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Achillies tendinopathy treatment revolution of sorts

Discussion in 'Biomechanics, Sports and Foot orthoses' started by mike weber, Jan 30, 2010.

  1. Michael, I've only glanced at this thread. The reason I posted the links to the other threads is because in these discussions we described how as well as generating internal moment, muscles can also influence the external moment. So if we had an increase in internal plantarflexion moment about the ankle joint axis from the achilles, we may also have a concomitant increase in external dorsiflexory moment generated from GRF as the CoP is driven more distal along the plantar foot.

    I think Kevin is on the money with regard to interpretation here.
     
  2. Thanks Simon I´ll go look at them with another light. Kevin made a point that the researchers were looing at motion not moments and then I guess making the link that the muscle was causing the joint motion not another factor.

    Ive relaxed now on the way home soon I got go look at the other thread in see the internal-external moment thing which I´m still getting my head around.
     
  3. I think I should have written Achilles Tendionopathy treatment what the...

    as my title for the thread.
     
  4. Athol Thomson

    Athol Thomson Active Member

    Dear Michael,

    Apologies if it was my posts that got you grumpy.......that was not the intention.

    I had never seen the Rick Neptune work Kevin pointed out which is fantastic. Really enjoyed reading it.

    Kind regards,
    Athol Thomson
     
  5. Hi Athol No not your posts I was probably getting grumpy with myself for not being able my ideas well enough and with the paper. I did not make any sense for a muslce to be able to push.

    I love this place for it´s discussion and I hope you did not take offence from me either.

    Have a good weekend.

    :drinks Mike

    ps It was a great paper that Kevin put up
     
  6. musmed

    musmed Active Member

    Dear Mr. W
    I like the red writing, is Valentine's day in the air.
    I must admit it looed rather calming (as red is) just look at the McDonald's colours. why do you think they use these colours.
    I hate to tell you this, but the gastroc is the strrongest knee extensor (just sit for any USA sports medicine exam)
    and there are another 17 beleivers in the UK.

    Regards
    from Sunny Australia
    Paul C
     
  7. Where are all the papers with this evidence for the fact that the Gastroc in now not a knee flexor but a knee extensor, I´m sorry Paul I´m not going to take your word for it cause it still makes no sense. Have you read all the paper that have been posted in the last few days about the role of the Gastroc and have you also read the problems with the research completed discussed above here ? If you read Kevin Kirby´s post below, the 1st 2 lines in blue for you today.

     
  8. musmed

    musmed Active Member

    Dear All
    The late Vladamir Janda, the father of rehabilitation used to say that when looking at movement in the upper limb, look at agonists antagonists.
    When looking in the lower limb look for synergists.
    Now in knee standing for extension
    everyone is taught the quadriceps and hamstrings
    where is the synergist. The only muscle that can come close is the gastrocnemius.
    Do you have another muscle in mind?
    Have you ever spoken to a patient that had their knee either replaced or reconstructed and told you that when they were standing the knee felt loose or not strong or not secure?
    When you do just ask them what mkusclwes were rehabilitated and they will tell you the quads and hammies and nothing else. Once a programme concentrating on the gastroc, followed by the hammies and nothing else their function/abnormal sensation disappears.

    I'll leave it up to you.
    Regards
    Paul C
    musmed
     
  9. Paul I will go over this as I see it and everything I ve read indicates.

    Muscle can only contract they can not lengthen by themselves, they can lengthen thru movement of bone, joints this can be acheived thru direct muscle contraction of angnositic muscle or movement of the body above it.

    so muscle can contract cause direct movement or eccentric contract to slow movement.

    If looking at using a simple example of the knee any muscle which is anterior to the knee joint axis and crosses that joint when contracting will cause a extension moment at the knee joint, whether the movement of extension occurs is a completly different thing and depends on many factors.

    The same can be said for muscle that cross the knee joint and are posterior to the knee joint axis, They will cause a flexion moment at the knee joint when they contract. Ie the hamstrings and Gastroc are these muscles.

    Now as I have stated these muscle will also go thru eccentric contraction to help stabile the joint slow motion in this case knee extension. But and this is the big BUT just because the muscle is working it does not mean that it is causing the motion. It is slowing the movement.

    Muscles can not push the Gastroc is posterior to the knee joint axis it can not cause an extension moment to occur at the knee joint.
     
  10. musmed

    musmed Active Member

    Dear Sir
    I beg to differ.

