Isolated Rupture of the Plantaris Tendon in a High School Track Athlete

Harmon, Kelley J.; Reeder, Michael; Udermann, Brian E.; Murray, Steven R.

doi:10.1097/00042752-200607000-00015

Cited by 17 publications

(8 citation statements)

References 6 publications

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“…The plantaris tendon, which classically ruptures at the proximal muscle belly, has also been known to rupture in an acute isolated manner at the mid-plantaris tendon. 15 Symptoms are often less severe, and the location of focal tenderness is in the mid-Achilles region rather than the proximal calf. 15,25 Whereas pain is typically a major limitation in movement after gastrocnemius strain, patients with isolated plantaris injury will have full active range of motion without major strength loss or symptom provocation.…”

Section: Discussionmentioning

confidence: 99%

“…15 Symptoms are often less severe, and the location of focal tenderness is in the mid-Achilles region rather than the proximal calf. 15,25 Whereas pain is typically a major limitation in movement after gastrocnemius strain, patients with isolated plantaris injury will have full active range of motion without major strength loss or symptom provocation. Ultrasound can confirm the diagnosis, although the plantaris can be difficult to identify in some patients given its small size.…”

Section: Discussionmentioning

confidence: 99%

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Ultrasound Diagnosis of Calf Injuries

2017

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Context:The medial head of the gastrocnemius is the third most commonly strained muscle in elite athletes after the biceps femoris and rectus femoris. The differential diagnosis of posterior calf injury includes musculoskeletal and nonmusculoskeletal causes. Classically, delineation of these injuries from one another relied primarily on historical features and physical examination findings. The utilization of musculoskeletal ultrasound (sonography) has augmented the diagnosis of these injuries by providing dynamic, real-time confirmation.Evidence Acquisition:A review of PubMed, OVID, and MD Consult prior to January 2016 was performed using search terms, including soleus ultrasound, gastrocnemius ultrasound, and tennis leg. The references of the pertinent articles were further reviewed for other relevant sources.Study Design:Clinical review.Level of Evidence:Level 4.Results:There have been few reviews to date of calf injuries and the use of sonography in their diagnosis. Prompt diagnosis utilizing ultrasound allows the clinician to focus management on gastrocnemius injury if present. Two-thirds of calf injuries occur at the junction of the fascia between the medial head of the gastrocnemius and the soleus. Injuries to the lateral head of the gastrocnemius occur in up to 14% of patients in some case series, but injury may occur anywhere from the proximal origin to the mid-belly to the fascial junction with the soleus. Numerous injuries to the posterior compartment can mimic gastrocnemius strain, and musculoskeletal ultrasound can aide in their diagnosis by incorporating real-time imaging into the grading of the injury and visual confirmation of physical examination findings.Conclusion:Acute injury to the posterior compartment of the lower extremity can represent a diagnostic challenge. Medial gastrocnemius strain represents the most common injury of the posterior compartment of the lower extremity. Ultrasound is a useful tool to assist the clinician in determining the specific cause of calf injury, estimate the severity of the injury, and monitor progress of healing. The vast majority of calf injuries can be diagnosed and managed without any additional imaging. Serial diagnostic ultrasound of an injured area allows for direct monitoring of tissue healing and may allow the clinician to more confidently assess response to treatment and help guide return-to-play decisions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Ultrasound Diagnosis of Calf Injuries

2017

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“…Nonsurgical treatment is typically administered for 3 to 16 weeks, particularly when there is involvement of the gastrocsoleus complex. 7,24,25 While immobilization is indicated during the acute phase of muscle healing due to histological factors such as capillary growth, granulation tissue formation, muscle fiber regeneration, and biomechanical tensile strength development, these factors have more precedence when healing, repair, and tissue regeneration are the goals. 30,38,39 In this case, immobilization, protected weight bearing, and edema-control strategies were implemented, with the aim to improve function by decreasing pain, inflammation, and muscle soreness; however, as the likelihood of an isolated plantaris rupture increased and the suspicion of a medial gastrocsoleus strain diminished, it was recognized that rehabilitation should focus on treating the objective clinical symptoms and on functional ability, because healing of the tendon was not the aim.…”

