Lateral Gastrocnemius Research Articles

Investigating in vivo force and work production of rat medial gastrocnemius at varying locomotor speeds using a muscle avatar.

Traditional work loop studies, that use sinusoidal length trajectories with constant frequencies, lack the complexities of in vivo muscle mechanics observed in modern studies. This study refines methodology of the 'avatar' method (a modified work loop) to infer in vivo muscle mechanics using ex vivo experiments with mouse extensor digitorum longus (EDL) muscles. The 'avatar' method involves using EDL muscles to replicate in vivo time-varying force, as demonstrated by previous studies focusing on guinea fowl lateral gastrocnemius (LG). The present study extends this method by using in vivo length trajectories and electromyographic activity from rat medial gastrocnemius (MG) during various gaits on a treadmill. Methodological enhancements from previous work, including adjusted stimulation protocols and systematic variation of starting length, improved predictions of in vivo time-varying force production (R2=0.80-0.96). The study confirms there is a significant influence of length, stimulation and their interaction on work loop variables (peak force, length at peak force, highest and average shortening velocity, and maximum and minimum active velocity), highlighting the importance of these interactions when muscles produce in vivo forces. We also investigated the limitations of traditional work loops in capturing muscle dynamics in legged locomotion (R2=0.01-0.71). While in vivo length trajectories enhanced force prediction, accurately predicting work per cycle remained challenging. Overall, the study emphasizes the utility of the 'avatar' method in elucidating dynamic muscle mechanics and highlights areas for further investigation to refine its application in understanding in vivo muscle function.

Age and sex-related differences in elastic properties of the gastrocnemius muscle-tendon unit: an observational prospective study

IntroductionChanges in the mechanical properties of the gastrocnemius muscle-tendon unit can lead to abnormal biomechanics of lower limbs, which is a risk factor for the development of many diseases. However, fewer studies have explored physiological changes in the gastrocnemius muscle-tendon unit stiffness. This study aimed to investigate the age- and sex-related differences in the gastrocnemius muscle-tendon unit stiffness.MethodsThe study included 20 older women, 20 young women, and 20 older men. Shear wave elastography (SWE) was used to measure the stiffness of the medial gastrocnemius (MG), lateral gastrocnemius (LG), and Achilles tendon (AT) in all subjects in relaxed, neutral, and standing positions.ResultsThe results showed no significant differences in the MG, LG, and AT stiffness between the dominant and non-dominant sides (p > 0.05). The MG, LG, and AT stiffness changed with positions (p < 0.05). The LG stiffness in older women was lower than in older men and young women in any position (p < 0.05). The MG stiffness in older men was greater than that in older women in any position, and age-related changes were found only in the relaxed and standing positions (p < 0.05). The AT stiffness was higher in older men only in the relaxed position (p < 0.05). There was no significant difference in AT stiffness between older and younger women at any position (p > 0.05).DiscussionThese results suggest that the bilateral gastrocnemius muscle-tendon unit stiffnesses were similar regardless of sex, age, and position. The stiffness of the gastrocnemius in women decreased with age. However, the effect of aging on AT stiffness was slight. Men have greater gastrocnemius stiffness in older adults.

Effects of Supervised Exercise Therapy on Muscle Function During Walking in Patients with Peripheral Artery Disease

