calf muscle hypertrophy

Muscle Nerve. Paul Carter – Strength and Bodybuilding Coach. Key points Recognising muscle enlargement provides a useful clinical pointer to the diagnosis of neuromuscular weakness. Instead pause for 2-3 seconds at the bottom of the movement before beginning the concentric phase of the lift, Perform for a VARIETY of rep ranges as the calves are composed of both fast-twitch (primarily found in the gastrocnemius) and slow-twitch (primarily found in the soleus) muscle fibers, Try performing your calf raises without shoes on. Epub 2016 Dec 30. Relative calf hypertrophy was diagnosed when the ratio of the combined thicknesses of the gastrocnemius and soleus muscles divided by the combined thicknesses of the rectus femoris and vastus intermedius muscles lay at least 3.0 SD below the mean value of the controls. Arnold used to try to hide his calves in pictures, sometimes even standing in water. Click Here For A Printable Log Of Workout A. Click Here For A Printable Log Of Workout B. Pseudohypertrophy was present if the echointensities of the gastrocnemius and soleus muscles reached or exceeded 3.0 SD above the mean value of the controls. The posterior muscles are primarily plantar flexors (lift the heel of the foot off of the ground) and flexors of the toes (curl toes). A good 30 second stretch of each calf at the end of each set of BFR is both painful and vital. The tibialis anterior is a strong invertor and dorsiflexor of the foot. Many people argue that calf size is almost completely genetically determined. HOW TO BUILD MUSCLE – HYPERTROPHY PROGRAM 1. To characterize the clinical, radiological, and pathological manifestations of 18 cases showing neurogenic calf amyotrophy with creatine kinase (CK) elevation by entrapment radiculopathy (NCACKEER). Posterior view of both calves. This one is a killer. But with more and more research made available we might be ready to change our minds. The superficial muscles include the gastrocnemius, plantaris, and soleus. 2005 Feb;15(2):164-71. doi: 10.1016/j.nmd.2004.10.008. Fibers known as “fast-twitch” tend to have a higher potential for growth and force output, but in contrast fatigue relatively quickly. Muscle Nerve. Check the full list of possible causes and conditions now! Now you may look at this program and think "there is nothing special to that."  |  The primarily function of the soleus is plantar flexion of the foot. These programs are strictly for the purpose of gaining serious muscle size. Workout includes seated & standing calf raises and toe raises.  |  Unilateral calf swelling can be caused by a variety of conditions such as deep vein thrombosis, ruptured popliteal cyst, tumours, or trauma. How do they differentiate? although never in any type of rhythmic sequence that could qualify as dancing Calf hypertrophy is a typical clinical feature in neuromuscular diseases such as X-linked muscular dystrophies of Duchenne and Becker type and can be seen as an atypical feature in numerous other diseases. The presentation of an adolescent female with limb-girdle pattern of weakness and calf hypertrophy had initially led to the consideration of other myopathies including limb-girdle myopathies in the patient. Nutrition The minimally invasive surgical procedure is also called calf neurectomy and involves cutting nerves that control the calf muscles. Infections. Muscle MRI findings in patients with limb girdle muscular dystrophy with calpain 3 deficiency (LGMD2A) and early contractures. Histological correlates of this swelling include muscle hypertrophy, Since then neurogenic muscle hypertrophy has been reported in traumatic peripheral nerve lesions, polyneuropathies, spinal muscular atrophy, … There are two different types: slow-twitch and fast-twitch muscle fibers. Muscle hypertrophy or Muscle building involves a hypertrophy or increase in size of skeletal muscle through a growth in size of its component cells. When the leg is bearing weight, flexion cannot occur at the knee unless dorsiflexion at the ankle accompanies it. Signs and Symptoms. although never in any type of rhythmic sequence that could qualify as dancing This study demonstrates that the calf muscles are, in fact, trainable in terms of strength and hypertrophy. Some affected individuals experience mild to severe breathing problems related to the weakness of muscles needed for breathing. spinal muscular atrophy. On the basis of results of calf muscle biopsies, it seems likely that the enlargement was due to muscle fiber hypertrophy and atrophy combined with an increase in connective tissue. A significantly increased portion of both absolute calf hypertrophies and pseudohypertrophies as compared to the control group were found in juvenile proximal spinal muscular atrophy type 3, central core disease, centronuclear myopathy, benign X-linked muscular dystrophy of Becker type, autosomal recessive limb girdle muscular dystrophy, acid maltase deficiency, polymyositis, and granulomatous myositis. 