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Is Achilles tendon blood flow related to foot pronation?

Evi Wezenbeek (UGent), Tine Willems (UGent), Nele Mahieu (UGent), Ine Van Caekenberghe (UGent), Erik Witvrouw (UGent) and Dirk De Clercq (UGent)
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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.
Keywords
Achilles tendon, blood flow, eversion, pronation, running, vascular constriction, whipping phenomenon, RUNNING SHOE, RISK-FACTORS, LOWER-LIMB, TENDINOPATHY, RUNNERS, EXERCISE, SPECTROSCOPY, TENDINITIS, INJURIES, BAREFOOT

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Chicago
Wezenbeek, Evi, Tine Willems, Nele Mahieu, Ine Van Caekenberghe, Erik Witvrouw, and Dirk De Clercq. 2017. “Is Achilles Tendon Blood Flow Related to Foot Pronation?” Scandinavian Journal of Medicine & Science in Sports 27 (12): 1970–1977.
APA
Wezenbeek, E., Willems, T., Mahieu, N., Van Caekenberghe, I., Witvrouw, E., & De Clercq, D. (2017). Is Achilles tendon blood flow related to foot pronation? SCANDINAVIAN JOURNAL OF MEDICINE & SCIENCE IN SPORTS, 27(12), 1970–1977.
Vancouver
1.
Wezenbeek E, Willems T, Mahieu N, Van Caekenberghe I, Witvrouw E, De Clercq D. Is Achilles tendon blood flow related to foot pronation? SCANDINAVIAN JOURNAL OF MEDICINE & SCIENCE IN SPORTS. 2017;27(12):1970–7.
MLA
Wezenbeek, Evi, Tine Willems, Nele Mahieu, et al. “Is Achilles Tendon Blood Flow Related to Foot Pronation?” SCANDINAVIAN JOURNAL OF MEDICINE & SCIENCE IN SPORTS 27.12 (2017): 1970–1977. Print.
@article{8531246,
  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 {\textacutedbl}whipping phenomenon{\textacutedbl} (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{\textpm}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.},
  author       = {Wezenbeek, Evi and Willems, Tine and Mahieu, Nele and Van Caekenberghe, Ine and Witvrouw, Erik and De Clercq, Dirk},
  issn         = {0905-7188},
  journal      = {SCANDINAVIAN JOURNAL OF MEDICINE \& SCIENCE IN SPORTS},
  keyword      = {Achilles tendon,blood flow,eversion,pronation,running,vascular constriction,whipping phenomenon,RUNNING SHOE,RISK-FACTORS,LOWER-LIMB,TENDINOPATHY,RUNNERS,EXERCISE,SPECTROSCOPY,TENDINITIS,INJURIES,BAREFOOT},
  language     = {eng},
  number       = {12},
  pages        = {1970--1977},
  title        = {Is Achilles tendon blood flow related to foot pronation?},
  url          = {http://dx.doi.org/10.1111/sms.12834},
  volume       = {27},
  year         = {2017},
}

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