STUDY DESIGN: Controlled laboratory study. OBJECTIVES: To examine the effects of standing wall stretching with and without medial arch support (WMAS versus WOMAS) on the displacement of the myotendinous junction (DMTJ) of the medial gastrocnemius, rearfoot angle, and navicular height in subjects with neutral foot alignment and pes planus. BACKGROUND: Standing wall stretching is often prescribed to increase ankle dorsiflexion range of motion for sports fitness and rehabilitation. However, the effect of standing wall stretching WMAS on DMTJ is unknown. METHODS: Fifteen subjects with neutral foot alignment and 15 subjects with pes planus performed standing wall stretching under WMAS and WOMAS conditions. Measurements of DMTJ and rearfoot position were performed using ultrasonography and video imaging. Navicular height was measured using a ruler. Dependent variables were examined with a 2-way mixed-design analysis of variance. The 2 factors were foot type (neutral foot versus pes planus) and stretching condition (WMAS versus WOMAS). RESULTS: There were significant interactions of medial arch support by foot type for DMTJ, rearfoot angle, and navicular drop (P<.001). A post hoc paired t test showed that standing wall stretching in the WMAS condition significantly increased the DMTJ, compared to stretching in the WOMAS condition, in subjects with neutral foot (mean ± SD, 9.6 ± 1.6 versus 10.5 ± 1.6 mm; difference, 0.9 mm; 99% CI: 0.4-1.4 mm) and in those with pes planus (10.0 ± 1.8 versus 12.7 ± 2.0 mm; difference, 2.7 mm; 99% CI: 1.9-3.5 mm) (P<.001). When comparing WOMAS and WMAS, the difference in DMTJ (1.8 mm; 99% CI: 0.9-2.7 mm) was significantly greater in subjects with pes planus than in those with neutral foot (P<.001). CONCLUSION: Standing wall stretching with medial arch support maintained subtalar joint neutral position and increased the length of the gastrocnemius in subjects with pes planus. When prescribing standing wall stretching, clinicians need to emphasize the use of medial arch support to effectively stretch the gastrocnemius in subjects with pes planus.

J Orthop Sports Phys Ther 2009;39(12):867-874. doi:10.2519/jospt.2009.3158

KEY WORDS: ankle stretching, myotendinous junction, standing wall stretching, ultrasonography

STUDY DESIGN: Comparative, repeated-measures study. OBJECTIVES: To examine the effects of an abdominal drawing-in maneuver (ADIM) using a pressure biofeedback unit on electromyographic (EMG) signal amplitude of the hip and back extensors and the angle of anterior pelvic tilt during hip extension in the prone position. BACKGROUND: Prone hip extension is a commonly used position for testing hip extensors strength and performing hip extension exercises. Performing an ADIM during hip extension exercise in prone may reduce the activity of erector spinae and angle of anterior pelvic tilt and increase the activity of hip extensors. METHODS: Twenty ablebodied volunteers (10 male, 10 female) aged 19 to 26 years (mean ± SD, 22.3 ± 3.4 years) were recruited for this study. The EMG signal amplitude and angle of anterior pelvic tilt were measured during prone hip extension with and without performing an ADIM. Surface EMG signal was recorded from the erector spinae, gluteus maximus, and medial hamstrings. Kinematic data for anterior pelvic tilt were measured using a motion analysis system. Data were analyzed using 2-way ANOVAs. RESULTS: When performing an ADIM during hip extension exercises done in a prone position, the EMG signal amplitude decreased significantly in the erector spinae (mean ± SD, 49 ± 14 %MVIC versus 17 ± 12 %MVIC, P‹.001), and increased significantly in both the gluteus maximus (mean ± SD, 24 ± 8 %MVIC versus 52 ± 15 %MVIC, P‹.001) and medial hamstrings (mean ± SD, 47 ± 14 %MVIC versus 58 ± 20 %MVIC, P = .008). The angle of anterior pelvic tilt decreased significantly during prone hip extension with an ADIM (mean ± SD, 10° ± 2° versus 3° ± 1°, P‹.001). CONCLUSIONS: Based on these findings, an ADIM could be used as an effective method to disassociate erector spinae activation from gluteus maximus and medial hamstrings during prone hip extension exercise.

J Orthop Sports Phys Ther. 2007;37(6):320-324, Epub 15 March 2007. doi:10.2519/jospt.2007.2435

KEY WORDS: electromyography, low back, lumbar spine, lumbar stabilization