    From 81 odd degrees to 90 full knee extension. This is produced by the gastroc muscle.

    Just for one moment, look at the ischial tubersoity and the hams (origin to insertion).
    Now turn it upside down, do they not look lie the gastroc and calcaneus.

    If you do not beleive me, give the great Professor Nicoli Bogduk an email at the bone and joint institute at the Newcastle Hospital NSW australia. If I cannot put you straight he will.

    Bye
    www.musmed.com.au

    I never look inside the box, only outside of the box (this is the hard part). Those who do only look inside the box see what the rest have seen, basicaly nothing.
     
  11. I guess it goodbye then, but if you read this it does not matter what you or I think where is the evidence in a journal of peer review. I´m sure Professor Nicoli Bogduk must have produced one. Until then Gastroc contraction produces a plantarflexion moment at the talocural joint and a flexion moment at the Knee .
     
  12. musmed

    musmed Active Member

    Buddy Holly was right.
    Dumb dee dumb dumb, Oh Boy.

    Just sit on a chair, place your fingers around your gastrocnemius muscle and stand up.
    Notice anything?
    Yes the gastroc contracted, there was no plantar flexion in this motion.
    Please explain, just use your observation, not a peer review journal. Simple it not.

    Do you not think that over many millions of years, the foot was designed to:
    get away from danger (and not get eaten) catching food and breeding?
    So when you look at what muscles and joints of the lower limb do, think about what I have just written.
    It is absolutely pointless to be able to plantar flex the foot if you cannot stand up prior to this motion.
    Have a gentle think about it. This is what looking outside the box is all about.

    Regards
    Pauy Conneely.
     
  13. Pauy:

    I believe your "experiment of one" is a good example of how not to teach biomechanics to medical professionals. It uses the same type of logic that I have been trying to make podiatry move away from for the past quarter century. It is about as logical as the arguments that the barefoot running fanatics make when they sy that running shoes cause all running injuries and that all runners should run barefoot.

    Why don't we try to talk biomechanics like the biomechanists do so we can have a meaningful discussion on lower extremity function, rather than cloud the issue with useless arguments that have little to do with the topic of discussion. I have found, over the years, that many "experts" that are continually encouraging others to think "outside the box" simply do so because they haven't taken the time themselves to learn the very useful and important knowledge that was always "within the box" in the first place.:drinks
     
  14. musmed

    musmed Active Member

    Dear Kevin
    Two things:
    1. Roots theory was based on a 1, n'est pas?
    2. Anthropology has no role in the evolution of foot mechanics?

    I suppose my study was a study of 1 when some ancient soul heard the sound of say a sabre toothed tiger, arose and ran.

    And thus here we are discussing this today.

    Floodimng here. Must have brought the rain from the UK
    Regards
    Musmed
     
  15. fatboy

    fatboy Active Member

    i agree.

    i think the foot is designed to get away from danger; however, i also believe there are people who prove Darwin may have been wrong...
     
  16. musmed

    musmed Active Member

    Dear Sir
    If you think evolution does not exist, just have a look at a toad that was introduced into Australia called the cane toad.

    Over the past 10 years it has developed the ability to jump an extra 15cms per leap. Maybe not much too you but you multiply it by thousands of leaps they are beginning to over run many parts of Australia.

    I know many athletes who would be very happy with a 15cms increase in stride length.
    Regards
    Paul C
    musmed
     
  17. Craig Payne

    Craig Payne Moderator

    Articles:
    8
    Here is a n=1 observation on achilles tendonitis ... as I subject myself to a rigourous routine in preparation for the Run 4 The Kids and pushing the arena'ettes in their stroller for the race. .... I have managed to develop achilles tendonitis ......

    If I stand with my knee slightly flexed and pronate my foot, it hurts the achilles. If I supinate the foot and flex the knee some more, it does not hurt ... I think that means a good pair of orthotics should help ... now only if I find a good podiatrist ... :D
     
  18. CraigT

    CraigT Well-Known Member

    GO barefoot Craig! Go on... :D
    That is the standard clinical test I use on achilles patients. Low-dye should also help...
     
  19. Pod on sea

    Pod on sea Active Member

    Does anyone use Nitrate patches (Glyceryl Trinitrate) for treating achilles tendinopathy? Any thoughts?
     
  20. Ive never used them but this paper indicates that they help.

     
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