Abstract
The elastic properties of the Achilles tendon (AT) are altered in local injury or other diseases and in response to changes in mechanical load. Recently, elastography has been used to evaluate variations in tendon elastic properties, mainly among healthy individuals or athletes. Therefore, this study evaluated the biomechanical changes in ATs in individuals with and without plantar fasciitis (PF). The purposes were as follows: (1) to evaluate the passive stiffness of three regions of the AT which defined as 0 (AT0 cm), 3 (AT3 cm), and 6 cm (AT6 cm) above the calcaneal tuberosity in participants with and without PF, (2) to investigate the interplay between the passive stiffness in patients with PF and pain, (3) to detect optimal cut-off points of stiffness of the AT in assessing individuals with chronic PF, and (4) to determine the correlation between the plantar fascia thickness (PFT) and pain. This cross-sectional study included 40 participants (mean age = 51 ± 13 years). When the ankle was in a relaxed position, patients with PF experienced increased passive stiffness in AT0 cm (p = 0.006) and AT3 cm (P = 0.003), but not in the neutral position. Significant correlations were observed between pain and stiffness of AT (AT0 cm r = 0.489, P = 0.029; AT3 cm r = 487, P = 0.030; AT6 cm r = 0.471, P = 0.036), but not in the PFT (P = 0.557). Optimal cut-off stiffness was AT (452 kPa) in the relaxed ankle position. The plantar fascia of patients with PF was significantly thicker than that of the controls (P < 0.001). Findings from the present study demonstrate that tendon stiffness is a good indicator of the clinical situation of patients with PF. Monitoring passive tendon stiffness may provide additional information to assess severity of the condition and guide therapeutic. The treatment programs for PF should also be tailored to the distal AT, as conventional therapy might not be targeted to tight tendons.
Highlights
Plantar fasciitis (PF) is a common disorder of the foot, with an incidence of approximately 1% (Siriphorn and Eksakulkla, 2020)
The present study is the first to assess the relationship between heel pain severity and Achilles tendon (AT) stiffness in patients with plantar fasciitis (PF)
The increase in passive stiffness of distal AT is associated with pain, and initial cut-off points of distal AT stiffness at the ankle relaxed position may provide additional information to assess severity of the condition and guide therapeutic
Summary
Plantar fasciitis (PF) is a common disorder of the foot, with an incidence of approximately 1% (Siriphorn and Eksakulkla, 2020). It is generally accepted that the most common causes of PF include. Tendon Elasticity of Plantar Fasciitis tightness of the AT and/or plantar fascia (Nakale et al, 2018). From the perspective of anatomy, the AT is connected to the plantar fascia via the highly regular aligned calcaneal trabeculae of the posterior calcaneus (Zwirner et al, 2020). These published findings all demonstrate a close functional relationship between the AT and plantar fascia. A better understanding of the pathological changes in the AT of patients with PF will enable rehabilitative physicians to better diagnose ankle joint function, and assist therapists with formulating more effective and targeted treatment programs
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
