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Article Summary: Facilitating activation of the peroneus longus: electromyographical analysis of exercises consistent with biomechanical function | Boddicker Performance

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Article Summary: Facilitating activation of the peroneus longus: electromyographical analysis of exercises consistent with biomechanical function

by on Mar 5th, 2010

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As I believe that evidence based practice is a necessity in today’s performance enhancement world, I have decided that I will begin to more frequently review articles that I find relevant to our field.

Bellew, Frilot, Busch, Lamothe, and Ozane. “Facilitating activation of the peroneus longus: electromyographical analysis of exercises consistent with biomechanical function.” Journal of Strength and Conditioning Research 24.2 (2010): 442-46. Print.

Introduction

The peroneus longus is the primary source of stability of the lateral ankle, and it is commonly misunderstood and inadequately trained due to its complexity. The peroneus longus originates on the posterio-lateral aspect of the fibula and takes a complex path to its insertion. First it passes posteriorly and inferiorly to the lateral maleolus, progressing posteriorly to the trochlear process of the lateral calcaneus, wrapping around the lateral aspect of the cuboid before being held into a grove on the plantar aspect of the cuboid with the help of the long plantar ligament.

In gait the peroneus longus serves to stabilize and transform the first ray of metarsals into a ridgid lever for propulsion, enhanced by the cuboid’s role as a pulley.

Many attempt to train the peroneus longus in an open-chain fashion, training solely the eversion function. Unfortunately, this is not consistent with the biomechanics of the PL and may be less effective. As a result the authors chose to evaluate the effectiveness of several biomechanically correct exercises.

Methods

To have a reference level of EMG activity for comparison, the authors chose to use a single leg heel raise as the reference test. Additionally, subjects performed a series of three exercises.

1.  Quarter Heel Raise.

A heel raise performed with the first metatarsal atop a quarter for tactile feedback. As plantar flexion was performed, the subject was told to remain firm contact with the quarter.

2.  Band Heel Raise

A band was placed around the midfood, and anchored laterally with a tension of 5 pounds. The subject then performed a heel raise while resisting the band’s pull of the foot into inversion/supination.

3.  Open Chain Eversion

This exercise was done in sidelying on a table, with the feet hanging from the edge and a band anchored to the top foot with five pounds of tension. The subject then everted the foot fully and returned the starting position.

Results

It was determined that the band heel raise resulted in 7.33% greater activation of the PL compared to reference. The QHR, while 4.18% less than reference, still resulted in 28.59% greater PL activity than eversion in open chain. Conventional eversion resulted in nearly 33% less EMG activity than a reference heel raise.

Discussion

As lateral injury is quite common, and the PL is necessary for stability of the lateral ankle, training the muscle in a pattern that is biomechanically specific can offer better activation and potential gains in function. Additionally, as weak PL has been correlated with ankle inversion injuries along with sensory issues, the addition of such exercises may potentially enhance proprioceptive afferent activity and the subsequent motor response.

How can you use it in practice?

Lateral ankle injury is common in sport, and the resultant impacts on proximal and distal musculature can result in profound functional impairments. In rehabilitation of ankle injuries, these can be part of a program that includes various exercises to enhance mobility and stability in the right places. From a prevention standpoint, these exercises can be incorporated within the confines of a traditional strength and conditioning session. As it is a low level exercise, it may be wise to incorporate this type of exercise as “fillers” during rest breaks of bigger, upper body lifts.

Best regards,

Carson Boddicker

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Leave a Comment »6 Comments
  • Mark Young March 5, 2010

    Hey Carson,

    Great post! I love the scientific approach to training. I’d love to see a video of the winner if you have a chance to film and post it. I find this helps take things from science to the real world.

    Also, since you seem to know a lot about the foot/ankle, I think it would be great to hear your thoughts in a blog about deconstructed shoes (Nike Frees and Vibrams), orthotics, etc. People seem to have a lot of opinions based primarily on what their profession has told them, but I’ve never seen a great review of the science on this stuff.

  • Frank Neuman March 5, 2010

    Carson,

    Would there ben any value to performing some type of calf raise with the foot/feet turned slightly outward, since this would result in eversion of the foot during the concentric phase of the movement? Or do you think this would be of limitd value (if any) and or not worth it from a risk-reward standpoint?

  • Dmetri Landness March 6, 2010

    I quite enjoyed this, sir. If you would please inform us as to the weather in Sunnyland! 😉 I have heard of this one before, but am quite confused about this peroneus longus. It’s an elusive bugger! But that can’t stop us. Would you please go into more detail on your thoughts of said longus. I have been searching for years but no luck. Heheh.

    I do agree with you that ankle problems abound in sport but don’t however agree with your assessment that we should be incorporating these exercises in between those already in our regime. We have what we have. Let’s keep to the simple principle!

    Good training!!

    Dmetri

  • Carson Boddicker March 7, 2010

    Mark,

    I’ll get to the gym today and shoot a video for your learning pleasure. Likewise, with respect to shoes, I’ve been a huge proponent of minimalistic footwear for runners since I began in the sport. I’ll write something up in the near future.

    Best regards,
    Carson Boddicker

  • Carson Boddicker March 7, 2010

    Frank,

    In my mind, doing the exercise ducktoed may gain some degree of EMG activity, but at what cost?

    Reinforcing a foot position that can alter the rigid lever effect? Fighting with our ankle mobility training? Training a joint at end range?

    What I particularly liked about the exercises in said study were their ability to maintain a neutral joint position (at mid range) at the subtalar. We know that there are a great deal of joint position sense deficits in athletes with a history of ankle dysfunction, so by keeping it neutral in a “safe” range of motion, we may be contributing to the restoration of JPS and thus preventing further injury.

    Best regards,
    Carson Boddicker

  • Carson Boddicker March 7, 2010

    Dmetri,

    Thanks for the comments. I’m unsure if your tongue-in-cheek humor is pointing to the fact that many now choose to call the peroneals the fibularis or something else. Please forgive my density.

    With respect to your simplicity comment, I am all in favor of maintaining simplicity however it seems to me that providing a 5 pound elastic force perpendicular to the foot and raising up and down one’s heel is a pretty simple exercise with potentially big returns. Recall that about 40% of ankle injuries metastasize into recurring or chronic instability, which not only puts further damage to the ankle on the block but additionally to the knee, lumbo-pelvo-hip complex, and potentially the shoulder.

    For me, the investment of 60 seconds during a “rest period” in training to perform some low level exercise is well worth the potential reward. Rising onto the toes is very simple. Now don’t get me wrong, I’m not programming this with all athletes. It is simply one tool that that we have in our toolbox and it’s application should not be willynilly.

    Best regards,
    Carson Boddicker

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