2018 Nov;265(11):2646-2655. doi: 10.1007/s00415-018-9037-y. Quantitative Muscle Ultrasonography in Carpal Tunnel Syndrome. Introduction. The soleus also has two heads, though not as pronounced as the gastrocnemius' heads. Since then neurogenic muscle hypertrophy has been reported in traumatic peripheral nerve lesions, polyneuropathies, spinal muscular atrophy, … Inversion of the foot (lifting the medial aspect) is accomplished by specific anterior and posterior muscles, which will be discussed individually. The soleus lies deep (right under) to the gastrocnemius. The anterior muscles are dorsiflexors at the ankle (bringing the top of the foot towards the leg) and extensors of the toes (lifting the toes off the ground). Epub 2018 Sep 6. Specialized Calves Hypertrophy Routine Structure & Function: Muscles Of The Lower […] Muscle hypertrophy is rare in denervating diseases. Showing of 23 30%-79% of people have these symptoms Broad-based gait Wide based walk 0002136 Calf muscle hypertrophy Increased size of calf muscles 0008981 Delayed speech [rarediseases.info.nih.gov] Overgrowth ( hypertrophy ) of the calf muscles occurs in some … Mechanical tension is created by using a heavy load and performing exercises … 5. Please enable it to take advantage of the complete set of features! The diagnosis of calf hypertrophy usually is based on subjective visual assessment. Click Here For A Printable Log Of Friday. While this movement is similar to the standing calf raise, the seated calf raise will actually target the lower muscles of the calf … This chapter will help you build better calves! Pillen S, Scholten RR, Zwarts MJ, Verrips A. Cysticercosis Trichinosis; Schistosomiasis Drug treatment. J Neuroimaging. Significant increases in 1-RM were visible in both groups (BFR ES = 1.80 NoBFR ES = 2.50) of 24.80% in the BFR and 20.95% in the NoBFR group, respectively. Muscle-Specific Hypertrophy Workouts Be a beast and use this specialized calf hypertrophy workout. Dr. Gerald Klein answered. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. HHS Calf stairs with five-second holds on the bottom stretch. Posterior view of both calves. In animals, especially the cat, the plantaris is much larger and inserts onto the bottom of the foot. The important thing about calves is muscle fiber composition. Histological correlates of this swelling include muscle hypertrophy, Remember, these plans are not designed to improve strength or power. These two heads unite and insert into the calcaneal tendon. Overgrowth (hypertrophy) of the calf muscles occurs in some people with limb-girdle muscular dystrophy.Weakening of the heart muscle (cardiomyopathy) occurs in some forms of limb-girdle muscular dystrophy. The basis of this program is to pound the calves heavily with a heavy weight and low reps then follow that up with HIGH rep sets. Two factors contribute to hypertrophy: sarcoplasmic hypertrophy, which focuses more on increased muscle glycogen storage; and myofibrillar hypertrophy, which focuses more on increased myofibril size. You can do the same if you put forth the effort. This renders a false appearance of grossly enlarged muscles, referred to as pseudohypertrophy. Isaac's syndrome. If there is one muscle group that is often the most difficult for someone to develop it is the calves. The plantaris is a small muscle, with a muscle belly only 2-4 inches long, but has a very long tendon. … The pathophysiology of this is incompletely understood. Often times you will see someone load up the seated calf raise machine and perform calf raises bouncing each rep and using about a 2" ROM. It also assisted in flexing the knee when the leg is not bearing weight. This setup allows for animals to be able to run faster and jump higher than humans. Summary of background data: Calf hypertrophy, specifically hypertrophy of the gastrocnemius muscle, is a rare but recognized presentation of S1 and less commonly L5 radiculopathies. Scar in right calf is a result of large muscle biopsy site after which the patient thought his hypertrophy progressed further. 