Wezenbeek E, Willems T M, Mahieu N, Van Caekenberghe I, Witvrouw E, De Clercq D
Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium.
Ine Van Caekenberghe, Research Consultancy, Sint-Lievens-Houtem, Belgium.
Scand J Med Sci Sports. 2017 Dec;27(12):1970-1977. doi: 10.1111/sms.12834. Epub 2017 Feb 24.
In the etiology of Achilles tendinopathy (AT), it is frequently suggested that excessive pronation causes a vascular constriction of the Achilles tendon, described as the "whipping phenomenon" (Clement et al., 1984). Although previous studies focused on the association between pronation and AT, it is striking that the underlying association between foot pronation and blood flow has not been studied yet. Therefore, the aim of this study was to investigate whether the amount of pronation during running influences the Achilles tendon blood flow. Twenty-five experienced runners, aged 34.5±10.2 years, participated in this study. 2D-lower limb kinematics during barefoot and shod running in both frontal and sagittal plane were assessed. Blood flow of the Achilles tendon was measured before and after barefoot and shod running, using the oxygen-to-see device. The results of this study showed a significant effect of eversion excursion on the increase in Achilles tendon blood flow after shod running. More specifically, the more the eversion excursion observed, the lower the increase in blood flow (P=.013). We therefore suggest, in individuals with increased inversion at touchdown and increased eversion around midstance during shod running, that antipronation measures could be useful in both preventing and managing Achilles tendinopathy.
在跟腱病（AT）的病因学中，人们常认为过度旋前会导致跟腱血管收缩，即所谓的“鞭打现象”（克莱门特等人，1984年）。尽管先前的研究聚焦于旋前与跟腱病之间的关联，但令人惊讶的是，足部旋前与血流之间的潜在关联尚未得到研究。因此，本研究的目的是调查跑步时的旋前程度是否会影响跟腱血流。25名经验丰富的跑步者参与了本研究，他们的年龄为34.5±10.2岁。评估了他们在赤脚和穿鞋跑步时在额状面和矢状面的二维下肢运动学。使用氧可视设备测量了赤脚和穿鞋跑步前后的跟腱血流。本研究结果显示，外翻偏移对穿鞋跑步后跟腱血流增加有显著影响。更具体地说，观察到的外翻偏移越多，血流增加越低（P = 0.013）。因此，我们建议，对于在穿鞋跑步时着地时内翻增加且在步幅中点左右外翻增加的个体，抗旋前措施可能有助于预防和管理跟腱病。