Section: Rehabilitation and Return To Playmentioning

confidence: 99%

“…72 Other symptoms include swelling of the posteromedial calf proportional to the severity of soft tissue damage and pain with ankle dorsiflexion, resisted plantar flexion, and/or knee flexion. 4,9,16,30,35,44,47 Cases describing the injury, diagnosis, intervention, and rehabilitation of plantaris tendon rupture have been reported, 5,13,24,25 but there is little regarding the return to elite professional basketball.…”

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confidence: 99%

Considerations in the Diagnosis and Accelerated Return to Sport of a Professional Basketball Player With a Triceps Surae Injury: A Case Report

Anloague¹,

Strack²

2018

Journal of Orthopaedic & Sports Physical Therapy

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Study Design Case report. Background Acute injuries of the triceps surae and Achilles tendon are common in sports. Rupture of the plantaris tendon can be challenging to diagnose. There is limited evidence detailing the diagnosis, rehabilitation, and accelerated return to sport of elite professional basketball players who have sustained calf injuries. Case Description A 25-year-old male professional basketball player sustained an injury to his calf during a professional basketball game. This case report details the presumptive diagnosis, graduated progression of intervention, and return to play of a professional athlete with a likely isolated plantaris tendon tear. Outcomes The patient returned to postseason competition 10 days post injury. Objective measures were tracked throughout rehabilitation and compared to baseline assessments. Before returning to play, the athlete showed improvements beyond the minimal clinically important difference for calf girth (2 cm) and numeric pain-rating scale score (4 points, 0-10 scale). Functional testing was conducted that included the Y Balance Test lower quarter and the Functional Movement Screen, with results that exceeded or returned the athlete to preseason levels. Discussion This report details the case of a professional basketball player who returned to competitive play in an accelerated time frame following injury to his calf. Diagnosing a plantaris tendon rupture can be challenging, and anatomical variations of this muscle should be considered. It was demonstrated in this case that physical therapy rehabilitation was helpful in making a treatment-based clinical diagnosis when imaging was unclear. Level of Evidence Therapy, level 5. J Orthop Sports Phys Ther 2018;48(5):388-397. Epub 6 Apr 2018. doi:10.2519/jospt.2018.7192.

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“…[142][143][144] Bu kasın yırtılması nadir de olsa görülebilir ve psödotromboflebit benzeri semptomlara, baldır ağrısına ve şişliğe neden olur. [145,146] Aşil tendonu yırtığı düşünülen olgularda göz ardı edilmemelidir. kAynAklAr…”

Section: Fleksör Di̇gi̇torum Longus Tendon Sorunlariunclassified

The problems of the tendons at the ankle

Doral

2013

TOTBİD Dergisi

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Aşil tendonu dışındaki ayak bileği çevresi tendonlarının sorunları, çok da nadir görülmeyen, ancak çoğu zaman ayırıcı tanıda düşünülmediği için tanısı atlanan patolojilerdir. Daha çok tendonların yırtıkları, çıkıkları, aşırı kullanıma bağlı tendinitleri ve tenosinovitleri klinik pratikte karşı karşıya kalınabilecek durumlardır. Bu derlemede ayak bileği tendon sorunları kasların anatomik yerleşimine göre ön, yan ve arka olmak üzere üç bölümde incelendi.

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Isolated Rupture of the Plantaris Tendon in a High School Track Athlete

Cited by 17 publications

References 6 publications

Ultrasound Diagnosis of Calf Injuries

Ultrasound Diagnosis of Calf Injuries

Considerations in the Diagnosis and Accelerated Return to Sport of a Professional Basketball Player With a Triceps Surae Injury: A Case Report

The problems of the tendons at the ankle

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