title: Electromyographic analysis of the triceps surae muscle complex during achilles tendon rehabilitation program exercises.
abstract: BACKGROUND
  Specific guidelines for therapeutic exercises following an Achilles tendon repair are lacking.
  
  
  OBJECTIVE
  A hierarchical progression of triceps surae exercises can be determined on the basis of electromyographic (EMG) activity.
  
  
  METHODS
  Randomized laboratory trial.
  
  
  METHODS
  Bipolar surface electrodes were applied over the medial and lateral heads of the gastrocnemius as well as the soleus on 20 healthy lower extremities (10 participants, 27 ± 5 years old). Muscle activity was recorded during 8 therapeutic exercises commonly used following an Achilles repair. Maximal voluntary isometric contractions (MVICs) were also performed on an isokinetic device. The effect of exercise on EMG activity (% MVIC) was assessed using repeated measures analysis of variance with Bonferroni corrections for planned pairwise comparisons.
  
  
  RESULTS
  Seated toe raises (11% MVIC) had the least amount of activity compared with all other exercises (P < 0.01), followed by single-leg balance on wobble board (25% MVIC), prone ankle pumps (38% MVIC), supine plantarflexion with red elastic resistance (45% MVIC), normal gait (47% MVIC), lateral step-ups (60% MVIC), single-leg heel raises (112% MVIC), and single-leg jumping (129% MVIC).
  
  
  CONCLUSIONS
  There is an increasing progression of EMG activity for exercises that target the triceps surae muscle complex during common exercises prescribed in an Achilles tendon rehabilitation program. Seated toe raises offer relatively low EMG activity and can be utilized as an early rehabilitative exercise. In contrast, the single-leg heel raise and single-leg jumping should be utilized only during later-stage rehabilitation.
  
  
  CONCLUSIONS
  EMG activity in the triceps surae is variable with common rehab exercises.
authors.affiliation: Nicholas Institute of Sports Medicine and Athletic Trauma, New York, New York ; Mullaney & Associates Physical Therapy, Matawan, New Jersey.
authors.forename: Michael
authors.initials: M
authors.lastname: Mullaney
authors.forename: Timothy F
authors.initials: TF
authors.lastname: Tyler
authors.forename: Malachy
authors.initials: M
authors.lastname: McHugh
authors.forename: Karl
authors.initials: K
authors.lastname: Orishimo
authors.forename: Ian
authors.initials: I
authors.lastname: Kremenic
authors.forename: Jessica
authors.initials: J
authors.lastname: Caggiano
authors.forename: Abi
authors.initials: A
authors.lastname: Ramsey