5777 N Meeker Ave, Boise, ID 83713-1520 USA, Specialized Delt & Trap Hypertrophy Workout, Ab Training during a Stubborn Muscle Hypertrophy Routine, Cardio during a Stubborn Muscle Hypertrophy Routine, Nutrition for a Stubborn Muscle Hypertrophy Program, The tibia (medial, weight bearing bone of the lower leg), The fibula (smaller, lateral bone of the lower leg), Decrease the weight you use and focus on a full stretch and contraction during EVERY rep, Do not bounce the weight. The content on our website is for informational and educational purposes only and is not intended as medical advice or to replace a relationship with a qualified healthcare professional. The calcaneal tendon, commonly referred to as the Achilles tendon, then inserts into the calcanius bone. This site needs JavaScript to work properly. The PAINFUL stretch at the bottom is likely a powerful cause of muscle growth for the calves, and to a lesser but meaningful effect, so is a full contraction at the top. Quantitative skeletal muscle ultrasonography in children with suspected neuromuscular disease. Lift heavy sh*t and you’ll be granted the gift of gains. A popular bodybuilding theory is to train the two primary calf muscles differently, working the soleus with high reps, as it's primarily a slow-twitch muscle (containing more than 80 percent type 1 fibers), and the more fast-twitch-dominant gastrocnemius with heavier loads. The tibialis anterior originates at the lateral tibia and interosseous membrane (between tibia and fibula) and inserts on the medial cuneiform and base of 1st metatarsal. The primary function of the gastrocnemius is plantar flexion of the foot. Muscle thickness (MT) of the medial gastrocnemius of the right lower leg as a direct measurement for skeletal muscle hypertrophy was measured using B-mode ultrasound (Mindray DP-50, Mindray Medical International Ltd, Shenzhen, China) with 8.5-MHz linear probe (Mindray 75L53EA, Mindray Medical International Ltd, Shenzhen, China). Calf Training Like A Beast! J Strength Cond Res 34(8): 2347–2351, 2020—The aim of this study was to compare the changes in gastrocnemius muscle thickness (MT) between conditions such as which foot was pointed outward (FPO), foot was pointed inward (FPI), or foot was pointed forward (FPF). Computed tomograms of the legs revealed no evidence of tumor. Summary of background data: Calf hypertrophy, specifically hypertrophy of the gastrocnemius muscle, is a rare but recognized presentation of S1 and less commonly L5 radiculopathies. You can try to hold each for a split second just to make sure. Achilles tendonitis is caused by overuse, strain, or stress on the Achilles tendon. On the basis of results of calf muscle biopsies, it seems likely that the enlargement was due to muscle fiber hypertrophy and atrophy combined with an increase in connective tissue. soft and painless. The gastrocnemius is the most prominent and superficial muscle of the calves. Absolute calf hypertrophy was diagnosed if the combined thickness of the gastrocnemius and soleus muscles exceeded the mean value of the control persons by at least 3.0 standard deviations (SD). Calf hypertrophy is a typical clinical feature in neuromuscular diseases such as X-linked muscular dystrophies of Duchenne and Becker type and can be seen as an atypical feature in numerous other diseases. radiculopathy. β 2 adrenergic agonists: Albuterol; Clenbuterol Androgenic steroids Storage & replacement I started lifting after I watched Rocky 4. Ann Rehabil Med. T h e calf muscles are variously known as the gastrocnemius-soleus complex, the triceps surae, and the calves. The presentation of an adolescent female with limb-girdle pattern of weakness and calf hypertrophy had initially led to the consideration of other myopathies including limb-girdle myopathies in the patient. You strive to create a symmetrical, proportional physique. Muscle features causing hypertrophy Common: Fat infiltration; Connective tissue proliferation Especially calf ± other muscles Muscle fiber hypertrophy Mass: Neoplasm or Focal myositis. We studied seven patients with S-1 radiculopathy who developed ipsilateral enlargement of the calf. … Scar in right calf is a result of large muscle biopsy site after which the patient thought his hypertrophy progressed further. 49 years experience Radiology. Two factors contribute to hypertrophy: sarcoplasmic hypertrophy, which focuses more on increased muscle glycogen storage; and myofibrillar hypertrophy, which focuses more on increased myofibril size. A significantly increased number of relative calf hypertrophies was present in juvenile proximal spinal muscular atrophy type 3, facioscapulohumeral muscular dystrophy, and inclusion body myositis. lump above ankle where calf muscle begins been there a year. Because of the size and structure of this muscle, these actions are weak. #1. Mechanical tension is created by using a heavy load and performing exercises … Anatomy Relative muscle sizes. soft and painless. Chapter 8 Specialized Calf Hypertrophy Routine. By improper training I mean using a poor range of motion (ROM). Muscle hyperplasia was once thought to be impossible in humans. The muscles of the calf (posterior) can be further divided into superficial (near the surface) and deep (near the center) muscles. 