all were confirmed as heel
Posted: January 28th, 2019, 10:43 pm
We’ve all been waiting for data to trickle out regarding actual outcomes from studies that have employed gait modification for the treatment of specific running injuries. Those data are now starting to appear.A group led by Major Angela Diebal from Keller Army Community Hospital in West Point, NY just released a on-line version of a forthcoming 2012 article in the American Journal of Sportsl] Medicine. The article is titled “Forefoot Running Improves Pain and Disability Associated With Chronic Exertional Compartment Syndrome.”Chronic exertional compartment syndrome (CECS) is a condition that primarily affects active people (about 69% of those diagnosed are runners), and is characterized by swelling of affected tissues. There are four separate muscle compartments in the lower limb, of which the anterior compartment is most frequently affected in compartment syndrome. The connective tissues that encapsulate these muscle compartments do not stretch much, and thus excessive swelling in these compartments can lead to diminished blood flow to the affected tissues, as well as compression of nerves leading to pain.Diebal et al. indicate that accepted belief as to the cause of compartment syndrome is “that exercise increases intramuscular ressure, which in turn compromises circulation, prohibits muscular function, and causes pain and disability in the lower leg.” They go on to state that “As the problematic exertional activity (typically running) continues, compartment pressures incrementally increase, which presumably causes increasing lower leg pain, sensory abnormalities, and muscle weakness, eventually resulting in a premature cessation of the activity.”The Mayo Clinic website reports that “Conservative treatments typically don’t help with chronic exertionalcompartment syndrome. However, surgery is usually successful, allowing you — whether you’re a recreational or serious athlete — to return to your sport.” The surgery mentioned is known as a fasciotomy, and involves cutting the connective tissue sheaths surrounding the swollen compartment to reduceintracompartmental pressure (fair warning – if you have a strong stomach, you can see gruesome photos of this surgery here). Surgery can successfully treat the condition, but side effects are possible, recovery time can be extensive, and lets face it, if you can avoid having your leg sliced open that’s probably not a bad thing.
Tibialis anteriorThus, the goal of this study was to determine whether an alteration in running gait could serve as an effective, and more conservative, alternative to surgery for the treatment of CECS. Previous research suggests that ankle position can influence intracompartmental pressure (ICP) in the anterior compartment (e.g., forefoot running decreases anterior compartment pressure, and ankle dorsiflexion increases ICP in the anterior compartment). Furthermore, the authors report that forefoot running has Nike Air Max 2017 Femme been shown to reduce eccentric activity in the tibialis anterior muscle (eccentric contraction is that which occurs while the muscle is lengthening, such as during the post heel-strike foot slap).The tibialis anterior, shown in red in the image to the left (image via Gray’s Anatomy and Wikipedia), is the major dorsiflexor of the ankle and is found on the front, outer portion of your shin (it is the largest muscle of the anterior compartment; other muscles in the compartment include those that extend your toes upward). The idea is that by having patients with CECS adopt a forefoot striking running style, they would reduce pressure in the anterior compartment where this muscle is located, reduce eccentric activity in this muscle, and thereby reduce pain and disability associated with the condition.The researchers recruited tenpatients with CECS Nike M2k Tekno Heren who were candidates for surgical intervention (as determined by an orthopaedic surgeon) – all were physically fit members of the military, and all had experienced symptoms for at least six months. Furthermore, all were confirmed as heel strikers, and pain onset occurred with less than five minutes of running.After taking a battery of pre-intervention measurements {e.g., ICP, ground reaction forces, step length and rate, 2-mile run time, run distance before severe pain onset (up to 5km) etc.}, the subjects went through a training program to instruct them to forefoot strike with an increased cadence (3 steps per second, 180 steps/min). They also performed a variety of drills taught by the POSE method of running, and did some barefoot running and were cued to “run quietly.” Training sessions occurred 3 times per week for 6 weeks (45 minutes each session).
Tibialis anteriorThus, the goal of this study was to determine whether an alteration in running gait could serve as an effective, and more conservative, alternative to surgery for the treatment of CECS. Previous research suggests that ankle position can influence intracompartmental pressure (ICP) in the anterior compartment (e.g., forefoot running decreases anterior compartment pressure, and ankle dorsiflexion increases ICP in the anterior compartment). Furthermore, the authors report that forefoot running has Nike Air Max 2017 Femme been shown to reduce eccentric activity in the tibialis anterior muscle (eccentric contraction is that which occurs while the muscle is lengthening, such as during the post heel-strike foot slap).The tibialis anterior, shown in red in the image to the left (image via Gray’s Anatomy and Wikipedia), is the major dorsiflexor of the ankle and is found on the front, outer portion of your shin (it is the largest muscle of the anterior compartment; other muscles in the compartment include those that extend your toes upward). The idea is that by having patients with CECS adopt a forefoot striking running style, they would reduce pressure in the anterior compartment where this muscle is located, reduce eccentric activity in this muscle, and thereby reduce pain and disability associated with the condition.The researchers recruited tenpatients with CECS Nike M2k Tekno Heren who were candidates for surgical intervention (as determined by an orthopaedic surgeon) – all were physically fit members of the military, and all had experienced symptoms for at least six months. Furthermore, all were confirmed as heel strikers, and pain onset occurred with less than five minutes of running.After taking a battery of pre-intervention measurements {e.g., ICP, ground reaction forces, step length and rate, 2-mile run time, run distance before severe pain onset (up to 5km) etc.}, the subjects went through a training program to instruct them to forefoot strike with an increased cadence (3 steps per second, 180 steps/min). They also performed a variety of drills taught by the POSE method of running, and did some barefoot running and were cued to “run quietly.” Training sessions occurred 3 times per week for 6 weeks (45 minutes each session).