in the normal foot, and 85.95±21.19% in the foot with pes cavus. Conclusion: In the study, it was determined that the success of branch prediction made with machine learning techniques was low, and the success of deep learning was high. With the development of the method used in this study in future studies, an idea can be obtained about which branch of the foot plantar pressure type is more prone to and innovations can be brought to the branch selection methods.

Neurodevelopmental Disorders and Connective Tissue-Related Symptoms: An Exploratory Case-Control Study in Children.

Background/Objectives: Autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), and Tourette syndrome (TS) are neurodevelopmental disorders (NDDs) with overlapping symptoms, suggesting a partially shared genetic origin. This study investigates the prevalence of connective tissue-related conditions in individuals with ASD, ADHD, or TS. Methods: A questionnaire was administered to families of 120 individuals with ASD, ADHD, or TS, collecting sociodemographic data and examining 10 types of disorders affecting various organs and systems. Statistical analyses were performed using STATA 16.0, with the significance level set at 5%. Results: Among the 120 patients, 48 had ASD, 36 had ADHD, and 36 had TS. Flat feet were significantly more common in individuals with ASD (52.1%; OR 7.20; p < 0.001), ADHD (52.8%; OR 6.73; p = 0.001), and TS (38.9%; OR 3.70; p = 0.034) compared to controls (13.6%). Hypersensitivity was more frequent in individuals with ASD (56.3%; OR 5.90; p = 0.001), ADHD (50.0%; OR 4.11; p = 0.011), and TS (58.3%; OR 5.35; p = 0.003) compared to controls (18.2%). Myopia and ptosis were more common in ADHD (30.6%). There was a possible trend towards orthodontic device use in TS (OR 3.20; p = 0.076). Flat feet and hypersensitivity were also common in fathers (31.0% and 36.4%, respectively), mothers (31.0% and 15.2%), and patients (43.8% and 55%). Conclusions: The findings of this study highlight the significant associations between ASD, ADHD, and TS and specific physical symptoms, such as flat feet, sensory hypersensitivity, and other connective tissue-related manifestations. The familial prevalence of these symptoms suggests a potential genetic underpinning, further supporting the hypothesis of shared aetiological pathways. These insights underscore the need for interdisciplinary research to explore the mechanisms linking neurodevelopmental and connective tissue disorders, aiming to improve diagnosis and management strategies.

Insoles in the treatment of pes planovalgus : A prospective, randomised, double-blind, placebo-controlled comparative trial of sensomotoric and supportive insoles

In adults, flexible symptomatic flat foot is treated conservatively with supportive foot orthoses. Sensorimotor foot orthoses, however, are controversial due to insufficient data. Comparison of the effectiveness of sensorimotor and supportive foot orthoses in adults. In 73patients, in addition to foot gymnastics, supportive, sensorimotor or placebo insoles were compared over 3measurement points during 1 year as part of adouble-blind, prospective, randomised placebo-controlled clinical trial using Numeric Rating-Scala, the Foot and Ankle Disability Index, as well as pedobarography and valgus index. The statistical analysis was performed using ANOVA with repeated measures. The valgus index increased significantly with supportive foot orthoses. In the follow-up, the foot contact area was only significantly reduced with sensorimotor foot orthoses in static and dynamic measurements. Supportive foot orthoses led to afaster reduction in pain, but withoutreducing the contact area of the foot. There were no relevant differences in functionality. The reduction of the contact surface in combination with sensorimotor foot orthoses shows the potential for muscular addressing of the flexible flat foot. There were no disadvantages compared to other treatments. Supportive foot orthoses led to afaster reduction in subjective complaints, but appear to weaken the muscles supporting the arch of the foot. In the longer term, consistent foot muscle training also appears to be effective, as wearing placebo foot orthoses also led to an improvement in subjective well-being without significant biomechanical changes.

