Comparison of Two Taping Techniques on Navicular Drop and Center-of-Pressure Measurements During Stance

This study examined the eff ectiveness of an antipronation spiral stirrup (APSS) taping technique, compared with the augmented low-Dye (ALD) technique, in controlling navicular drop (ND) and producing a lateral shift in the center-of-pressure (COP) line during the stance phase of gait. Twenty college volunteers participated in a crossover design, testing 2 taping techniques across 3 conditions. Repeated measures analysis of variance revealed that the APSS technique produced signifi cantly less ND, compared with the ALD technique, at the pre(P .05) and postexercise (P .05) conditions. The APSS technique produced signifi cantly less ND than the barefoot condition at preand postexercise (P .01) conditions. A signifi cant (P .05) lateral shift in COP was noted between 30% and 90% of the stance phase in the tape reexercise condition in the APSS technique. The APSS technique seems to be eff ective at controlling ND and preventing a medial shift of the COP during the deceleration phase of foot pronation. [Athletic Training & Sports Health Care. 2014;6(6):252-260. ] Overuse lower-leg injuries, although often of uncertain etiology, are frequently affected by anatomical, mechanical, training intensity, volume, and injury type factors.1,2 The catch-all term shin splints has been used to describe a variety of conditions, including compartment syndrome, periostitis, stress fractures, nerve entrapment syndrome, and various tendinopathies.3,4 More recently, the shin splints term has been used interchangeably with an equally ambiguous, but more medically descriptive phrase, medial–tibial stress syndrome (MTSS). 5 This syndrome is characterized by exercise-induced pain along the posteromedial border of the tibia, is not attributed to compartment syndrome or stress fracture,6,7 and is of idiopathic origins. A common link of these varied pathologies with abnormalities in foot position is an increased drop in the location of the navicular bone. This drop, resulting in a “fallen arch,”8 is often referred to as pes planus. In a pes planus foot, the center of pressure (COP) is deviated more medially during gait than in those with a neutrally aligned foot.9-12 Williams et al13 found that low-arched individuals have a more medial COP than those with high arches, allowing the possibility that COP may be useful in detecting changes in foot orientation throughout the stance phase of gait (heel strike through toe-off). 9-13 In addition, pes planus feet have been associated with tibialis posterior dysfunction.14,15 One of the primary functions of the tibialis posterior is to contract eccentrically throughout the deceleration phase of foot pronation.16 If the tibialis posterior is dysfunctional, it cannot effectively control the force that must be transferred from the foot to the lower leg, leading to its inability to control the “falling” of the arch. This hyperpronation during gait can result in lower-leg pain,3 which supports the theory that suggests that foot overpronation, attributable to tibialis posterior muscle dysfunction, is a possible cause of MTSS.7 Several researchers13,14 have studied the effectiveness of taping or use of custom shoe inserts as an effort to control navicular drop (ND). Orthotic inserts have proven to be Ms Prusak from Maple Mountain High School, Spanish Fork; and Dr Prusak is from the Department of Teacher Education, and Dr Hunter, Dr Seeley, and Dr Hopkins are from the Department of Exercise Sciences, Brigham Young University, Provo, Utah. Received: December 9, 2013 Accepted: November 12, 2014 Posted Online: December 3, 2014 The authors acknowledge the contributions of Devin Francom, MS (Brigham Young University), for his creative use of functional statistical analyses and cubic smoothing splines, allowing for the examination of changes in the center-of-