Background: Although supervised exercise therapy (SET) is a primary treatment for peripheral artery disease (PAD), the current literature is limited regarding the mechanisms contributing to increased walking distances, including how lower extremity muscle function is altered after SET. This study aimed to investigate the effects of SET on lower extremity muscle function during walking in patients with PAD. Methods: Twelve patients with PAD participated in a 6-month SET program consisting of three weekly exercise sessions (a total of 72 sessions) and adhered to the American College of Sports Medicine’s (ACSM) recommendations. Each session started with a 5 min warm-up of mild walking and static stretching of upper and lower body muscles, followed by 50 min of intermitted exercise on a treadmill, and then finished with 5 min of cool-down activities similar to the warm-up. Each patient walked across a 10 m pathway with reflective markers on their lower limbs twice: before (baseline) and after six months of participation in SET (post-exercise). Marker coordinates and ground reaction forces were recorded and imported to OpenSim software (version 4.0) for gait simulations. Muscle force, muscle power, and metabolic rate were estimated from OpenSim and compared between the baseline and post-exercise. Results: The mean plantar flexor force was not altered after SET. However, individuals’ plantar flexor muscles demonstrated improvements in force production (lateral gastrocnemius: 75–80% of stance, Cohen’s d = 0.20–0.43; medial gastrocnemius: 65–85% of stance, Cohen’s d = 0.20–0.71; soleus: 90–95% of stance, Cohen’s d = 0.20–0.26). Furthermore, plantar flexor power increased (80–95% of stance, Cohen’s d = 0.20–0.39) and this was attributed to increased power in the lateral gastrocnemius (80–85% of stance, Cohen’s d = 0.20–0.47), medial gastrocnemius (80–90% of stance, Cohen’s d = 0.22–0.60), and soleus muscles (85–95% of stance, Cohen’s d = 0.20–0.49). Similarly, other muscle groups (knee extensors, knee flexors, hip abductors, hip adductors, hip extensors, and hip flexors) also exhibited force and power increases after SET. Additionally, force and power variances were significantly decreased in several muscle groups (plantar flexors, knee extensors, hip abductors, hip external rotators, hip extensors, and hip flexors). Total metabolic rate also increased during the stance period where muscle force and power were elevated after SET (early stance: 5–25%, Cohen’s d = 0.20–0.82; mid stance: 35–45%, Cohen’s d = 0.20–0.47; late stance: 75–80%, Cohen’s d = 0.20–0.36). Conclusions: Our results suggest that from a biomechanics perspective, muscle functions during walking are improved in patients with PAD after SET; however, the improvements were generally small and were not reflected by all muscle groups.

Discipline-specific adaptation patterns in respiratory and lower limb musculotendinous structures: cyclists vs. basketball players.

This study aimed at assessing how chronic exposure to specific exercise training (high-intensity intervals vs. endurance), comparing experienced basketball-players (BP, N.=16), cyclists (CY, N.=16), and non-specifically trained individuals (CN, N.=16), influences the structural and functional characteristics of both lower limb and respiratory musculotendinous structures. Vastus lateralis, gastrocnemius lateralis, and medialis, diaphragm muscles, as well as patellar tendon and Achilles tendon, were assessed using B-mode ultrasonography. Maximal voluntary isometric and passive torque measurements were conducted in the knee-extensors and plantar-flexors. Additionally, a subset of participants (N.=10 for each group) underwent a fatigue-inducing exercise-till-exhaustion protocol, and the strength of lower limb and respiratory muscles was evaluated immediately before and after the trial. Athletes had bigger and stronger musculotendinous structures and greater endurance to fatigue than CN (P<0.05). BP had bigger plantar-flexors and diaphragm, greater fascicles length, more explosive plantar-flexors and respiratory muscles and bigger tendons than CY (P<0.05). On the other hand, CY showed greater muscle pennation angle and greater endurance to fatigue for both, lower limb, and respiratory muscles (P<0.05). The present study emphasizes that chronic and specific exercise training leads to distinctive adaptations, not only in lower limb musculotendinous structures but also in other components such as respiratory muscles.

Gastrocnemius Neuromuscular Activation During Standing Explosive Acceleration

The gastrocnemius muscle plays a crucial role in transmitting and generating energy during standing explosive accelerations, and as a consequence, is a muscle with high injury prevalence, especially the medial gastrocnemius (MG). This study aimed to compare the neuromuscular activation of the lateral gastrocnemius (LG) and MG during one of the most common standing explosive accelerations performed in team sports—the false start that occurs in jumps where the leg steps back before moving forward. Forty-two physically active participants (34 males: age = 24 ± 5 years, body mass = 73 ± 10.4 kg; and 8 females: age = 26 ± 5 years, body mass = 57.1 ± 6.8 kg) underwent electromyography analysis of the MG and LG in the four first foot contacts of standing explosive acceleration. The results showed that the third contact differed significantly from others (LG vs. MG: 76.48 ± 3.10 vs. 66.91 ± 2.25, p = 0.01, ES = 0.5), with the LG exhibiting earlier activation and higher peak sEMG activity compared to the MG (LG vs. MG: 0.12 ± 0.01 vs. 0.13 ± 0.01, p = 0.02, ES = 0.4). Additionally, the MG displayed longer duration contractions in all the foot contacts except the third foot contact. In conclusion, the MG showed an earlier activation timing and a longer duration of contraction than the LG in the first foot contact. Additionally, the third foot contact showed a different pattern of neuromuscular activation between the MG and LG compared to the rest of the foot contacts.

