Abstract
Purpose: The goal of the present study was to assess, by ultrasound imaging (USI), the thickness of the plantar fascia (PF) at the insertion of the calcaneus, mid and forefoot fascial locations, and the calcaneal fat pad (CFP) in patients with Achilles tendinopathy (AT). Methods: An observational case-control study. A total sample of 143 individuals from 18 to 55 years was evaluated by USI in the study. The sample was divided into two groups: A group composed of the chronic non-insertional AT (n = 71) and B group comprised by healthy subjects (n = 72). The PF thicknesses at insertion on the calcaneus, midfoot, rearfoot and CFP were evaluated by USI. Results: the CFP and PF at the calcaneus thickness showed statistically significant differences (P < 0.01) with a decrease for the tendinopathy group with respect to the control group. For the PF midfoot and forefoot thickness, no significant differences (P > 0.05) were observed between groups. Conclusion: The thickness of the PF at the insertion and the CPF is reduced in patients with AT measured by USI.
Highlights
Chronic Achilles tendinopathy (AT) is one of the most common conditions of the ankle and foot, characterized by the combination of pain, swelling and a deficit of functionality in the lower limb [1]
Foot overpronation was considered a risk factor to the predisposition of AT [31] through disturbances in ankle biomechanics producing an extra mechanical stress on the soft tissue structures, such as the plantar fascia (PF). Those findings were related to a thickness decrease in the PF at the calcaneus, a structure that serves as a link between the PF and the Achilles tendon
Our findings showed an altered thickness in the PF at the calcaneus insertion, which could be explained by the changes in the ankle biomechanics, the extrinsic and intrinsic foot muscles observed in patients with AT
Summary
Chronic Achilles tendinopathy (AT) is one of the most common conditions of the ankle and foot, characterized by the combination of pain, swelling and a deficit of functionality in the lower limb [1]. The mechanism of AT remains unclear; Galloway et al [9] reported that changes in the architecture of the tendon and surrounding structures in response to the mechanical load were related in patients with AT. Those adaptations were associated with changes in plantar fascia (PF) morphology, such as the thickness. The goal of the present study was to assess, using USI, the thickness of the PF at the insertion of the calcaneus, mid and forefoot fascial locations, and the CFP in patients with AT We hypothesized that these selected soft tissue structures would demonstrate changes in individuals with AT
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