title: Effect of medial arch support on displacement of the myotendinous junction of the gastrocnemius during standing wall stretching.
abstract: 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.
authors.affiliation: Department of Prosthetics and Orthotics, College of Suncheon First, Republic of Korea.
authors.forename: Do-Young
authors.initials: DY
authors.lastname: Jung
authors.forename: Eun-Kyung
authors.initials: EK
authors.lastname: Koh
authors.forename: Oh-Yun
authors.initials: OY
authors.lastname: Kwon
authors.forename: Chung-Hwi
authors.initials: CH
authors.lastname: Yi
authors.forename: Jae-Seop
authors.initials: JS
authors.lastname: Oh
authors.forename: Jong-Hyuck
authors.initials: JH
authors.lastname: Weon
mesh_terms: 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