Effect of foot type on electromyography characteristics and synergy of lower limb muscles during running

The foot structure is associated with different running mechanics. The central nervous system is responsible for using the muscles through synergies during locomotion. The purpose of the present study was to examine the effect of foot structure on the electromyography factors and the synergy of the selected muscles of the lower extremity. Tibialis anterior, extensor digitorum longus, peroneus longus, soleus, biceps femoris, vastus lateralis, gastrocnemius lateralis and medialis muscles activity of 60 barefoot recreational runners with different foot structures was recorded while running at a speed of 3.3 m/s. Muscle activity was measured in the running cycle. Besides, muscle synergies were extracted using non-negative matrix factorization algorithm. The results showed that there were differences between groups with different foot type in muscle activity under different phases of running in some muscles. Furthermore, the findings indicated that the number of synergies was similar in different groups and the relative weight of muscles was not different across groups. In conclusion, despite the difference in muscle activity under different phases of the running cycle, muscle synergies are similar among the groups. This can indicate similar control by the central nervous system in runners with different arch structures while running and the observed changes in muscle activity can be attributed to the type of forces exerted on the body, the length-tension relationship, and changes in the direction of the lower limbs in people with different arch structures.

Changes in Motor Strategy and Neuromuscular Control During Balance Tasks in People with a Bimalleolar Ankle Fracture: A Preliminary and Exploratory Study

Ankle fractures can lead to issues such as limited dorsiflexion, strength deficits, swelling, stiffness, balance disorders, and functional limitations, which complicate daily activities. This study aimed to describe neuromuscular adaptations at 6 and 12 months post-surgery during static and dynamic balance tasks, specifically using the Y-Balance Test (YBT). Additionally, the relationship between neuromuscular patterns, balance, and musculoskeletal deficits was evaluated. In 21 participants (14 at 6 months and 21 at 12 months) with bimalleolar fractures, hip strength, ankle dorsiflexion, ankle functionality, and static and dynamic balance were assessed using electromyography of five lower limb muscles (tibialis anterior, peroneus longus, lateral gastrocnemius, biceps femoris, and gluteus medius). A significant interaction effect (limb × proximal [hip]—distal [ankle] muscle) (F = 30.806, p &lt; 0.001) was observed in the anterior direction of the Y-Balance Test (YBTA) at 6 months post-surgery. During the YBTA and YBT posteromedial (YBTPM), it was found that a lower dorsiflexion range of movement was associated specifically at 6 months with greater activation of the lateral gastrocnemius. However, these differences tended to diminish by 12 months. These findings suggest that neuromuscular patterns differ between operated and non-operated limbs during the YBTA at 6 months post-surgery. The Y-Balance Test, particularly its anterior direction, effectively highlighted these neuromuscular changes. This is a preliminary study; further research is needed to explore these findings in depth.

Impact of contraction intensity and ankle joint angle on calf muscle fascicle length and pennation angle during isometric and dynamic contractions

During muscle contraction, not only are the fascicles shortening but also the pennation angle changes, which leads to a faster contraction of the muscle than of its fascicles. This phenomenon is called muscle gearing, and it has a direct influence on the force output of the muscle. There are few studies showing pennation angle changes during isometric and concentric contractions for different contraction intensities and muscle lengths. Therefore, the aim was to determine these influences over a wide range of contraction intensities and ankle joint angles for human triceps surae. Additionally, the influence of contraction intensity and ankle joint angle on muscle gearing was evaluated. Ten sport students performed concentric and isometric contractions with intensities between 0 and 90% of the maximum voluntary contraction and ankle joint angles from 50° to 120°. During these contractions, the m. gastrocnemius medialis and lateralis and the m. soleus were recorded via ultrasound imaging. A nonlinear relationship between fascicle length and pennation angle was discovered, which can be described with a quadratic fit for each of the muscles during isometric contraction. A nearly identical relationship was detected during dynamic contraction. The muscle gearing increased almost linearly with contraction intensity and ankle joint angle.

