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The heel pad (HP) which is located below the calcaneus comprises a composition of morphometrical and morphological arrangements of soft tissues that are influenced by factors such as gender, age and obesity. It is well known that HP pain and Achilles tendonitis consist of discomfort, pain and swelling symptoms that usually develop from excessive physical activities such as walking, jumping and running. The purpose of this study was to develop biomechanical techniques to evaluate the function and characteristics of the HP. Ten healthy participants (five males and five females) participated in this laboratory-based study, each performing a two-footed heel raise to mimic the toe-off phase during human locomotion. Twenty-six (3 mm) retroreflective markers were attached to the left and right heels (thirteen markers on each heel). Kinematic data was captured using three-dimensional motion analysis cameras synchronised with force plates. Descriptive and multivariate statistical tests were used in this study. In addition, a biomechanical technique that utilises only six markers from 26 markers to assess HP deformation and function has been developed and used in this study. Overall HP displacement was significantly higher in males on the most lateral part of the right heel (p < 0.05). No significant differences were evident when comparing the non-dominant and dominant heels during the baseline, unloading and loading phases (p > 0.05). Findings from this study suggested that biomechanical outputs expressed as derivatives from tracked HP marker movements can morphologically and morphometrically characterise HP soft tissue deformation changes. The outcome of this study highlights the importance of 3D motion analysis being used as a potential prospective intervention to quantify the function / characteristics of the heel pad soft tissues.

Global participation in running continues to increase, especially amongst adolescents. Consequently, the number of running-related injuries (RRI) in adolescents is rising. Emerging evidence now suggests that overuse type injuries involving growing bone (e.g., bone stress injuries) and soft tissues (e.g., tendinopathies) predominate in adolescents that participate in running-related sports. Associations between running biomechanics and overuse injuries have been widely studied in adults, however, relatively little research has comparatively targeted running biomechanics in adolescents. Moreover, available literature on injury prevention and rehabilitation for adolescent runners is limited, and there is a tendency to generalize adult literature to adolescent populations despite pertinent considerations regarding growth-related changes unique to these athletes. This perspective article provides commentary and expert opinion surrounding the state of knowledge and future directions for research in adolescent running biomechanics, injury prevention and supplemental training.

Minimal footwear has existed for tens of thousands of years and was originally designed to protect the sole of the foot. Over the past 50 yr, most footwear has become increasingly more cushioned and supportive. Here, we review evidence that minimal shoes are a better match to our feet, which may result in a lower risk of musculoskeletal injury.

Only a small number of muscle activation patterns from lower limbs have been reported and simultaneous muscle activation from several lower limb muscles have not yet been investigated. The purpose of this study was to examine any gender differences in surface electromyography (EMG) activity from six recorded lower limb muscles of the dominant limb at baseline (i.e., with the foot placed flat on the floor and in the neutral position), and during concentric and eccentric phases when performing a heel raise task. In total, 10 females and 10 males performed a standing heel raise task comprising of three continuous phases: baseline, unloading (concentric muscle action), and loading (eccentric muscle action) phases. Muscle activation from six muscles (gastrocnemius medialis, gastrocnemius lateralis, soleus, tibialis anterior, peroneus longus, and peroneus brevis) were measured using the Myon 320 EMG System. Root mean squared values of each muscle were calculated for each phase. Descriptive and inferential statistics were incorporated into the study. Statistically significant p values were set at 0.05. The results showed no significant differences between baseline, concentric, and eccentric phases with respect to each of the muscles investigated. Except for the gastrocnemius medialis at baseline and concentric phases, no significant differences were observed between genders or contractions. The data suggests that gender does not significantly influence the eccentric phase during the standing heel raise task.

