The role of the heel pad and shank soft tissue during impacts: a further resolution of a paradox.

The aim of this study was to test the hypothesis that the motion of the soft tissue of the lower leg contributes significantly to the attenuation of the forces during heel impacts. To examine this, a two-dimensional model of the shank and heel pad was developed using DADS. The model contained a heel pad element and a rigid skeleton to which was connected soft tissue which could move relative to the bone. Simulations permitted estimation of heel pad properties directly from heel pad deformations, and from the kinematics of an impacting pendulum. These two approaches paralleled those used in vitro and in vivo, respectively. Measurements from the pendulum indicated that heel pad properties changed from those found in vitro to those found in vivo as relative motion of the bone and soft tissue was allowed. This would indicate that pendulum measures of the in vivo heel pad properties are also measuring the properties of the whole lower leg. The ability of the wobbling mass of the shank to dissipate energy during an impact was found to be significant. These results demonstrate the important role of both the heel pad and soft tissue of the shank to the dissipation of mechanical energy during impacts. These results provide a further clarification of the paradox between the measurements of heel pad properties made in vivo and in vitro.