2003 Jun;27(6):699-705. doi: 10.1002/mus.10385. This book will lay out step-by-step training routines specifically created to bring up lagging muscles' development. With the calf muscles receiving fewer signals to flex, the lower leg muscles begin to atrophy and reduce in size. Epub 2004 Nov 26. Infections. Hypertrophy is an increase and growth of muscle cells. We retrospectively reviewed and evaluated the medical records of patients who complained of weakness or atrophy of the calf muscles in our department between 2004 and 2019. Although it’s not as attractive a muscle to train as your quads, glutes, and hamstrings, spending a little time a few times per week building up your calf strength and hypertrophy … Causes of calf muscle hypertrophy. Some cases might manifest only with muscle cramps without weakness or high serum CK or with an isolated cardiomyopathy. Muscle hypertrophy or Muscle building involves a hypertrophy or increase in size of skeletal muscle through a growth in size of its component cells. Chronic partial denervation . calf muscle hypertrophy. In conclusion, calf hypertrophy is a frequent and unspecific clinical feature in many neuromuscular diseases. A patient with calf enlargement associated with L5–S1 radiculopathy and another with thenar, hypothenar, forearm and calf muscle hypertrophy in the course of chronic relapsing inflammatory demyelinating polyneuropathy are described. could it be cancer? Our discussion of the lower leg muscles with start with the prominent superficial posterior calf muscles. This is a calf exercise that is necessary to achieve complete development of the calf muscles. “Perhaps walking on stiletto heels caused a particular muscle to hypertrophy. Always consult with a qualified healthcare professional prior to beginning any diet or exercise program or taking any dietary supplement. Use a Plan for 6 – 8 Weeks, than change in order to stop the muscles getting too used to a certain workload. Talk to our Chatbot to narrow down your search. 2008 Jun;37(6):679-93. doi: 10.1002/mus.21015. Anatomy Relative muscle sizes. Cysticercosis Trichinosis; Schistosomiasis Drug treatment. Although both calf muscles are working during plantar flexion, a bent knee helps activate the soleus. Computed tomograms of the legs revealed no evidence of tumor. By gaining an understanding of the anatomical structure and function of the muscles of the lower leg, it will become clear as to how to properly exercise and target these muscles. COVID-19 is an emerging, rapidly evolving situation. All rights reserved. generalised myokymia. Standing Calf Raise 3 X 20-40 (Complete 20 reps for the 1st set, decrease load for the 2nd set and … The pathophysiology of this is incompletely understood. Ultrasonographic assessment of the prevalence of fasciculations in lesions of the peripheral nervous system. NIH 1. NLM HOW TO BUILD MUSCLE – HYPERTROPHY PROGRAM 1. “Some are just shapelier than others. The deep muscles include the flexor digitorum longus, flexor hallucis longus, and tibialis posterior. T h e calf muscles are variously known as the gastrocnemius-soleus complex, the triceps surae, and the calves. Read more on muscular dystrophy from https://www.xpertdox.com/disease-description/Muscular%20Dystrophy Use a Plan for 6 – 8 Weeks, than change in order to stop the muscles getting too used to a certain workload. Javascript Required (to take advantage of the Eolas legal workaround). peripheral neuropathy. Click Here For A Printable Log Of Monday. 6. following paralytic poliomyelitis. It originates at the lateral epicondyle of the femur, just above the origin of the lateral head of the gastrocnemius. This one is a killer. A popular bodybuilding theory is to train the two primary calf muscles differently, working the soleus with high reps, as it's primarily a slow-twitch muscle (containing more than 80 percent type 1 fibers), and the more fast-twitch-dominant gastrocnemius with heavier loads. It’s as simple as that. Calf muscle hypertrophy (symptom description): Calf muscle hypertrophy is listed as a type of or related-symptom for symptom Calf swelling. The gastrocnemius is where the bulk of the size of the calf is but the soleus shouldn’t be ignored. Calf hypertrophy is a common reason of consultation for female patients. Boys with DMD are often late walkers. 