TMG Symmetry and Kinematic Analysis of the Impact of Different Plyometric Programs on Female Athletes’ Lower-Body Muscles

Asymmetries in sports are common and can lead to various issues; however, different training programs can facilitate change. This study aimed to assess the effects of opposing plyometric programs on tensiomyography lateral symmetry (TMG LS)/inter-limb asymmetry in female athletes’ lower-body muscles, alongside kinematic and body composition parameters. Twenty female subjects from basketball, volleyball, and track and field (sprinting disciplines) were divided into two experimental groups (n = 10 each). Two six-week plyometric programs (two sessions/week) were implemented: the first program (E1) focused on eccentric exercises, depth landings, while the second (E2) emphasized concentric exercises, squat jumps. TMG assessed LS in six muscles: vastus lateralis, vastus medialis, biceps femoris, semitendinosus, gastrocnemius lateralis, and gastrocnemius medialis. A kinematic analysis of the countermovement jump (CMJ) and body composition was conducted using “Kinovea; Version 0.9.4” software and InBody 770, respectively. The results showed significant increases in LS percentages (E1—VL 9.9%, BF 18.0%, GM 10.6% and E2—BF 22.5%, p &lt; 0.05), and a significant large effect in E1 for VL, and in E2 for BF, p &lt; 0.01). They also showed that E1 had a significant effect on VL, and that E2 had a significant large effect on BF (p &lt; 0.01). E1 also led to increased lean muscle mass in both legs (left: 1.88%, right: 2.74%) and decreased BMIs (−0.4, p &lt; 0.05). Both programs improved LS, with E1 enhancing muscle mass and lower-body positioning in CMJ. We recommend future studies use varied jump tests, incorporate 3D kinematic analysis, include male subjects, and examine more muscles to enhance TMG LS analysis.

Effects of altered contractile environment on muscle shape change in the triceps surae.

Skeletal muscles change shape when they contract. Current insights into the effects of shape change on muscle function have primarily come from experiments on isolated muscles operating at maximal activation levels. However, when muscles contract and change shape, the forces they apply onto surrounding muscles will also change. The impact of an altered contractile environment (i.e., mechanical behaviour of surrounding muscle) on muscle shape change, remains unknown. To address this, we altered the mechanical contributions of the gastrocnemii during isometric plantarflexion contractions [via changing knee angle] and determined if there were associated changes in how the muscles of the triceps surae bulged in thickness during a ramped contraction. We combined B-mode ultrasound imaging with surface electromyography to quantify the neuromechanical contributions of the medial (MG) and lateral gastrocnemius (MG) and soleus (SOL) muscles during isometric plantarflexion contractions. Our results demonstrated that at the same SOL activity levels, altering knee angle had no influence on the magnitude of muscle shape change (thickness) in the triceps surae muscles. We observed high levels of inter-individual variability in muscle bulging patterns, particularly in the knee flexed position, suggesting a complex relationship between muscle bulging and activation strategies in the triceps surae, which may be related to differences in muscle mechanical properties between participants or across muscles. Our findings highlight the dynamics of in vivo bulging interactions among muscles within the triceps surae and provide insights for future investigations into the impact of altered contractile environments on three-dimensional muscle deformations and force production.

The impact of anterior knee displacement on knee joint load during the forward bow step in Tai Chi.

