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Function of the peroneal tendons

Discussion in 'Biomechanics, Sports and Foot orthoses' started by NewsBot, Oct 31, 2012.

  1. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
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    The role of the peroneal tendons in passive stabilisation of the ankle joint: an in vitro study.
    Ziai P, Benca E, von Skrbensky G, Graf A, Wenzel F, Basad E, Windhager R, Buchhorn T.
    Knee Surg Sports Traumatol Arthrosc. 2012 Oct 30
     
  2. Admin2

    Admin2 Administrator Staff Member

  3. efuller

    efuller MVP

    So essentially they are trying to find out if passive motion of the peroneal tendons allows full range of motion of the joint. Or are they trying to find out if the peroneal tendons can limit motion in cadavers? Without reading the paper it looks bad on the surface.

    Eric
     
  4. I would say they are trying to determine if the peroneal tendons, without active muscular contraction, influence the stiffness of the joint.
     
  5. musmed

    musmed Active Member

  6. efuller

    efuller MVP

    What role do you think the fibula and short head of the biceps have? Are you referring to the fibular head manipulation that Howard talks about? How would that affect passive tension?
     
  7. efuller

    efuller MVP

    After reading the paper, I can see how they would do that. The protocol raises an interesting question. They transect the lateral ligaments and then don't see much change in what appears to be talar tilt stability. Then they transect the peroneus longus tendon and brevis is still intact and see a decrease in stiffness at the ankle. So, if it is passive muslce tension that provides the stiffness, why doesn't the increase in motion of the ankle joint occur after the brevis is transected? In the picture it appears they cut the speciman mid shaft of the tibia below at least part of the origin of longus.

    An alternae explanation is that after transecting the ligaments there are still some strutures intact that could cause some stiffness that were torn by the testing. Anyway, there needs to be an explanation of why peroneus longus limits ankle inversion and peroneus brevis doesn't before you can accept the explanation of passive muscle stiffness.
     
  8. musmed

    musmed Active Member

    Dear Eric

    The answer is everything.
    Embryologically the peroneals, dorsal foot muscles and short head of the biceps (Along with several pelvic muscles) are derived from the dorsal limb bud while everything else in the lower limb is from the ventral bud.
    Thus these muscles are involved with inversion of the foot.

    That is why the short head of the biceps femoris has its own nerve supply. It also has more fast twitch fibres and muscle spindles than the other hamstrings.

    Being attached to the fibula it produces an inversion movement to the calcaneum via the lateral ligaments while the peroneals produce a plantar longitudinal rotation to help pull the great toe into the ground.

    The short head of the biceps femoris also is a synergist to the peroneal by being able to pull the fibula up and thus assist the passive tension in the muscle and thus tendon.

    Here we have a dual system
    1. the biceps can rest and the peroneals pull
    2. the peroneal set a length and the biceps can pull up the fibula= equating to the peroneals working.

    This is why you must rehab the short head of the biceps along with the superior tib fib joint in any inveresion sprain/injury to the lateral ankle for a successful outcome.

    There are several other roles of fibula motion that have never been mentioned as far as I am aware.

    The role of the fibula and interosseous membrane and tibialis posterior.
    Again the biceps femoris is a synergist to the tibialis posterior.
    This is achieved by the fibula elevation causing a change in the orientation of the interosseous membrane and thus the orientation of the muscle fibres of the tibialis posterior.
    This in turn causes the Tib. Post. tendon to rotate and thus tension the various individual tendons of the mother tendon as they go to the various bones of the foot.

    This enables the tibialis posterior to load the various bones throughout the walking and standing cycles and thus not cause them to wear out and lat a life time.

    Next time you see a collapse of the tib post tendon see how many reps the patient can do for the biceps (hammies in general). Usually it is 2-3 reps to failure sometimes up to 10 but that is rare.

    By the way I have several photos of a completely denuded foot of all structure except for the bones and the short plantar ligs. and the foot still stands quite comfortably on its own.

    Unfortunately due to copyright I am unable to show them at present.

    Green moon won the Melbourne Cup payin $24 for a dollar on the tote

    Regards to all.
    Paul Conneely
    www.musmed.com.au
     
  9. efuller

    efuller MVP

    Ok, it's theoretically possible for the biceps tendon to move the fibula that would move the origin of the muscle belly in the correct direction to add some pull. I'm skeptical that it does. What evidence is there for this mechanism?

    Also there will be times in your life that you may perform a maneuver where you want the peroneal tendons active and the short head of the biceps inactive. This could occur when you want extension of the knee at the same time you want the peroneals active. So, the muscle should work without the need for the pull of the biceps femoris tendon.

    In regards to the study, if the muscle does passively add joint torque, it could do it when the fibula is in its maximally inferior position, so this concern would not effect the study.

    I have no doubt that it does. The old Basmajian study noted that you didn't see contraction of the muscles until there was quite a bit of load on the foot. So, if you subjected the denuded foot to repetative loads then you could eventually expect collapse.

    Eric
     
  10. musmed

    musmed Active Member

    Dear Eric
    In your example of knee extension and inactive biceps I cannot see how this can occur as the hamstrings are a knee extender.

    just sit with your knees at 90 degrees, place your fingers on the short head tendon, supinate your foot= bingo the biceps activates.
    I doubt that this is theoretical.

