# Stretching and Eccentric Exercises Normalize Gait Parameters in Gastrocnemius Tightness Subjects
## 4 Discussion  
One of the main findings of our study was the significant reduction in knee flexion observed in the IGT subjects following stretching and eccentric exercises performed according to the Stanish protocol. Going further, our study did not show any significant difference between the controls and IGT after the Stanish protocol, thus considering their gait to be normalized. Our hypothesis was therefore confirmed. This phenomenon suggests that the protocol not only addresses gastrocnemius tightness but also contributes to a substantial improvement in gait parameters [20; 21]. Our results are consistent with the clinical efficacy of the Stanish protocol as a self-management technique for IGT [27; 28]. The reduction in knee flexion during gait observed in our study participants after the Stanish protocol indicates a potential corrective mechanism that aligns with the protocol's objectives. Increased knee flexion might be a compensatory strategy to alleviate excessive pressure on the forefoot in individuals with IGT [15; 29]. By targeting the gastrocnemius muscle, the Stanish protocol appears to mitigate the need for this compensatory knee flexion, resulting in a more normalized gait pattern. Gastrocnemius tightness can contribute to a range of foot pathologies, and its impact on gait abnormalities has been the subject of various studies [13; 14; 15; 30]. Our results provide empirical evidence that a Stanish protocol can not only mitigate the effects of gastrocnemius tightness on gait but also restore a more physiologically sound walking pattern. This has significant implications for the clinical management of IGT, emphasizing the importance of noninvasive self-management techniques that address the underlying biomechanical issues. Our findings also contribute to the understanding of the intricate interplay between muscle flexibility, joint mobility, and gait dynamics. These results underscore the protocol's potential as a valuable tool in gait rehabilitation, particularly for individuals with IGT. Consequently, IGT-related foot and ankle pathologies, such as metataralsalgia, hallux valgus or rigidus, ankle instability, Achilles tendinopathy, or fascitits, could benefit from the Stanish protocol [31; 32; 33; 34]. However, the persistence of these effects over time and the potential for long-term gait improvement warrant further investigation. Several limitations need to be acknowledged in the context of this study. Firstly, it is important to note that the individuals in our study did not present with painful pathologies such as metataralsalgia, hallux valgus, or Achilles tendinopathy, which are often associated with IGT. This absence of painful pathologies may have contributed to a potentially lower degree of tightness in our study participants compared with those experiencing associated discomfort. However, including individuals with painful conditions might have introduced complexities in analyzing gait parameters, making it challenging to isolate the effects of IGT. Another limitation relates to the method used to assess tightness. We employed a device that applies force, which is different from assessing IGT under weight-bearing conditions. The precise threshold distinguishing pathological IGT from nonpathological IGT remains scientifically unknown. Consequently, our study does not assert a direct comparison between patients with pathological IGT and controls; rather, it focuses on patients with varying degrees of IGT and their comparison with controls. Furthermore, it is important to emphasize that our study is based on a population with bilateral IGT. Drawing conclusions regarding a unilateral IGT population would be premature, as the relationship between limbs in such a context remains uncharted territory. Additionally, there was variation in the walking rhythms among our participants. We did not impose a specific walking rhythm, allowing participants to adopt their own comfortable walking speeds.