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Heel lifts and achilles tendon tension

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  #1  
Old 28th February 2011, 01:42 AM
Asher Asher is offline
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Default Heel lifts and achilles tendon tension

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I'm trying to get my head around the fact that heel lifts don't decrease tension in the achilles tendon, in fact, they potentially increase tension.

If anyone has the following paper, would they be so kind as to forward a copy?

Sharon J. Dixon; David G. Kerwin: The Influence of Heel Lift Manipulation on Achilles Tendon Loading in Running. JAB, 14(4), November 1998

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  #2  
Old 28th February 2011, 02:12 AM
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Default Re: Heel lifts and achilles tendon tension

Not the full text but a good summary ?

http://www.staffs.ac.uk/isb-fw/Manuscr/Dixon05.pdf

Also I have a copy of - Variations in Achilles Tendon Loading With heel lift intervention in heel toe runners by Dixon and Kerwin if you want a copy of that let me know.
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Old 28th February 2011, 08:28 AM
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Default Re: Heel lifts and achilles tendon tension

Hey Rebecca,

I've got this at home - will email it to you when I get back tonight

Ian
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Old 28th February 2011, 10:45 AM
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Default Re: Heel lifts and achilles tendon tension

I thought I had this one but just checked and I don't. Would you be so kind as to e mail it to me as well please Ian?

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Old 28th February 2011, 11:32 AM
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Default Re: Heel lifts and achilles tendon tension

ASHER

"the fact that heel lifts don't decrease tension in the achilles tendon, in fact, they potentially increase tension"

That is not what this study shows.

"Compared with zero heel lift, both heel lift conditions resulted in a reduction in peak Achilles
tendon force and Achilles tendon stress ......"

Steve
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Old 28th February 2011, 01:08 PM
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Default Re: Heel lifts and achilles tendon tension

Quote:
Originally Posted by drsarbes View Post
ASHER

"the fact that heel lifts don't decrease tension in the achilles tendon, in fact, they potentially increase tension"

That is not what this study shows.

"Compared with zero heel lift, both heel lift conditions resulted in a reduction in peak Achilles
tendon force and Achilles tendon stress ......"
Steve - sorry to hijack your post.

In addition the discussion says "Alternatively, if peak force is of consequence, the
success of heel lift interventions is likely to be subject-specific."

Notice that the study was undertaken with only seven subjects.
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Old 28th February 2011, 02:42 PM
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Default Re: Heel lifts and achilles tendon tension

How timely,
i am potentially doing a talk next month on achilles tendonopathy. Mike and Ian, would you be so grateful as to forward on a copy of the ones mentioned to me as well?
many thanks
JB
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Old 28th February 2011, 02:52 PM
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Default Re: Heel lifts and achilles tendon tension

Ooops - sorry I don't have this; just had a look and it was another heel lift article I was thinking of instead.

Apologies all.

IG
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Old 28th February 2011, 02:57 PM
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Default Re: Heel lifts and achilles tendon tension

no problem Ian. Its all this talk of helen Mirren has made you take your eye off the ball!!
thanks anyway.
JB
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Old 28th February 2011, 02:59 PM
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Default Re: Heel lifts and achilles tendon tension

You're not wrong!

I've emailed you some papers for your presentation anyway

IG
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Old 28th February 2011, 03:01 PM
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Default Re: Heel lifts and achilles tendon tension

Ah youre a good man and no mistake.
i'll buy you a beer sometime.
JB
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Old 28th February 2011, 03:05 PM
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Default Re: Heel lifts and achilles tendon tension

There is active and passive tension in the tendon. Active is from muscle contraction. Passive from motion of some other part, for example the leg rotating anteriorly over the foot planted on the ground. The tendon, itself, can't distinguish the difference between the two. Tension is tension. So, if a heel lift enabled the subject to contract their gastroc soleus more than without a lift it is theoretically possible to get more tension with a lift.