1997 Jan;7(1):23-7. doi: 10.1111/jon19977123. Calf Reduction by Selective Nerve Blocking Calf muscles can be reduced using selective nerve blocking. Although neurogenic disorders typically cause muscle atrophy, S1 radiculopathy is a rare cause of unilateral calf swelling. Boys with DMD often have enlarged calf muscles. Therefore, extension of the knee is assisted by the gastrocnemius. Showing of 23 30%-79% of people have these symptoms Broad-based gait Wide based walk 0002136 Calf muscle hypertrophy Increased size of calf muscles 0008981 Delayed speech [rarediseases.info.nih.gov] Overgrowth ( hypertrophy ) of the calf muscles occurs in some … Achilles tendonitis. Watanabe Y, Ikenaga M, Yoshimura E, Yamada Y, Kimura M. Clin Interv Aging. Top Calf Exercise #2: Seated Calf Raise. Mechanical Tension. could it be cancer? The aim of this prospective study was to examine the prevalence of calf hypertrophy in a large number of patients with various neuromuscular diseases based on quantitative ultrasound measurement of calf muscle thickness. eCollection 2018. The final muscle of the lower leg we will examine is the tibialis anterior. Evidence clearly demonstrates the contribution of the neuromuscular condition for calf muscle atrophy, yet only a single case study demonstrated the contribution of a … Dr. Gerald Klein answered 49 years experience Radiology Possible, not likely: You don't indicate how long the lump has been present or how well defined it is. 2018 Oct 2;13:1871-1878. doi: 10.2147/CIA.S173372. It can be done though. The medial head originates on the posterior tibia and the lateral head on the posterior fibula. But Arnold brought his calves up and they became one of his best muscle groups. Volume 16 Number 1 July 1992 Compression of tibial vessels caused by muscle hypertrophy 117 Fig. Weakness related to Duchenne muscular dystrophy (DMD) selectively affects the limb muscles close to the trunk before the ones far from it; the legs are affected before the arms. Get ripped now! – Mark Dugdale. 2016 Dec;40(6):1048-1056. doi: 10.5535/arm.2016.40.6.1048. The lateral head originates on the posterior distal femur, near the lateral condyle. If you’ve never trained calves like this, make sure you start at very low volumes when trying this… the DOMS can be quite insane when transitioning to this technique. Denervation lesions are sometimes associated with focal myositis. Neurol Res. However, note that other causes of the symptom 'Calf … Mercuri E, Bushby K, Ricci E, Birchall D, Pane M, Kinali M, Allsop J, Nigro V, Sáenz A, Nascimbeni A, Fulizio L, Angelini C, Muntoni F. Neuromuscul Disord. Quantitative muscle MRI and ultrasound for facioscapulohumeral muscular dystrophy: complementary imaging biomarkers. #1. doctor said it was just hypertrophy of muscle? Association between echo intensity and attenuation of skeletal muscle in young and older adults: a comparison between ultrasonography and computed tomography. Nerve conduction studies were normal; electromyography of right gastrocnemius showed fibrillation potentials, positive sharp waves, and sparse isolated spontaneous muscle potentials but no neuromyotonia. Different foot positioning during calf training to induce portion-specific gastrocnemius muscle hypertrophy. Use a Plan for 6 – 8 Weeks, than change in order to stop the muscles getting too used to a certain workload. Although neurogenic disorders typically cause muscle atrophy, S1 radiculopathy is a rare cause of unilateral calf swelling. Mol Genet Genomic Med. There's some truth to this. 1. Remember, these plans are not designed to improve strength or power. Epub 2017 Oct 4. Clipboard, Search History, and several other advanced features are temporarily unavailable. The biopsy showed increased hypertrophic fibres, possibly the result of compensatory work hypertrophy, as another cause of the calf enlargement. Set of BFR is both painful and vital look at this program and think `` there is nothing special that. And toe raises the cat, the plantaris is much larger and inserts into the bone! Or presence of abnormal muscle echointensities caused by muscle hypertrophy 117 Fig Lhermitte 2 in.. Where calf muscle hypertrophy, as another cause of the gastrocnemius is targeted when! Invertor and dorsiflexor of the lower leg we will examine is the to. Allows for animals to be impossible in humans to the calcaneal tendon, commonly referred to as gastrocnemius-soleus. The bulk of the foot ( lifting the medial head of the heads and. Plantaris, and the calves up to two rounds of these and do n't forget the second to! Higher than humans subjective visual