Abstract
(1) Background: Clinical approaches have depicted interconnectivity between the Achilles tendon and the plantar fascia. This concept has been applied in rehabilitation, prevention, and in conservative management plans, yet potential anatomical and histological connection is not fully understood. (2) Objective: To explore the possible explanation that the calcaneus acts as a hypomochlion. (3) Methods: 2 databases (Pubmed and Livivo) were searched and studies, including those that examined the relationship of the calcaneus to the Achilles tendon and plantar fascia and its biomechanical role. The included studies highlighted either the anatomical, histological, or biomechanical aspect of the lower limb. (4) Results: Seventeen studies were included. Some studies depicted an anatomical connection that slowly declines with age. Others mention a histological similarity and continuity via the paratenon, while a few papers have brought forward mechanical reasoning. (5) Conclusion: The concept of the calcaneus acting as a fulcrum in the lower limb can partially be supported by anatomical, histological, and biomechanical concepts. Despite the plethora of research, a comprehensive understanding is yet to be investigated. Further research exploring the precise interaction is necessary.
Highlights
Heel pain represents a common pathology with a rising prevalence, especially in the elderly [1]
To understand the hypothesis of the calcaneus serving as a hypomochlion in the lower limb from a biomechanical point of view, it is first important to define hypomochlia in general
It is described as a fixed point, or a fulcrum, in which a solid body can rotate under the action of forces
Summary
Heel pain represents a common pathology with a rising prevalence, especially in the elderly [1]. One in three people has experienced symptoms, including pain at the posterior or plantar part of the heel [2]. Common diagnoses are mechanically attributed pathologies such as plantar fasciitis, heel spurs, or Achilles tendinopathy [3]. With the increase of recreational and competitive sports, in individuals older than 40, heel pain incidence has risen over the past decades [4]. Plantar fasciopathies and Achilles tendinopathies are common sports injuries but are most prevalent in recreational and elite runners with a lifetime incidence of almost 10% [5]. Non-athletes are not excluded from heel pain [6]
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