While the forward bow step is a crucial component of Tai Chi (TC) practice, little research has been conducted on its impact on knee joint load and muscle coordination. This study aims to investigate the effects of three different knee forward positions during the TC forward bow step on knee joint loading. Twenty TC practitioners were recruited, and motion capture systems, force platforms, and surface electromyography were utilized to synchronously collect biomechanical parameters of three types of forward bow steps: knee joint not exceeding the tip of the foot (NETT), knee joint forward movement level with the tip of the foot (LTT), and knee joint forward movement exceeding the tip of the foot (ETT). Ligament and muscle forces were calculated using OpenSim software for musculoskeletal modeling and simulation. One-way ANOVA was used to analyze the variations of the indicators during the peak anterior displacement of the knee joint in three movements. Additionally, spm1d one-way ANOVA was employed to examine the variations in the one-dimensional curve of the indicators throughout the entire movement process. Compared with LTT and ETT, the NETT posture was associated with significantly decreased knee flexion angle (F = 27.445, p = 0.001), knee anterior-posterior translation (F = 36.07, p < 0.001), flexion-extension torque (F = 22.232, p = 0.001), ligament force (F = 9.055, p = 0.011). Additionally, there was also a significant reduction in muscle strength, including quadriceps (F = 62.9, p < 0.001), long biceps femoris (F = 18.631, p = 0.002), lateral gastrocnemius (F = 24.933, p = 0.001) and soleus (F = 7.637, p = 0.017). This study further confirms that in the forward lunge movement of Tai Chi, the knee joint load is mainly concentrated during the forward movement phase. Compared to the knee joint load at the NETT position, the load is greater at the LTT position; and compared to the LTT position, the load is even greater at the ETT position.

Effects of Fatigue on Ankle Flexor Activity and Ground Reaction Forces in Elite Table Tennis Players.

Fatigue specifically affects the force production capacity of the working muscle, leading to a decline in athletes' performance. This study investigated the impact of fatigue on ankle flexor muscle activity and ground reaction forces (GRFs) in elite table tennis players, with a focus on the implications for performance and injury risk. Twelve elite male table tennis athletes participated in this study, undergoing a fatigue protocol that simulated intense gameplay conditions. Muscle activity of the soleus (SOL) and gastrocnemius lateralis (GL) muscles, heel height, and GRFs were measured using a combination of wireless electromyography (EMG), motion capture, and force plate systems. Results showed a significant decrease in muscle activity in both legs post-fatigue, with a more pronounced decline in the right leg. This decrease in muscle activity negatively affected ankle joint flexibility, limiting heel lift-off. Interestingly, the maximal anteroposterior GRF generated by the left leg increased in the post-fatigue phase, suggesting the use of compensatory strategies to maintain balance and performance. These findings underscore the importance of managing fatigue, addressing muscle imbalances, and improving ankle flexibility and strength to optimize performance and reduce the risk of injuries.

Exploring the use of wearable sensors for assessing risk factors during orthopedic surgeries: A protocol for data collection

During orthopedic surgeries, surgeons are generally exposed to prolonged periods of standing, awkward and sustained body postures, and forceful movements, which can increase the likelihood of developing work-related musculoskeletal disorders (WRMSD). Therefore, this study proposes a protocol to measure parameters related to physical risk factors contributing to lower limb WRMSD, during orthopedic surgery procedures. The protocol development was preceded by an initial phase of understanding and specifying the context of use, followed by pre-tests in laboratory environment. It integrates a motion capture system, using inertial measurement units (IMU) to collect posture data from hip, knee, and ankle, and electromyography system (EMG) to measure and record data from muscle activity of biceps femoris, rectus femoris, and gastrocnemius lateralis. Pre-tests provided insights for protocol optimization, estimating a 3-hour data collection session per surgery due to sensor battery limitations, streamlining the process by placing EMG sensors before IMU and refining thigh sensor placement strategies. The protocol presents an opportunity for a real-time and quantitative approach to monitor surgeon's exposure to risk factors contributing to lower limb WRMSD while performing surgical procedures. Two months after pre-tests, the protocol implementation began in a real work context. The study's final outcomes fall outside the paper's scope.

Validation of Markerless Motion Capture for Soldier Movement Patterns Assessment Under Varying Body-Borne Loads.