Background: Instrumented treadmills that incorporate pressure platforms are increasingly used to characterize gait in children. Although footprint size is known to influence the measurement performance of pressure platforms, published evidence on the reliability of such systems for children's gait is lacking. Research question: This study evaluated the test–retest reliability of temporospatial gait parameters and vertical ground reaction forces measured in healthy children during barefoot walking and running on a capacitance–based treadmill system. Methods: Temporospatial gait parameters, including cadence, stride length, stride duration, stance and swing phase durations and the magnitude and timing of conventional vertical ground reaction force peaks were determined on two occasions in 17 healthy children (mean age, 11 ± 2 years; height, 148.4 ± 9.3 cm; and mass, 43.3 ± 10 kg) during walking and running at preferred speed on an instrumented treadmill. Reliability was assessed using Intra Class Correlation Coefficients (ICC) and the standard error of measurement (SEM). The minimum detectable change (MDC95%) was also calculated. Results: ICC values ranged from 0.91–0.99 for all variables. When expressed as a percentage of the mean, the SEM was <5% for all gait parameters assessed during walking and running. The MDC95% values for gait parameters were typically higher during running than walking, and were ±4% of the gait cycle for temporal parameters, ±55 cm for stride length and ±0.1 bodyweights for peak vertical ground reaction force. Significance: Children's gait parameters varied by <5% between test occasions and were more consistent during walking than running. These findings provide clinicians and researchers with an index of the reliability and sensitivity of the treadmill to detect changes in common spatiotemporal gait parameters and vertical ground reaction forces in children.

Reduced Cl− conductance causes inhibited muscle relaxation after forceful voluntary contraction due to muscle membrane hyperexcitability. This represents the pathomechanism of myotonia congenita. Due to the prevailing data suggesting that an increased potassium level is a main contributor, we studied the effect of a modulator of a big conductance Ca2+- and voltage-activated K+ channels (BK) modulator on contraction and relaxation of slow- and high-twitch muscle specimen before and after the pharmacological induction of myotonia. Human and murine muscle specimens (wild-type and BK−/−) were exposed to anthracene-9-carboxylic acid (9-AC) to inhibit CLC-1 chloride channels and to induce myotonia in-vitro. Functional effects of BK-channel activation and blockade were investigated by exposing slow-twitch (soleus) and fast-twitch (extensor digitorum longus) murine muscle specimens or human musculus vastus lateralis to an activator (NS1608) and a blocker (Paxilline), respectively. Muscle-twitch force and relaxation times (T90/10) were monitored. Compared to wild type, fast-twitch muscle specimen of BK−/− mice resulted in a significantly decreased T90/10 in presence of 9-AC. Paxilline significantly shortened T90/10 of murine slow- and fast-twitch muscles as well as human vastus lateralis muscle. Moreover, twitch force was significantly reduced after application of Paxilline in myotonic muscle. NS1608 had opposite effects to Paxilline and aggravated the onset of myotonic activity by prolongation of T90/10. The currently used standard therapy for myotonia is, in some individuals, not very effective. This in vitro study demonstrated that a BK channel blocker lowers myotonic stiffness and thus highlights its potential therapeutic option in myotonia congenital (MC).

Aging is a one-way process associated with profound structural and functional changes in the organism. Indeed, the neuromuscular system undergoes a wide remodeling, which involves muscles, fascia, and the central and peripheral nervous systems. As a result, intrinsic features of tissues, as well as their functional and structural coupling, are affected and a decline in overall physical performance occurs. Evidence from the scientific literature demonstrates that senescence is associated with increased stiffness and reduced elasticity of fascia, as well as loss of skeletal muscle mass, strength, and regenerative potential. The interaction between muscular and fascial structures is also weakened. As for the nervous system, aging leads to motor cortex atrophy, reduced motor cortical excitability, and plasticity, thus leading to accumulation of denervated muscle fibers. As a result, the magnitude of force generated by the neuromuscular apparatus, its transmission along the myofascial chain, joint mobility, and movement coordination are impaired. In this review, we summarize the evidence about the deleterious effect of aging on skeletal muscle, fascial tissue, and the nervous system. In particular, we address the structural and functional changes occurring within and between these tissues and discuss the effect of inflammation in aging. From the clinical perspective, this article outlines promising approaches for analyzing the composition and the viscoelastic properties of skeletal muscle, such as ultrasonography and elastography, which could be applied for a better understanding of musculoskeletal modifications occurring with aging. Moreover, we describe the use of tissue manipulation techniques, such as massage, traction, mobilization as well as acupuncture, dry needling, and nerve block, to enhance fascial repair.