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Scand J Med Sci Sports. 2017 Oct;27(10):1114-1121. doi: 10.1111/sms.12722. Epub 2016 Sep 27.

The effect of foot overpronation on Achilles tendon blood supply in healthy male subjects.

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Department of Physiotherapy, Asklipieio General Hospital of Voula, Athens, Greece.
Department of Medical Imaging, Medical Centre Palaiou Falirou, Athens, Greece.
School of Physical Education and Sport Science, Department of Sport Medicine and Biology of Exercise, National and Kapodistrian University of Athens, Athens, Greece.


The purpose of this study was to investigate Achilles tendon blood flow in individuals with overpronated feet during non-weight- and weight-bearing positions. Achilles tendon blood flow was measured by means of the pulsatility index (PI) and the resistance index (RI) in 15 male individuals with overpronated feet and 15 counterparts with normal feet, using power Doppler ultrasonography (PDI). Achilles tendon ultrasonographic (US) assessment was performed at its musculo-tendinous junction (MTJ), mid-tendon (MT), and osseotendinous junction (OTJ) at a non-weight-bearing relaxed position (RP) and during two-leg stance (TLS) and one-leg upright stance (OLS). PI and RI indices were significantly greater in individuals with overpronated feet compared to individuals with normal feet at the OTJ in OLS position (P < 0.01), and at MT in both TLS (P < 0.001) and OLS positions (P < 0.001). All individuals demonstrated also greater PI and RI indices at MT followed by the OTJ and MTJ in all positions (P < 0.001), and in OLS compared to TLS and the RP at the OTJ (P < 0.01) as well as at MT and MTJ (P < 0.001). The findings of the present study suggest that foot overpronation may affect Achilles tendon blood flow, particularly at mid-tendon, thus enhancing the possibility for injury.


Achilles tendon; blood supply; foot overpronation; power Doppler US

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