Sometimes academics do overthink things

I have to be careful what I say here as I am criticizing my professional colleagues, but …

A while back there was this a couple of studies on proximal changes in those with Achilles tendinopathy. I blogged about one of them here and the other one is here. Both studies found those with Achilles tendinopathy did have change in proximal function such as muscle activity and hip motion. Both studies did lead the author to discuss the role of the proximal structures in Achilles tendinopathy. This lead to responses in social media on how important the hip and core are and that we need to focus the treatment interventions there. This was despite that this is not what the studies showed as correlation is not causation.

Now, just today we get this systematic review on gait alterations in those with heel pain that showed that:

There was moderate to strong evidence of decreased rearfoot center of pressure duration, impulse, and peak vertical ground reaction force at loading response. In compensation there was increased contact time of the midfoot and forefoot, increased midfoot and forefoot impulse, delayed time to the mid-stance vertical ground reaction force valley, and decreased peak force at terminal stance. The only quantitative measure of pronation/supination included limited evidence of increased medial forefoot and rearfoot inversion-eversion total mobility, and medial forefoot plantar flexion.

Despite correlation ≠ causation they still managed to conclude:

The variables identified in this review may be used to assist in identifying movement-related gait dysfunction for treatment decisions

I am not sure how they could reach that conclusion as like the Achilles tendinopathy and proximal issues, those with heel pain will be walking differently because of the pain. I call that limping. It does not need to be over thought.

Phillips, A., & McClinton, S. (2016). Gait deviations associated with plantar heel pain: A systematic review Clinical Biomechanics DOI: 10.1016/j.clinbiomech.2016.12.012

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