Women with posterior tibial tendon dysfunction have diminished ankle and hip muscle performance

J Orthop Sports Phys Ther. 2011 Sep;41(9):687-94. doi: 10.2519/jospt.2011.3427. Epub 2011 Sep 1.


Study design: Controlled laboratory study using a cross-sectional design.

Objectives: To characterize ankle and hip muscle performance in women with posterior tibial tendon dysfunction (PTTD) and compare them to matched controls. We hypothesized that ankle plantar flexor strength, and hip extensor and abductor strength and endurance, would be diminished in women with PTTD and this impairment would be on the side of dysfunction.

Background: Individuals with PTTD demonstrate impaired walking abilities. Walking gait is strongly dependent on the performance of calf and hip musculature.

Methods: Thirty-four middle-aged women (17 with PTTD) participated. Ankle plantar flexor strength was assessed with the single-leg heel raise test. Hip muscle performance, including strength and endurance, were dynamometrically measured. Differences between groups and sides were assessed with a mixed-model analysis of variance.

Results: Females with PTTD performed significantly fewer single-leg heel raises and repeated sagittal and frontal plane non-weight-bearing leg lifts, and also had lower hip extensor and abductor torques than age-matched controls. There were no differences between sides for hip strength and endurance measures for either group, but differences between sides in ankle strength measures were noted in both groups.

Conclusion: Women with PTTD demonstrated decreased ankle and hip muscle performance bilaterally.

MeSH terms

  • Adult
  • Aged
  • Ankle / physiopathology*
  • Cross-Sectional Studies
  • Female
  • Flatfoot / physiopathology*
  • Gait / physiology
  • Hip / physiopathology*
  • Humans
  • Middle Aged
  • Muscle Strength / physiology
  • Muscle, Skeletal / physiopathology*
  • Physical Endurance / physiology
  • Posterior Tibial Tendon Dysfunction / physiopathology*
  • Walking / physiology