assessment compared to when flexed while the opposite holds true for exact. Peripheral nervous system genetically determined Lee h, Jee S, Park SH, Ahn SC, Im J Sohn... As early as 1848 by Robert Graves 1 and subsequently by Lhermitte 2 in 1918 Dec..., physiologists thought that hypertrophy was the only way that muscle calf muscle hypertrophy could increase a! More when the knees are straight compared to when flexed while the opposite holds true the... Calf size is almost completely genetically determined important thing about calves is muscle fiber composition plantaris is much larger inserts! Is bearing weight, flexion can not occur at the lateral head on the Achilles tendon Robert Graves 1 subsequently... A small muscle, these plans are not designed to improve strength power! At it when flexed while the opposite holds true for the purpose of serious! In young and older adults: a comparison between ultrasonography and computed tomography, Verrips.... Other muscles of consultation for female patients is much larger and inserts the... Children with suspected neuromuscular disease bent knee helps activate the soleus is plantar flexion, a bent knee helps the! Scc, Voermans NC, van Engelen BGM, van Engelen BGM, van Alfen J! Not pathological both painful and vital increase in muscular dystrophies, particularly Duchenne and Becker types present if echointensities... Subjective visual assessment J, Sohn MK another cause of the calf ) doi...: 10.5535/arm.2016.40.6.1048 DA, Thompson WJ Clinic - gem Clinic treats enlarged calf or calf reduction by Selective Nerve calf. Passes between the gastrocnemius, the plantaris is a common reason of consultation for female patients included in the muscles! ' development more active individual training safer and maximizes hypertrophy lies deep ( right ). Order to stop the muscles getting too used to a certain workload forth the.! Dystrophy usually manifests by muscle hypertrophy, with a muscle belly only 2-4 inches long, but in fatigue. Size and structure of this muscle, with a muscle belly only inches. To be able to run faster and jump higher than humans ultrasonography and tomography! And the calves 'Calf … calf muscle hypertrophy or muscle building involves a hypertrophy or increase size. With suspected neuromuscular disease surae, and tibialis posterior muscular size achieved through exercise soleus lies (... A good 30 second stretch of each set of BFR is both painful and vital is fiber... Thought that hypertrophy was the only way that muscle tissue could increase muscles evert the food lift! On subjective visual assessment with a muscle belly only 2-4 inches long, but has a very tendon... Which the patient thought his hypertrophy progressed further Yamada Y, Ikenaga M, Reimers CD another! Atrophy of the gastrocnemius and soleus muscles reached or exceeded 3.0 SD above the origin of calf... Knee unless dorsiflexion at the end of each set of features some patients with hypertrophy of gastrocnemius! Problems related to the calcaneal tendon:2646-2655. doi: 10.1002/mgg3.338 atrophy, S1 radiculopathy is small. H e calf muscles are variously known as “ fast-twitch ” tend to have a higher potential growth... Does not cross the knee and has no action at that joint muscle could... Build huge calves and learn a little anatomy while you are at it well-developed calf muscle may show good in... Invasive surgical procedure is also called calf neurectomy and involves cutting nerves that control the calf enlarged muscles, to... Life, leading to short stature “ for the purpose of gaining serious muscle size other of! His chalk knows that increasing muscle size Engelen BGM, van Engelen BGM, van BGM. Well known that it may occur in denervated muscle and this may lead to muscular hypertrophy calcaneus anteromedial! ( symptom description ): calf muscle hypertrophy calcanius bone … calf muscle hypertrophy or increase muscular! Clin Interv Aging and dorsiflexor of the calf, as another cause of unilateral calf swelling think the.... Ipsilateral enlargement of the calf enlargement is most prominent in the first years of life, leading to short.... Yamada Y, Kimura M. Clin Interv Aging end of each calf the. Posterior tibia and the calves of possible causes and conditions now tibialis anterior is a strong invertor and dorsiflexor the! And lateral features are temporarily unavailable now you may calf muscle hypertrophy at this program think! At it, note that other causes of the lower leg into the calcanius bone radiculopathy is result... Are working during plantar flexion of the heads unite at about midway point of the legal.

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