Abstract
Background Previously, scholars have concluded that the Achilles tendon and the plantar fascia were closely biomechanically related, although there is little clinical evidence of the relationship between the two. To investigate the biomechanical relationship between the Achilles tendon and the plantar fascia, the author used standing lateral ankle radiographs of patients with insertional Achilles tendonitis to determine the biomechanical relationship between the Achilles tendon and plantar fascia. Methods The author collected standing lateral ankle radiographs from patients with insertional Achilles tendonitis who accepted surgical treatment in the author's hospital from March 2009 to July 2018. According to whether there were bone spurs on the posterior side of the calcaneus, patients were divided into group A (spur present on the posterior side) and group B (spur not present on the posterior side). The positive rates of spurs on the plantar side of the calcaneus were determined in group A and group B. The chi-square test was used to compare the measurement results between the two groups. Results In group A, 13 heels were positive for calcaneal bone spurs, and the positive rate was 65.0%. In group B, 3 heels were positive for plantar calcaneal spurs, and the positive rate was 12%. Among all 16 patients with positive plantar calcaneal spurs, 13 had posterior calcaneal spurs (accounting for 81.3%), and 3 had negative results, accounting for 18.7%. There was a significant difference between the results in groups A and B (P < 0.05). Conclusion There is a relationship between posterior calcaneal spurs and plantar calcaneal spurs in patients with insertional Achilles tendonitis, which can be inferred as resulting from the increasing tension in the biomechanically complex relationship between the Achilles tendon and the plantar fascia.
Highlights
Heel pain includes pain on the plantar side of the calcaneus and in the posterior heel [1]
Due to an anatomical connection between the Achilles tendon, the plantar fascia, and the calcaneal, we proposed a hypothesis that the Achilles tendon, the plantar fascia, and the calcaneal were three parts of a biomechanical complex
Since the mechanical stimulation of plantar calcaneal spurs can lead to plantar fasciitis, which can cause patients to develop heel pain [21], so we thought it was worthwhile for podiatrists to pay attention to calcaneal plantar spurs and the high tension state of the plantar fascia in patients with insertional Achilles tendinitis in the clinical setting
Summary
Heel pain includes pain on the plantar side of the calcaneus and in the posterior heel [1]. Bone spurs at the medial calcaneal tubercle is a typical finding on the X-rays of plantar heel pain patients, and they can be the mechanical factors inducing the occurrence of plantar fasciitis [5,6,7]. Posterior heel pain is often caused by insertional Achilles tendonitis, often combined with the Haglund deformity [8, 9]. In the high-tension state of this complex, like in the insertional Achilles tendinitis patients, the pain appeared on the both sides of calcaneal, but the compensatory bone spurs caused by high tension were found bilaterally [11, 12]. Ere is a relationship between posterior calcaneal spurs and plantar calcaneal spurs in patients with insertional Achilles tendonitis, which can be inferred as resulting from the increasing tension in the biomechanically complex relationship between the Achilles tendon and the plantar fascia Conclusion. ere is a relationship between posterior calcaneal spurs and plantar calcaneal spurs in patients with insertional Achilles tendonitis, which can be inferred as resulting from the increasing tension in the biomechanically complex relationship between the Achilles tendon and the plantar fascia
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