Hallux valgus interphalangeus is more common in juvenile-onset hallux valgus than in adult-onset hallux valgus

BackgroundThis study aimed to compare the prevalence of hallux valgus interphalangeus (HVI) in juvenile-onset hallux valgus and adult-onset hallux valgus and to analyze the correlation between the hallux interphalangeal angle (HIA) and other radiographic parameters in juvenile-onset hallux valgus.MethodsThis retrospective study included 640 feet and 320 patients with hallux valgus (160 juvenile-onset and 160 adult-onset cases). Eight radiographic parameters were measured: HIA, hallux valgus angle, intermetatarsal angle, talonavicular coverage angle, anteroposterior talocalcaneal angle, lateral talocalcaneal angle, lateral talo-first metatarsal angle, and calcaneal pitch. The two groups were compared based on the radiographic parameters, and the correlation between the HIA and other radiographic parameters in juvenile-onset valgus was analyzed.ResultsThe prevalence of HVI in juvenile-onset hallux valgus (63%) was higher than that in adult-onset hallux valgus (28%), and juvenile-onset hallux valgus demonstrated a greater HIA than that displayed by adult-onset hallux valgus (mean ± standard deviation, 12.9 ± 5.7 and 8.3 ± 5.2, respectively). In juvenile-onset valgus, the HIA was negatively correlated with the hallux valgus (r = -0.218, p < 0.001) and intermetatarsal angles (r = -0.143, p = 0.015) and positively correlated with the talonavicular coverage (r = 0.240, p < 0.001) and anteroposterior talocalcaneal angles (r = 0.127, p = 0.008).ConclusionsJuvenile-onset hallux valgus is associated with more HVI than that in adults. Moreover, forefoot abduction deformity is related to the progression of HVI. These findings highlight the need to consider concomitant HVI when juvenile-onset valgus is encountered.Level of evidenceLevel III, retrospective comparative study.

Pes Planus Level and Foot Pain Affect Selected Performance Parameters: A Study on Team Sport Athletes

Aims to investigate the relationship between pes planus (PP) with foot pain (FP) and performance in team sport athletes. Correlational research was adopted to reveal the relationship between PP with FP and performance. There were 84 athletes were involved in this research. Measurement of PP with footprint test (FT), FP with knee pain intensity-visual analogue scale (KPI-VAS) and performance with items 30m sprint (30ms), modified agility t-test (MATT), counter movement jump (CMJ), standing stock balance test (SSBT). We observed that FT-PP variable has a moderate negative correlation with FP-KPI-VAS (p = 0.003), which shows that PP significantly causes foot pain. In CMJ (p = 0.035) and SSBT (p = 0.004) there is a moderate negative correlation, which shows that the PP level reduced the level of power and balance. Meanwhile, there is a moderate positive correlation with 30mS (p &lt; .001), and MATT (p &lt; .001), which shows that the level of PP will reduce the level of running speed and agility. At the same time, FP-KPI-VAS had a small negative correlation with 30mS (p = 0.017), MATT (p = 0.017) and CMJ (p = 0.048). Finally, FP-KPI-VAS was found to have a large positive correlation with SSBT (p &lt; .001). Thus, we confirm that PP is significantly correlated with FP and performance related to 30ms, MATT, CMJ, SSBT in team sports athletes.

Outcomes of Simultaneous Correction of Adult Hallux Valgus and Flexible Pes Planus Deformities.

There is a high correlation between hallux valgus and pes planus deformity. We sought to evaluate the outcomes of simultaneous Scarf osteotomy and extraosseous talotarsal stabilization (EOTTS) for correcting adult hallux valgus with flexible pes planus deformity. This retrospective study enrolled patients who had hallux valgus deformity with flexible pes planus and underwent combined Scarf osteotomy and EOTTS from January 2018 to October 2021. The hallux valgus angle (HVA), intermetatarsal angle (IMA), Meary's angle, calcaneal pitch, and lateral talocalcaneal angles were assessed preoperatively and at 1-year follow-up. Clinical outcomes were evaluated using the visual analog scale (VAS) score for pain, the American Orthopaedic Foot and Ankle Society (AOFAS) forefoot score, and the Maryland foot score (MFS). Complications were recorded. This study included 25 patients, 19 women and 6 men, with a mean age of 44.3 years. The mean follow-up period was 14.6 months. The mean HVA, IMA, Meary's angle, calcaneal pitch, and lateral talocalcaneal angles improved significantly at 1-year follow-up (P<.001). The mean VAS score decreased from 5.8 to 1.0, whereas the mean AOFAS forefoot score and MFS increased from 52.3 to 88.9 and 61.2 to 89.3, respectively, at 1-year follow-up (P<.001). Two patients had arthroereisis implant removal as a consequence of sinus tarsi pain. No other complications were seen during the follow-up. Management of hallux valgus with flexible pes planus deformity with combined Scarf osteotomy and EOTTS can achieve satisfactory clinical and radiologic results with low complication and recurrence rates. [Orthopedics. 202x;4x(x):xx-xx.].

