title: Gastrocnemius Stretching Program: More Effective in Increasing Ankle/Rear-Foot Dorsiflexion When Subtalar Joint Positioned in Pronation Than in Supination.
abstract: BACKGROUND
  Stretching exercises are commonly prescribed for patients and healthy individuals with limited extensibility of the gastrocnemius muscle.
  
  
  OBJECTIVE
  To determine if individuals demonstrate more dorsiflexion at the ankle/rear foot and less at the midfoot after a gastrocnemius-stretching program with the subtalar joint (STJ) positioned in supination compared with pronation.
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  Biomechanical laboratory.
  
  
  METHODS
  22 volunteers with current or recent history of lower-extremity cumulative trauma and gastrocnemius tightness (10 women and 4 men, mean age 28 y) randomly assigned to stretching groups with the STJ positioned in either pronation (n = 11) or supination (n = 11).
  
  
  METHODS
  3-wk home gastrocnemius-stretching program using a template to place the subtalar joint in either a pronated or a supinated position.
  
  
  METHODS
  A 7-camera Vicon motion-analysis system measured ankle/ rear-foot dorsiflexion and midfoot dorsiflexion of all participants during stretching with the STJ positioned in both pronation and supination before and after the 3-wk gastrocnemius-stretching program.
  
  
  RESULTS
  A 2-way mixed-model ANOVA revealed a significant interaction (P = .019). At posttest, the group who performed the 3-week stretching program with the STJ positioned in pronation demonstrated more increased ankle/rear-foot dorsiflexion when measured with the STJ in pronation than the group who performed the 3-wk stretching program with the STJ positioned in supination. No significant main effect of stretching group or interaction for dorsiflexion at the midfoot was detected (P = .755 and P = .820, respectively).
  
  
  CONCLUSIONS
  After a 3-wk gastrocnemius-stretching program, when measuring dorsiflexion with the STJ positioned in supination, the participants who completed a 3-wk gastrocnemius stretching program with the STJ positioned in pronation showed more increased dorsiflexion at the ankle/rear foot than participants who completed the stretching program with the STJ positioned in supination.
authors.affiliation: Dept of Rehabilitation Medicine, Emory University, Atlanta, GA.
authors.forename: Marie A
authors.initials: MA
authors.lastname: Johanson
authors.forename: Megan
authors.initials: M
authors.lastname: Armstrong
authors.forename: Chris
authors.initials: C
authors.lastname: Hopkins
authors.forename: Meghan L
authors.initials: ML
authors.lastname: Keen
authors.forename: Michael
authors.initials: M
authors.lastname: Robinson
authors.forename: Scott
authors.initials: S
authors.lastname: Stephenson
mesh_terms: D000328:Adult; D000843:Ankle Joint / Q000502:physiology*; D001696:Biomechanical Phenomena; D005260:Female; D005528:Foot; D006801:Humans; D008297:Male; D052580:Muscle Stretching Exercises / Q000379:methods*; D018482:Muscle, Skeletal / Q000502:physiology*; D016059:Range of Motion, Articular / Q000502:physiology*; D013380:Subtalar Joint / Q000502:physiology*