    Re the dissected foot. I doubt it was subjected to any other forces outside of gravity due to the time it took to produce this specimen.

    Everything will collapse if you exceed the stress strain curve for tendons, if you do not, it will last a life time.

    I think too much emphasis is placed on the role of tendons in stabilising of joints.
    Tendons do not do anything perse other than transfer energy from the muscle to a distal point.

    I have seen many an unconscious patient and I have never found their feet hands etc to fall apart.
    The only role a muscle has is to protect the joint it subtends, nothing else.
    Movement only occurs when you have anatagonists and synergists involved.

    The way i lengthen hamstrings is to mobilise the talus. The reason is this, the ROM of the ankle is poor thus the muscles will shorten to match the ROM. Since the biceps is a foot muscle, changing the ROM of the ankle, the Hamstring lengthens amongst many other things instantly.

    Wet today
    maybe a blue moon as green moon won yesterday
    Regards
    paul conneely
     
  11. Paul:

    The quadriceps are a "knee extender". The hamstrings are a "knee flexor".

    Please tell me how a muscle which passes posterior to the knee is a "knee extender"? Do you also think that the quadriceps are a "knee flexor"???? :confused:

    My biceps don't "activate" with this maneuver. Regardless, this has nothing to do with the hamstrings being the prime producers of knee joint flexion moment during weightbearing activities.

    I'm glad that you, Paul, never taught me biomechanics in podiatry school....I think I would have been jumping off the Golden Gate Bridge at the end of the semester.;)
     
  12. efuller

    efuller MVP

    Flexion is when the foot rotates toward the buttocks and extension is when the foot rotates the foot away from the buttocks. The hamstrings are knee flexors.


    Just tried it. I was able to supinate my foot without contracting my biceps femoris. Besides, with the knee at 90 degrees the bicesp is no longer oriented in such a way that it would cause a superior movement of the fibula. Another reason why the biceps femoris should not matter in peroneal function: sometimes you will want to use the peroneal muscles when the knee is flexed more than 90 degrees.

    Eric
     
  13. musmed

    musmed Active Member


    Wishful thinking

    The hamstrings working on their own flex the knee and that would be a concentric
    contraction....

    the lower limb muscles work best as eccentric contractors...n'est pas????
    if so the hamstring when combined with the quadriceps and gastrocnemius and to some extent the soleus working as a synergistic team in an eccentric capacity makes sense.

    The big problem is that so many out there cannot see the difference in what anatomist of the 16th centuary saw (I doubt biomechanics had been invented) and what biomechanically occurs, muscles in isolation versus in working groups.

    to annoy you more, the foot is a tensegrity object, your posting said there are hight forces in the joints, of course there are but you forgot to add that there is cartilage present between them, I did not.

    If your biceps did not activate, you have a problem so I suggest you get it sorted out.

    Regards
    Paul Conneely
     
  14. I think the only problem I need sorting out is in trying to make sense of anything you say in your posts. It's like you are from another planet.

    .....one exception......I do understand the Sydney weather reports you make at the end of all your posts.:drinks

    76 degrees Fahrenheit, calm, mostly sunny...but with cold front approaching in two days here in Sacramento...skiers are getting happy again for more new snow before Thanksgiving....:D
     
  15. musmed

    musmed Active Member

    Dear Kevin
    Thanks for the weather report.

    maybe one day dawn will and it will all make sense as it does to others.
    Spend some time thinking outside the box and when one of Austalia's greatest minds, Prof Bogduk agrees with me, that's all i need to know.

    an aside, ever thought about the role of space time continuum in relation to gravity and posture. I have, try it. Give you 5 years or so and I have no doubt that you will change your thinking model.
    Regards
    Paul C
    rain stopped but the hopefully more coming . we need it. drier than a dead dingo's donger!
     
  16. Live long and prosper.....at least Mr. Spock made sense to me.....
     
  17. Rob Kidd

    Rob Kidd Well-Known Member

    Never mind the rubbish above - not going there, the real issue is that you are all thinking like podiatrists, not evolutionary biologists, which is what you have to be to have this conversation. First: how many peronei? 3? Wrong, 5. And early examples of our genera clearly show fibularis (in the current words) quartus and quinti. So: where have they all gone? Well, Tertius, I think we all know about, though which way it is going - stuffed if I know. Next time you are in dissection class - bless it - just spent 3 months in dissection class in Adelaide, look hard at the FL tendon, and ask you self, why is is it so multipartite? Quartus and Quinti coming back to haunt? All answers are there for those that look
     
  18. musmed

    musmed Active Member

    Dear Kevin
    How wonderful for you.
    Whenever people in power have their bubble burst they immediately put it down.

    There is an old saying, 'if you want to become an expert, do not read outside your topic'

    Next time you consider whatever you are doing consider the space/time continuum and gravity and it is this active ongoing 'complex'.
    Without it you cannot do anything, even believe in the good doctor.

    Enjoying my space/time continuum and gravity.

    Off to tend the vegetable garden. rain stopped, snails will be out or sure.

    Regards
    Paul Conneely
    www.musmed.com.au
     
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    NewsBot The Admin that posts the news.

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