Field performance of modern soldiers is affected by an increase in body-borne load due to technological advancements related to their armour and equipment. In this project, the Theia3D markerless motion capture system was compared to the marker-based gold standard for capturing movement patterns of participants wearing various body-borne loads. The aim was to estimate lower body joint kinematics, gastrocnemius lateralis and medialis muscle activation patterns, and lower body joint reaction forces from the two motion capture systems. Data were collected on 16 participants performing three repetitions of walking and running under four body-borne load conditions by both motion capture systems simultaneously. A complete musculoskeletal analysis was completed in OpenSim. Strong correlations ( ) and acceptable differences were observed between the kinematics of the marker-based and markerless systems. Timing of muscle activations of the gastrocnemius lateralis and medialis, as estimated through OpenSim from both systems, agreed with the ones measured using electromyography. Joint reaction force results showed a very strong correlation ( ) between the systems; however, the markerless model estimated greater joint reaction forces when compared the marker-based model due to differences in muscle recruitment strategy. Overall, this research highlights the potential of markerless motion capture to track participants wearing body-borne loads.

Locomotion and Postural Control in Young Adults with Autism Spectrum Disorders: A Novel Kinesiological Assessment.

Background/Objectives: The purposes of the present study were to assess gait by using a novel approach that plots two adjacent joint angles and the postural control in individuals with autism (ASD) and individuals with typical neurodevelopmental (TD). Methods: The surface electromyography (sEMG) activity was measured synchronously with the other variables. Twenty young adult men, 10 with TD and 10 with a diagnosis of ASD, took part in this study. Results: There was a significant difference between ASD and TD groups in the area described by the knee-ankle diagram (p < 0.05). The sEMG activity recorded from the lateral gastrocnemius (LG) during the contact phase of gait was significantly lower in the ASD group compared with the TD group (p < 0.05). The sEMG activity recorded in the different postural conditions showed differences in LG and tibialis anterior (TA) between the ASD and TD groups (p < 0.05). Conclusions: The knee-ankle diagram provided a sensitive and specific movement descriptor to differentiate individuals with ASD from individuals with TD. The reduced LG activation is responsible for the reduced area in the knee-ankle diagram and 'toe-walking' in individuals with ASD and represents the common denominator of an altered ankle strategy during locomotion and postural control.

Barefoot vs shod walking and jogging on the electromyographic activity of the medial and lateral gastrocnemius

Gastrocnemius weakness is associated with Achilles tendinopathies and muscle strains, with the medial gastrocnemius (MG) more commonly injured than the lateral gastrocnemius (LG). Walking and jogging are common in daily activities and sports, and biomechanical differences between shod and barefoot exercise may influence MG and LG activation. Understanding these activation patterns could help optimize training programs for injury prevention and/or rehabilitation. The aim was to compare MG and LG electromyographic activity during walking and jogging, both shod and barefoot. Twenty-nine participants (25.28 ± 4.53 years, 171.31 ± 0.76 cm, 72.68 ± 6.36 kg) completed a warm-up followed by 1 min of walking (80–99 steps/min) and jogging (130–150 steps/min) in both conditions (barefoot and shod, random order). Electromyographic signals were recorded using wearable devices (mDurance Solutions S.L., Granada, Spain; 1024 Hz sampling rate). We measured the root-mean-square (RMS) amplitudes for an entire stride cycle and digitally filtered the signals. For analysis, we normalized electromyographic values to the average peak values obtained during two sprints. We analyzed differences with a repeated-measures analysis of variance. Significant effects of condition (barefoot-shod) and gastrocnemius (MG-LG) were observed (all p ≤ 0.023, ƞp2 = 0.17–0.39), with higher MG activation compared to LG in the barefoot conditions (p = 0.004–0.027, d = 0.72–0.83), and nonsignificant differences between muscles in the shod conditions (p > 0.05). Shod exercise compared to barefoot resulted in lower MG activation (p = 0.001–0.003, d = 0.62–0.63) and non-significant differences in LG activation. These results indicate that barefoot walking and jogging increase MG activation compared to shod conditions, with no differences in LG activation. Additionally, footwear reduces differences between MG and LG.

How does prolonged tennis playing affect lower limb muscles' activity during first and second tennis serves?

