title: Is Achilles tendon blood flow related to foot pronation?
abstract: In the etiology of Achilles tendinopathy (AT), it is frequently suggested that excessive pronation causes a vascular constriction of the Achilles tendon, described as the "whipping phenomenon" (Clement et al., 1984). Although previous studies focused on the association between pronation and AT, it is striking that the underlying association between foot pronation and blood flow has not been studied yet. Therefore, the aim of this study was to investigate whether the amount of pronation during running influences the Achilles tendon blood flow. Twenty-five experienced runners, aged 34.5±10.2 years, participated in this study. 2D-lower limb kinematics during barefoot and shod running in both frontal and sagittal plane were assessed. Blood flow of the Achilles tendon was measured before and after barefoot and shod running, using the oxygen-to-see device. The results of this study showed a significant effect of eversion excursion on the increase in Achilles tendon blood flow after shod running. More specifically, the more the eversion excursion observed, the lower the increase in blood flow (P=.013). We therefore suggest, in individuals with increased inversion at touchdown and increased eversion around midstance during shod running, that antipronation measures could be useful in both preventing and managing Achilles tendinopathy.
authors.affiliation: Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium.
authors.forename: E
authors.identifier: http://orcid.org/0000-0001-9303-6915
authors.initials: E
authors.lastname: Wezenbeek
authors.affiliation: Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium.
authors.forename: T M
authors.initials: TM
authors.lastname: Willems
authors.affiliation: Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium.
authors.forename: N
authors.initials: N
authors.lastname: Mahieu
authors.affiliation: Ine Van Caekenberghe, Research Consultancy, Sint-Lievens-Houtem, Belgium.
authors.forename: I
authors.initials: I
authors.lastname: Van Caekenberghe
authors.affiliation: Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium.
authors.forename: E
authors.initials: E
authors.lastname: Witvrouw
authors.affiliation: Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
authors.forename: D
authors.initials: D
authors.lastname: De Clercq
mesh_terms: D000125:Achilles Tendon / Q000098:blood supply*; D000328:Adult; D001696:Biomechanical Phenomena; D005260:Female; D005528:Foot; D005684:Gait; D006801:Humans; D008297:Male; D011403:Pronation; D012420:Running; D012775:Shoes
keywords: Achilles tendon; blood flow; eversion; pronation; running; vascular constriction; whipping phenomenon