Changes in gait associated with acute stage II posterior tibial tendon dysfunction

S. I. Ringleb, S. J. Kavros, B. R. Kotajarvi, D. K. Hansen, H. B. Kitaoka, K. R. Kaufman

Research output: Contribution to journalArticlepeer-review

68 Scopus citations


The purpose of this study was to examine differences in gait mechanics between patients with acute stage II PTTD and healthy volunteers. Hindfoot and midfoot kinematics, plantar foot pressures and electromyographic (EMG) activity of the posterior tibialis, gastrocnemius, anterior tibialis and the peroneals were measured in five patients with acute stage II PTTD. Kinematics and kinetics were compared to a database of 20 healthy volunteers. EMG and plantar pressure data were obtained from five healthy volunteers. Hindfoot moments and powers were also calculated. The center of pressure excursion index (CPEI) was calculated from the plantar pressures. Significant differences were observed between the two groups, which confirmed clinical observations. Limited hindfoot eversion and increased midfoot external rotation occurred during the first and third rockers. The EMG data suggested that tendon dysfunction in the posterior tibialis is associated with compensatory activity, not only in its antagonists (the peroneals), but also in the anterior tibialis and the gastrocnemius. These data suggest that non-operative treatment of patients with PTTD should consider minimizing the activity of the posterior tibialis as well as the peroneals, the anterior tibialis and the gastrocnemius.

Original languageEnglish (US)
Pages (from-to)555-564
Number of pages10
JournalGait and Posture
Issue number4
StatePublished - Apr 2007


  • EMG
  • Flatfoot deformity
  • Gait
  • Plantar pressure
  • Posterior tibial tendon dysfunction

ASJC Scopus subject areas

  • Biophysics
  • Orthopedics and Sports Medicine
  • Rehabilitation


Dive into the research topics of 'Changes in gait associated with acute stage II posterior tibial tendon dysfunction'. Together they form a unique fingerprint.

Cite this