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When you ask a patient to plantar flex a foot, what changes occur within the muscles involved

When you ask a patient to plantar flex a foot, what changes occur within the muscles involved

According to Maitland  (1977), the movement of foot in which ankle is bent is termed as Plantar Flexion. Posture where one stands on his/ her tiptoes or gas pedal of a vehicle is pushed, plantar flexion takes place. Through plantar flexion, ankle muscles and calf are relaxed so that they can properly work. The term “Plantar Flexion” is used to describe the movement of toe in which toe is pointed in the downward direction as a result of extending or straightening of ankle. Plantar flexor muscles, namely, the gastrocnemius, soleus, tibialis posterior, flexor digitorumlongus, flexor hallucislongus, peroneus longus and peroneus brevis are involved in plantar flexion (Kisner and Colby, 1990). More simply, it can be described as “the movement of the foot away from the body by bending the ankle.  Plantar flexion occurs when you stand on your tiptoes or when you push down on the gas pedal in your vehicle.  Plantar flexion depends on the muscles of the ankle and the calf to work properly” (Kisner and Colby, 1990).

Muscles present in the posterior compartment of the leg are the one which get involved in plantar flexion. The flexor hallucis longus, the flexor digitorum longus and the tibialis posterior are the main three muscles which are used in plantar flexion. Gastrocnemius, the soleus and the plantaris are the superficial posterior compartment muscles which get involved in plantar flexion.

The changes that occur when you ask a patient to plantar flex a foot involve the movement of the muscles and how each one works together to make the motion of the foot to move.  “The actions of a muscle are the main movements that occur when the muscle contracts” (Tropp and Norlin, 1995

). The most evident consequence of immobilization is loss of muscle force. The loss of force, similar to the loss of muscle mass, is a time-dependent process. The decrease in force, however, is not strictly proportional to the loss of muscle mass because neural input15, 16 and metabolic energy stores17 also play a role in determining the amount of force output.

If the heel is gently raised by the subject, the contraction of  the muscle fibres of gastrocnemius can be felt. After it if the knee is fully flexed and foot is plantar flexed, soleus can be felt contracting while gastrocnemius remains relaxed. This is because the upper (femoral) and lower (calcaneal) attachments of gastrocnemius are bought closer together, shortening the muscle and essentially preventing it from contracting” (Maitland, 1977).

In injury-free subjects the highest loss of 50% strength is seen to occur after the immobilization of knee which occurs in the quadricepos and in the hand muscles too which is followed by 35% value for the flexors and arm extensors along with 20% reduction in the plantarflexors. This indicates that there is no clear relationship between the sizes of the muscles its location and the loss of strength (Duchateau & Hainaut 1990). Thus this indicates that the muscles in the lateral compartment have very weak participation in the plantar flexion (Duzan 2009).It is the joints in the ankle which are highly involved in the plantar flexion.

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