Effects of Load Carriage and Step Length Manipulation on Achilles Tendon and Knee Loads.

Abstract:

INTRODUCTION:Longer steps with load carriage is common in shorter Soldiers when matching pace with taller Soldiers whereas shorter steps are hypothesized to reduce risk of injury with load carriage. The effects of load carriage with and without step length manipulation on loading patterns of three commonly injured structures were determined: Achilles tendon, patellofemoral joint (PFJ) and medial tibiofemoral joint (mTFJ). MATERIALS AND METHODS:ROTC Cadets (n = 16; 20.1 years ± 2.5) walked with and without load carriage (20-kg). Cadets then altered preferred step lengths ±7.5% with load carriage. Achilles tendon, PFJ and mTFJ loads were estimated via musculoskeletal modeling. RESULTS:Large increases in peak Achilles tendon load (p < 0.001, d = 1.93), Achilles tendon impulse per 1-km (p < 0.001, d = 0.91), peak mTFJ load (p < 0.001, d = 1.33), and mTFJ impulse per 1-km (p < 0.001, d = 1.49) were noted with load carriage while moderate increases were observed for the PFJ (peak: p < 0.001, d = 0.69; impulse per 1-km: p < 0.001, d = 0.69). Shortened steps with load carriage only reduced peak Achilles tendon load (p < 0.001, d = -0.44) but did not reduce Achilles impulse per km due to the resulting extra steps and also did not reduce peak or cumulative PFJ and mTFJ loads (p > 0.05). Longer steps with load carriage increased PFJ loads the most (p < 0.001, d = 0.68-0.75) with moderate increases in mTFJ forces (p < 0.001, d = 0.48-0.63) with no changes in Achilles tendon loads (p = 0.11-0.20). CONCLUSION:A preferred step length is the safest strategy when walking with load carriage. Taking a shorter step is not an effective strategy to reduce loading on the Achilles tendon, PFJ, and mTFJ.

journal_name

Mil Med

journal_title

Military medicine

authors

Willy RW,DeVita P,Meardon SA,Baggaley M,Womble CC,Willson JD

doi

10.1093/milmed/usz031

subject

Has Abstract

pub_date

2019-10-01 00:00:00

pages

e482-e489

issue

9-10

eissn

0026-4075

issn

1930-613X

pii

5370043

journal_volume

184

pub_type

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