Gastrocnemius Stretching Program: More Effective in Increasing Ankle/Rear-Foot Dorsiflexion When Subtalar Joint Positioned in Pronation Than in Supination

J Sport Rehabil. 2015 Aug;24(3):307-14. doi: 10.1123/jsr.2014-0191. Epub 2014 Oct 13.

Abstract

Context: Stretching exercises are commonly prescribed for patients and healthy individuals with limited extensibility of the gastrocnemius muscle.

Objective: To determine if individuals demonstrate more dorsiflexion at the ankle/rear foot and less at the midfoot after a gastrocnemius-stretching program with the subtalar joint (STJ) positioned in supination compared with pronation.

Design: Randomized controlled trial.

Setting: Biomechanical laboratory.

Participants: 22 volunteers with current or recent history of lower-extremity cumulative trauma and gastrocnemius tightness (10 women and 4 men, mean age 28 y) randomly assigned to stretching groups with the STJ positioned in either pronation (n = 11) or supination (n = 11).

Intervention: 3-wk home gastrocnemius-stretching program using a template to place the subtalar joint in either a pronated or a supinated position.

Main outcome measures: A 7-camera Vicon motion-analysis system measured ankle/ rear-foot dorsiflexion and midfoot dorsiflexion of all participants during stretching with the STJ positioned in both pronation and supination before and after the 3-wk gastrocnemius-stretching program.

Results: A 2-way mixed-model ANOVA revealed a significant interaction (P = .019). At posttest, the group who performed the 3-week stretching program with the STJ positioned in pronation demonstrated more increased ankle/rear-foot dorsiflexion when measured with the STJ in pronation than the group who performed the 3-wk stretching program with the STJ positioned in supination. No significant main effect of stretching group or interaction for dorsiflexion at the midfoot was detected (P = .755 and P = .820, respectively).

Conclusion: After a 3-wk gastrocnemius-stretching program, when measuring dorsiflexion with the STJ positioned in supination, the participants who completed a 3-wk gastrocnemius stretching program with the STJ positioned in pronation showed more increased dorsiflexion at the ankle/rear foot than participants who completed the stretching program with the STJ positioned in supination.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Ankle Joint / physiology*
  • Biomechanical Phenomena
  • Female
  • Foot
  • Humans
  • Male
  • Muscle Stretching Exercises / methods*
  • Muscle, Skeletal / physiology*
  • Range of Motion, Articular / physiology*
  • Subtalar Joint / physiology*