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This Article Full Text Full Text (PDF) All Versions of this Article: 32/8/1893    most recent 0363546504265191v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (11) Citing Articles via Google Scholar Google Scholar Articles by Weist, R. Articles by Rosenbaum, D. Search for Related Content PubMed PubMed Citation Articles by Weist, R. Articles by Rosenbaum, D. Related Collections Fracture Muscle Overuse

The Influence of Muscle Fatigue on Electromyogram and Plantar Pressure Patterns as an Explanation for the Incidence of Metatarsal Stress Fractures

From the Funktionsbereich Bewegungsanalytik (Movement Analysis Lab), Klinik und Poliklinik für Allgemeine Orthopädie (Orthopaedic Department), University Hospital Münster, Germany

^* Address correspondence to Priv Doz Dr Dieter Rosenbaum, Funktionsbereich Bewegungsanalytik, Klinik und Poliklinik für Allgemeine Orthopädie, Universitätsklinikum Münster, Domagkstr. 3, D-48129 Münster, Germany (e-mail: diro{at}uni-muenster.de).

Background: Stress fractures are common overuse injuries in runners and appear most frequently in the metatarsals.

Purpose: To investigate fatigue-related changes in surface electromyographic activity patterns and plantar pressure patterns during treadmill running as potential causative factors for metatarsal stress fractures.

Study Design: Prospective cohort study with repeated measurements.

Methods: Thirty experienced runners volunteered to participate in a maximally exhaustive run above the anaerobic threshold. Surface electromyographic activity was monitored for 14 muscles, and plantar pressures were measured using an in-shoe monitoring system. Fatigue was documented with blood lactate measurements.

Results: The results demonstrated an increased maximal force (5%, P < .01), peak pressure (12%, P < .001), and impulse (9%, P < .01) under the second and third metatarsal head and under the medial midfoot (force = 7%, P < .05; pressure = 6%, P < .05; impulse = 17%, P < .01) toward the end of the fatiguing run. Contact area and contact time were only slightly affected. The mean electromyographic activity was significantly reduced in the medial gastrocnemius (–9%, P < .01), lateral gastrocnemius (–12%, P < .01), and soleus (–9%, P < .001) muscles.

Conclusion: The demonstrated alteration of the rollover process with an increased forefoot loading may help to explain the incidence of stress fractures of the metatarsals under fatiguing loading conditions.

Key Words: running • stress fractures • fatigue • electromyography (EMG) • pedography • plantar pressure pattern

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