I recall one study that was mentioned on the arena that showed that measured ankle dorsiflexion in the chair was 10 degrees and in gait there was an average of 4 degrees. The active contraction of the muscle can prevent the ankle from going to its passive end of range of motion. So, if Achilles pathology is from a longer duration of high tension then I could see a heel lift working better if the passive dorsiflexion was less than 5 degrees. However, it may not help much if the tendon never gets to its passive end of range of motion, because all the tension will be from contraction of the muscle and this will most likely occur with or without the heel lift.

Eric

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Old 28th February 2011, 05:29 PM
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Default Re: Heel lifts and achilles tendon tension

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Originally Posted by m weber View Post
Not the full text but a good summary ?
http://www.staffs.ac.uk/isb-fw/Manuscr/Dixon05.pdf.
Thanks for that Mike.

Steve, the above summary of the paper indicates that the reduction in peak achilles tendon tensile force was not significant. But the rate of loading of the achilles was statistically significantly reduced.

What does that actually mean, can someone paint a picture for me? If the peak tension is the same, a reduced rate of loading means it happens quicker. My 'common sense' tells me that it would be better (for injury-prevention) to have the tendon build up to its peak tension over a longer time ie: increasing loading rate.

Quote:
Also I have a copy of - Variations in Achilles Tendon Loading With heel lift intervention in heel toe runners by Dixon and Kerwin if you want a copy of that let me know
Yes please Mike.

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Old 1st March 2011, 08:45 AM
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Default Re: Heel lifts and achilles tendon tension

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Originally Posted by Asher View Post
Thanks for that Mike.

Steve, the above summary of the paper indicates that the reduction in peak achilles tendon tensile force was not significant. But the rate of loading of the achilles was statistically significantly reduced.

What does that actually mean, can someone paint a picture for me? If the peak tension is the same, a reduced rate of loading means it happens quicker. My 'common sense' tells me that it would be better (for injury-prevention) to have the tendon build up to its peak tension over a longer time ie: increasing loading rate.



Yes please Mike.

Rebecca
Rebecca, I think you have loading rate backwards. Rate of loading would be change of load per unit of time. A reduced loading rate would be where the time to peak force would be longer.

Eric
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Old 1st March 2011, 10:35 PM
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Default Re: Heel lifts and achilles tendon tension

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Originally Posted by efuller View Post
Rebecca, I think you have loading rate backwards. Rate of loading would be change of load per unit of time. A reduced loading rate would be where the time to peak force would be longer.

Eric
Yes, I think so. Thanks for your patience Eric.

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Old 1st March 2011, 10:44 PM
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Default Re: Heel lifts and achilles tendon tension

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Originally Posted by m weber View Post
Also I have a copy of - Variations in Achilles Tendon Loading With heel lift intervention in heel toe runners by Dixon and Kerwin if you want a copy of that let me know.
This one shows that indeed some people exhibit increased Achilles tension with a heel lift. Unbelievable!

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Old 1st March 2011, 10:47 PM
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Wink Re: Heel lifts and achilles tendon tension

Quote:
Originally Posted by Asher View Post
Thanks for that Mike.

Steve, the above summary of the paper indicates that the reduction in peak achilles tendon tensile force was not significant. But the rate of loading of the achilles was statistically significantly reduced.

What does that actually mean, can someone paint a picture for me? If the peak tension is the same, a reduced rate of loading means it happens quicker. My 'common sense' tells me that it would be better (for injury-prevention) to have the tendon build up to its peak tension over a longer time ie: increasing loading rate.



Yes please Mike.

Rebecca
Common sense in the world of theory is always bloody good mate... I agree > In order to "prevent"further injury .. Hence the gradual reduction in the lift and mobilisation ..... Your thoughts are well within the realms of the real world .

all the best

FDCB
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Old 2nd March 2011, 12:06 AM
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Default Re: Heel lifts and achilles tendon tension

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Originally Posted by Asher View Post
This one shows that indeed some people exhibit increased Achilles tension with a heel lift. Unbelievable!

Rebecca
Rebecca have you read this thread in light of the papers - http://www.podiatry-arena.com/podiat...ad.php?t=16267

Craig P mentions the same papers, Dave Smith draws some diagrams. Might help ?
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