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The extensibility of the plantar fascia influences the windlass mechanism during human running.

ABSTRACT: The arch of the human foot is unique among hominins as it is compliant at ground contact but sufficiently stiff to enable push-off. These behaviours are partly facilitated by the ligamentous plantar fascia whose role is central to two mechanisms. The ideal windlass mechanism assumes that the plantar fascia has a nearly constant length to directly couple toe dorsiflexion with a change in arch shape. However, the plantar fascia also stretches and then shortens throughout gait as the arch-spring stores and releases elastic energy. We aimed to understand how the extensible plantar fascia could behave as an ideal windlass when it has been shown to strain throughout gait, potentially compromising the one-to-one coupling between toe arc length and arch length. We measured foot bone motion and plantar fascia elongation using high-speed X-ray during running. We discovered that toe plantarflexion delays plantar fascia stretching at foot strike, which probably modifies the distribution of the load through other arch tissues. Through a pure windlass effect in propulsion, a quasi-isometric plantar fascia's shortening is delayed to later in stance. The plantar fascia then shortens concurrently to the windlass mechanism, likely enhancing arch recoil at push-off.

SUBMITTER: Welte L

PROVIDER: S-EPMC7893268 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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The extensibility of the plantar fascia influences the windlass mechanism during human running.

Welte Lauren L Kelly Luke A LA Kessler Sarah E SE Lieberman Daniel E DE D'Andrea Susan E SE Lichtwark Glen A GA Rainbow Michael J MJ

Proceedings. Biological sciences 20210120 1943

The arch of the human foot is unique among hominins as it is compliant at ground contact but sufficiently stiff to enable push-off. These behaviours are partly facilitated by the ligamentous plantar fascia whose role is central to two mechanisms. The ideal windlass mechanism assumes that the plantar fascia has a nearly constant length to directly couple toe dorsiflexion with a change in arch shape. However, the plantar fascia also stretches and then shortens throughout gait as the arch-spring st ...[more]

PMID: 33468002

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Project description:BackgroundTaping is commonly prescribed to treat plantar fasciitis for runners by virtue of its alleged ability to offload the plantar fascia and facilitate positive injury prognosis. Our study aimed to investigate how different taping methods could change the loading on the plantar fascia during running using computational simulations.MethodsA finite element foot model was modified from a previous version to fit the study's purpose. The model featured twenty bones, bulk soft tissue, foot muscles, ligaments/tendons, and a solid part representing the plantar fascia. A runner performed several running trials under one untaped condition and two taped conditions-Low-Dye taping and Fascia taping, which were implemented by a physiotherapist using the Kinesio tapes. The captured motion data were processed to drive a scaled musculoskeletal model and calculate segmental kinematics, foot muscle force, and joint reaction force. These variables were then input as the boundary/loading conditions for finite element analyses of running. The principal tensile strain on the plantar fascia, subtalar eversion, and navicular height during the stance phase were averaged across five trials of each condition and compared using Friedman's test.ResultsMaximal subtalar eversion did not differ among conditions (p = 0.449). Fascia taping significantly reduced maximal strains on the fascia band (p = 0.034, Kendall's W = 0.64-0.76) and increased the navicular height (p = 0.013, Kendall's W = 0.84) compared with nontaping. There were no significant differences in all outcome variables between Low-Dye taping and nontaping (p = 0.173-0.618).ConclusionFrom a mechanical point of view, our study provided quantitative evidence to support the application of taping treatments for overstrained plantar fascia. The untensed fascia band by Fascia taping could be a potential indicator of pain relief for the runners. However, a prospective study targeting the patient population would be needed to address the point.The translational potential of this articleThe study quantified the loading status of the plantar fascia during running and provided mechanical evidence to support the usage of taping as a mean to reduce fascial strain, thus possibly controlling injury risks for the runners. The results of the study also highlighted the importance of selecting specific taping methods based on individuals' needs.

Project description:BackgroundDespite the established relevance of ultrasonography and assessment of pressure pain thresholds in patients with plantar fasciopathy, patient and probe positioning has been mostly ignored and are not necessarily reported in research. The primary aim of this study was to compare plantar fascia thickness in stretched and relaxed positions in patients with plantar fasciopathy. The secondary aim was to compare plantar heel pressure pain thresholds in these positions.MethodsIn this cross-sectional study, we measured the plantar fascia thickness with ultrasonography, and localised pressure pain thresholds using pressure algometry of 20 patients with plantar fasciopathy. These were assessed bilaterally, with the plantar fascia in both a stretched and relaxed position. In the stretched position, toes were maximally dorsiflexed, while in the relaxed position participants' feet were hanging freely over the end of the table.ResultsThe plantar fascia of the most symptomatic foot was significantly thicker when stretched compared with the relaxed position (sagittal: mean difference 0.2 mm, 95%CI: 0.1-0.4, P = 0.013; frontal: mean difference - 0.27, 95%CI: - 0.49 to - 0.06, P = 0.014). The plantar fascia was significantly thinner in the frontal plane compared with the sagittal plane in both positions (stretched: mean difference - 0.2 mm, 95%CI: - 0.42 to - 0.03, P = 0.025; relaxed: mean difference - 0.3 mm, 95%CI:-0.49 to - 0.08, P = 0.008). There was no difference between pressure pain thresholds in stretched or relaxed positions in either foot (P > 0.4).ConclusionsThe plantar fascia was significantly thicker in a stretched compared with a relaxed position and in the sagittal compared with the frontal plane, but differences were smaller than the standard deviation. Pressure pain thresholds were not different between the positions. These results highlight the importance of how ultrasonography is performed and reported in research to allow for replication.Trial registrationThe study was pre-registered September 25th, 2017 on ClinicalTrials.gov ( NCT03291665 ).

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The extensibility of the plantar fascia influences the windlass mechanism during human running.

Publications

The extensibility of the plantar fascia influences the windlass mechanism during human running.

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