We examined the effect of prolonged tennis playing on lower limb muscles' activity during the execution of first and second tennis serves. Ten male competitive tennis players executed five first and second serves before (pretest) and after (posttest) a 3-h tennis match. Surface electromyographic (EMG) activity of four lower limb muscles (vastus lateralis, rectus femoris, gastrocnemius lateralis, and soleus muscles) on each leg was recorded along with maximum ball velocity measured by a radar gun and peak vertical forces recorded by a force platform. For the vastus lateralis, gastrocnemius lateralis, and soleus muscles of the left leg as well as the vastus lateralis muscle of the right leg, EMG amplitude decreased from pre- to posttests (p≤0.033). These reductions in the EMG signal were generally more pronounced in the first serve (i.e., ranging from -10% to -40%) compared to the second serve (0% to -25%). Maximum ball velocity for both first (159±12 vs. 154±12km/h) and second (126±20 vs. 125±15km/h) serves remained unchanged from pre- to posttests (p=0.638) Similarly, peak vertical forces did not differ between pretest and posttest for both first (1.78±0.30 vs. 1.72±0.29 body weight) and second (1.62±0.25 vs. 1.75±0.23 body weight) serves (p=0.730). In conclusion, a 3-h tennis match led to decreased activation levels in various leg muscles during serves, particularly in first serves compared to second serves. Despite consistent maximum ball velocity and peak vertical forces, these reductions in EMG signals suggest that skilled tennis players may adopt compensatory strategies after prolonged play.

Hoffmann Reflex Measured Reliably From Lateral Gastrocnemius Muscle Among Older People With Peripheral Neuropathy

Hoffmann Reflex Measured Reliably From Lateral Gastrocnemius Muscle Among Older People With Peripheral Neuropathy

Anatomy of the Achilles tendon-Apictorial review.

The Achilles tendon (AT) is the strongest tendon of the human body. The knowledge of AT anatomy is abasic prerequisite for the successful treatment of acute and chronic lesions. The structure of the AT results from acomplicated fusion of three parts: the tendons of the medial and lateral gastrocnemius and the soleus muscles. From proximal to distal, the tendon fibers twist in along spiral into aroughly 90° internal rotation. The tendon is narrowest approximately 5-7 cm above its calcaneal insertion and from there it expands again. The topography of the footprints of the individual AT components reflects the tendon origins. The anterior (deep) AT fibers insert into the middle third of the posterior aspect of the calcaneal tuberosity, the posterior (superficial) fibers pass over the calcaneal tuberosity and fuse with the plantar aponeurosis. Adeep calcaneal bursa is interposed between the calcaneal tuberosity and the AT anterior surface. The AT has no synovial sheath but is covered along its entire length with asliding connective tissue, the paratenon which is, however, absent on its anterior surface. The AT is supplied by the posterior tibial artery (PTA) and the peroneal artery (PA). Motor innervation of the triceps surae muscle is provided by fibers of the tibial nerve which also gives off sensitive fibers for the AT. Sensitive innervation is also provided via the sural nerve. The sural nerve crosses the AT approximately 11 cm proximal to the calcaneal tuberosity. The forces acting on the AT during exercise may be up to 12 times the body weight. Physiological stretching of AT collagen fibers ranges between 2% and 4% of its length. Stretching of the tendon over 4% results in microscopic failure and stretching beyond 8% in macroscopic failure.

Iatrogenic Common Peroneal Nerve Injuries From Inside-out Lateral Meniscus Repair: A Report of 2 Cases.

We report 2 cases of common peroneal nerve (CPN) palsy after inside-out lateral meniscus (LM) repair with very different presentations, occurring despite the standard surgical precautions (open counter incision and proper retraction between the biceps femoris tendon, lateral gastrocnemius, and capsule). On exploration, needle was found to have penetrated the nerve in one case and the nerve sheath in the other case. Patient 1 had near-complete neurological recovery, while patient 2 had partial neurological recovery after suture removal and neurolysis. CPN palsy can occur despite following all precautions during LM repair and should be managed as an iatrogenic injury unless proven otherwise.