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- Issue 102
- Selective triceps surae weakness in Achilles…
Selective triceps surae weakness in Achilles tendinopathy: it is time to look beyond the soleus
Key Points
- Deficits in lateral Gastrocnemius neural drive exist with Achilles tendinopathy.
BACKGROUND & OBJECTIVE
Achilles Tendinopathy (AT) has long been associated with deficits in the Soleus muscle (in the authors view), but current research is suggesting that there may be greater deficits in gastrocnemius lateralis. This is primarily based on studies examining neural drive and selective muscle mass measurements, which suggest that the gastrocnemius of people with Achilles tendinopathy is smaller than those without.
The drive of the triceps surae muscles will directly influence the stress and strain through the sub-tendons of the Achilles tendon and this may in turn influence interfascicular sliding in positive and negative ways that may in turn trigger or prevent tendinopathy.
During muscle contractions the Soleus is identified as the primary contributor to muscle force generation, (1) but during tendinopathy there is a suggestion that the lateral gastrocnemius may see a greater % loss of force generation. Notably the tests identifying this are completed in knee extension and not knee flexion.
This review aims to synthesise the current evidence on neurophysiological alterations specifically affecting the gastrocnemius lateralis in individuals with AT.
If you can’t image the tendon or quantify muscle force/activation in your clinic, try altering the foot position to be rotated in/out during prescribed exercises.
METHODS
This study is a Narrative review: A narrative review is the most likely to lead to bias in findings as the study method does not necessitate completing a systematic search (as would be required if this work was completed as