How to Approach Plantar Fasciopathy in Elite Athletes? A Scoping Review of the Literature

Abstract

Category: Sports; Hindfoot Introduction/Purpose: Plantar fasciopathy (PF) is a common orthopaedic condition which often affects athletes and limits their performance. Our aim was to conduct a scoping review of the literature in order to summarise the evidence provided so far in the management of PF in Elite Athletes and identify potential gaps in the current knowledge. Methods: This scoping review followed the six-stage methodological framework of Arksey and O'Malley and was registered in the Open Science Framework (10.17605/OSF.IO/48S3K). Pubmed, Scopus and Web of Science were used to identify elegible papers. After charting of data, studies were pooled into three categories: 1) epidemiological/diagnostic studies, 2) outcome research and 3) studies on the rupture of the plantar fascia. The modified Coleman Methodology Score (mMCS) was used to assess the quality of manuscripts included. Results: Out of 742 initial studies, 10 were selected (109 patients) including 8 Level IV and 2 Level V articles. In four studies (91 athletes), potential risk factors (i.e. pre-existent thickening of the fascia, spike shoes, varus hindfoot/knee alignment) were discussed. In three studies (6 athletes), focusing on plantar fasciitis, the non-surgical treatment led to a satisfactory but poorly- documented outcome. In three studies (12 athletes), the rupture of the fascia was treated conservatively with contrasting results, while surgery was performed only in 2 cases. The mean mCMS was 19 (range, 3 to 42), demonstrating overall poor methodology. Conclusion: The limited number of studies and their poor quality do not allow to define the gold standard treatment of PF in Elite Athletes. Until high-quality studies are provided, clinicians have to rely on the available literature regarding the non- professional or non-athletic population to make the best evidence-based decision.