Effect of medial arch support on displacement of the myotendinous junction of the gastrocnemius during standing wall stretching.
METHODS
Controlled laboratory study.


OBJECTIVE
To examine the effects of standing wall stretching with and without medial arch support (WMAS versus WOMAS) on the displacement of the myotendinous junction (DMTJ) of the medial gastrocnemius, rearfoot angle, and navicular height in subjects with neutral foot alignment and pes planus.


BACKGROUND
Standing wall stretching is often prescribed to increase ankle dorsiflexion range of motion for sports fitness and rehabilitation. However, the effect of standing wall stretching WMAS on DMTJ is unknown.


METHODS
Fifteen subjects with neutral foot alignment and 15 subjects with pes planus performed standing wall stretching under WMAS and WOMAS conditions. Measurements of DMTJ and rearfoot position were performed using ultrasonography and video imaging. Navicular height was measured using a ruler. Dependent variables were examined with a 2-way mixed-design analysis of variance. The 2 factors were foot type (neutral foot versus pes planus) and stretching condition (WMAS versus WOMAS).


RESULTS
There were significant interactions of medial arch support by foot type for DMTJ, rearfoot angle, and navicular drop (P<.001). A post hoc paired t test showed that standing wall stretching in the WMAS condition significantly increased the DMTJ, compared to stretching in the WOMAS condition, in subjects with neutral foot (mean +/- SD, 9.6 +/- 1.6 versus 10.5 +/- 1.6 mm; difference, 0.9 mm; 99% CI: 0.4-1.4 mm) and in those with pes planus (10.0 +/- 1.8 versus 12.7 +/- 2.0 mm; difference, 2.7 mm; 99% CI: 1.9-3.5 mm) (P<.001). When comparing WOMAS and WMAS, the difference in DMTJ (1.8 mm; 99% CI: 0.9-2.7 mm) was significantly greater in subjects with pes planus than in those with neutral foot (P<.001).


CONCLUSIONS
Standing wall stretching with medial arch support maintained subtalar joint neutral position and increased the length of the gastrocnemius in subjects with pes planus. When prescribing standing wall stretching, clinicians need to emphasize the use of medial arch support to effectively stretch the gastrocnemius in subjects with pes planus.
Jung
Do-Young
DY
Department of Prosthetics and Orthotics, College of Suncheon First, Republic of Korea.
Koh
Eun-Kyung
EK
Kwon
Oh-Yun
OY
Yi
Chung-Hwi
CH
Oh
Jae-Seop
JS
Weon
Jong-Hyuck
JH
D000125:Achilles Tendon / Q000502:physiology*; D000328:Adult; D000843:Ankle Joint / Q000502:physiology*; D001696:Biomechanical Phenomena; D016022:Case-Control Studies; D005260:Female; D005413:Flatfoot / Q000503:physiopathology; D006801:Humans; D008297:Male; D052580:Muscle Stretching Exercises / Q000379:methods*; D018482:Muscle, Skeletal / Q000502:physiology*; D009989:Orthotic Devices; D013380:Subtalar Joint / Q000502:physiology; D013647:Task Performance and Analysis; D055815:Young Adult