Effects of a long-term triceps surae stretching program on the pennation angle of triceps surae heads in children with hypermobile flat foot and Achilles tendon shortening

BACKGROUND: Triceps surae retraction plays a key role in the pathogenesis of flat feet in children. This is a pennate muscle. The pennation angle is defined as the angle between triceps surae fascicles and aponeurosis. AIM: The aim of the study was to evaluate the effect of a long-term triceps surae stretching program on the pennation angle of the triceps surae head in children with flat feet and Achilles tendon shortening. MATERIALS AND METHODS: The study included a total of 82 children with hypermobile flat feet and Achilles tendon shortening. The pennation angle was measured by ultrasound. Triceps surae stretching was recommended for 6 months as a basic exercise. SPSS v.26.0 was used for statistical analysis of data. RESULTS: The study group included 63 children who performed stretching exercises and the control group included 19 children who did not perform stretching exercises at the required intensity. The study group showed a significant improvement in the Foot Posture Index (FPI)-6, while the control group showed no change. The baseline foot dorsiflexion was 4.84° ± 0.10° in the study group and 4.81° ± 0.17° in the control group. After 6 months of stretching, dorsiflexion was 11.34° ± 0.24° in the study group and 4.85° ± 0.19° in the control group (p 0.01). The pennation angle of the triceps surae heads showed a significant increase in the medial head of the gastrocnemius and soleus muscles. CONCLUSIONS: A long-term stretching program in children with flat feet resulted in a significant increase in foot dorsiflexion. These changes were associated with morphological and functional muscle restructuring, manifested by a significant increase in the pennation angle of the medial head of the gastrocnemius and soleus muscles. Further research will identify the mechanisms underlying anatomical and functional muscle restructuring and their effects on anatomical foot parameters in flat feet.

An osteopathic assessment of lower extremity somatic dysfunctions in runners.

Runners often experience acute/chronic pain due to pre-existing structural somatic dysfunction and/or acquired various overuse injuries of the lower extremity, specifically affecting the ligaments, tendons, muscles, and bones. Common structural and function dysfunctions include but are not limited to patellofemoral pain syndrome (PFPS), Achilles tendonitis, iliotibial band syndrome (ITBS), ligamentous and muscle tears, muscle sprains/strains, stress fractures, pes planus, plantar fasciitis, and shin splints. The purpose of this study is to assess the correlation between acute and chronic pain, overuse injuries, and observational and palpatory findings upon evaluation to establish common trends of somatic dysfunctions and determine possible etiology of the pain/injury. A total of 103 individuals were recruited (54.4% female, 45.6% male) aged 23-67 years old who consistently run at least 1 mile each week. They were categorized based on their weekly mileage- Novice (1-5 miles per week), Moderate (6-15), Advanced (15+)- with the intention to have a diversity of running types and to assess the data at various levels of commitment to running. The average was 7.8 miles/week with the range at 1 to 28 miles per week. The subjects included Touro students and individuals in the community. A history was collected through an anonymous survey on the individual's running habits, chronic/acute injuries, and any other relevant medical information. Data analyzing investigators were blinded to subjects' identifying information. Additionally, an osteopathic assessment was performed by two student investigators for reliability purposes and conducted under supervision by a board-certified osteopathic physician. Analysis of the data suggested an existing correlation between the number of somatic dysfunctions and years of running. A slight correlation was found between somatic dysfunctions and miles per week, sports injuries, time per week, and lower extremity pain. Finally, statistical correlations were also identified between the presence of pes planus and limb length discrepancy with three distinct muscular hypertonicities. Runners' pains and injuries of the lower extremity are complex, and injury treatment and prevention is equally multifaceted. An association was found between both pes planus and limb length discrepancy with lower extremity muscle hypertonicity, suggesting the interrelated nature of these somatic dysfunctions. The survey concluded that many runners continue to run in pain and/or after significant injury but do not necessarily capitalize on existing support such as fitted shoes, custom arches, and osteopathic treatment that may help to minimize their risk of or treat injury. The intention of the research is to bring awareness to practitioners to the most common somatic dysfunctions such that they can recommend runners to obtain gait analyses and/or osteopathic treatments, which may not only alleviate injuries faster but also prevent future injury.

Lower Extremity Biomechanical Comparison Analysis of Single Leg Drop Landing among Normal Foot and Flat Foot

Lower Extremity Biomechanical Comparison Analysis of Single Leg Drop Landing among Normal Foot and Flat Foot