Ultrasonography Features of the Plantar Fascia Complex in Patients with Chronic Non-Insertional Achilles Tendinopathy: A Case-Control Study

Romero‐Morales, Carlos; Martín-Llantino, Pedro Javier; Calvo‐Lobo, César; López‐López, Daniel; Sánchez-Gómez, Rubén; De-la-Cruz-Torres, Blanca; Rodríguez‐Sanz, David

doi:10.3390/s19092052

Cited by 19 publications

(18 citation statements)

References 37 publications

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“…Additionally, there has been some evidence to suggest that plantaris may play a role in the development and persistence of Achilles tendinopathy [47][48][49]. Coupled with other possible local impairments [50,51], in some cases eccentric exercise may not sufficiently improve outcomes for patients with Achilles tendinopathy because it may not address the predisposing problem.…”

Section: Discussionmentioning

confidence: 99%

Eccentric Exercise for Achilles Tendinopathy: A Narrative Review and Clinical Decision-Making Considerations

Jayaseelan

Mischke

Strazzulla

2019

JFMK

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Background: Achilles tendinopathy is a common health condition encountered in the orthopedic and sports medicine settings. Eccentric exercise is a common intervention in the management of pain and limited function for this patient population, although contemporary evidence suggests additional exercise methods may be effective as well. Study design: Narrative review: Methods: A literature review was performed using the electronic databases Pubmed and PEDRO for articles through February 2019. Randomized clinical trials integrating eccentric exercise, with or without co-interventions, were evaluated. Outcomes related to pain and/or function were considered. A patient case is provided to highlight decision making processes related to clinical prescription of eccentrics for Achilles tendinopathy. Results: After screening titles and abstracts, seven studies were included for full review. Two articles compared eccentric exercise to a control group, four compared eccentrics to the use of modalities, while one used eccentric exercise as part of a multimodal intervention. In each case, eccentric exercise was effective in reducing pain and improving function. In comparison to other forms of exercise or additional interventions, eccentric exercise was frequently not more effective than other options. Discussion: Eccentric exercise has been associated with clinical benefit in improving pain and function for patients with Achilles tendinopathy. Despite the available evidence reporting effectiveness of eccentrics, other options may be equally useful. Appropriate load modification and exercise prescription for patients with Achilles tendinopathy requires systematic clinical reasoning and incorporation of patient values to optimize outcomes.

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Section: Discussionmentioning

confidence: 99%

Eccentric Exercise for Achilles Tendinopathy: A Narrative Review and Clinical Decision-Making Considerations

Jayaseelan

Mischke

Strazzulla

2019

JFMK

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“…The dancers lay prone with their feet off the table [20,21]. As previously described [7,8], the FHL muscle was located, longitudinally and transversally, at 50% of the distance between the fibular head and inferior border of the lateral malleolus on the posterior aspect of the fibula using an ultrasound machine (Logiq, GE Healthcare: Chicago, IL, USA) with a 12 MHz linear transducer. In the ultrasound image, the CSA was defined as the area of the cross-section of the FHL muscle perpendicular to its longitudinal dimension, and the thickness was considered as the distance between aponeuroses.…”

Section: Ultrasonography Measurementsmentioning

confidence: 99%

“…Some authors have addressed the changes in thickness in the tendon and muscle complex in the foot in the presence of tendinopathy [8,36]. Therefore, ultrasonography signs of changes in the FHL thickness could be an early warning of tendon pathology development and promote the implementation of prevention and even early treatment protocols.…”

Section: Clinical Relevance and Future Linesmentioning

confidence: 99%

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Does Function Determine the Structure? Changes in Flexor Hallucis Longus Muscle and the Associated Performance Related to Dance Modality: A Cross-Sectional Study

De-la-Cruz-Torres

Barrera‐García‐Martín

Cueva-Reguera

et al. 2020

Medicina

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Background and Objectives: Flexor hallucis longus pathology is one of the most common conditions of the ankle and foot in dancers, due to the high demand of dance movements performed in an extreme plantar flexion and dorsiflexion range of motion. The objectives of this study were to determine the bilateral differences between the thickness and cross-sectional area of the flexor hallucis longus muscle in dancers, to establish possible differences between dance modalities, and to analyze whether there is a correlation between ultrasonographic parameters or performance variables and the dance modality. Material and Methods: A sample of 50 (29 classical and 21 contemporary) full-time pre-professional female dancers were included in the study. The thickness and cross-sectional area of the flexor hallucis longus muscle were evaluated for both limbs using ultrasound imaging. The range of movement of the first metatarsophalangeal joint was measured using functional extension with maximal ankle plantarflexion, balance was measured in a unilateral stance with the heel raised, endurance was evaluated through a modified heel rise fatigue test, and a counter movement jump to assess the vertical jump performance was measured bilaterally. Results: There were no significant differences recorded between the dominant and non-dominant limbs for each variable, within both groups. Contemporary dancers showed a greater thickness and cross-sectional area of the flexor hallucis longus muscle than classical dancers. However, classical dancers showed an increase of balance, endurance, range of movement of the first metatarsophalangeal joint, and counter movement jump with respect to contemporary dancers. Conclusion: Bilateral symmetry was identified in all variables for both groups. The size and performance of the flexor hallucis longus muscle may be influenced by the specific nature of dance modality.

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“…USI measurements of the abductor hallucis brevis (AHB), and flexor hallucis brevis (FHB) thicknesses, as well as flexor digitorum brevis (FDB) and FHB CSA, were increased in patients with AT with respect to a healthy group [17]. Romero et al [18] showed a reduced plantar fascia at the calcaneus insertion and also the calcaneal fat pad in subjects with AT. The use of the USI to assess the lower limb has been employed in other populations, such as individuals with ankle sprains and hallux valgus reporting a reduced peroneus longus CSA [19] and a reduced CSA and thickness of the abductor hallucis and flexor hallucis [20], respectively.…”

Section: Introductionmentioning

confidence: 98%

Ultrasound Imaging of the Abdominal Wall and Trunk Muscles in Patients with Achilles Tendinopathy versus Healthy Participants

et al. 2019

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Purpose: To compare and quantify with ultrasound imaging (USI) the inter-recti distance (IRD), rectus abdominis (RA), external oblique (EO), internal oblique (IO), transversus abdominis (TrAb), and multifidus thickness and the RA and multifidus cross-sectional area (CSA) between individuals with and without chronic mid-portion Achilles tendinopathy (AT). Methods: A cross-sectional study. A sample of 143 patients were recruited and divided into two groups: A group comprised of chronic mid-portion AT (n = 71) and B group composed of healthy subjects (n = 72). The IRD, RA, EO, IO, TrAb, and multifidus thickness, as well as RA and multifidus CSA, were measured by USI. Results: USI measurements for the EO (p = 0.001), IO (p = 0.001), TrAb (p = 0.041) and RA (p = 0.001) thickness were decreased as well as IRD (p = 0.001) and multifidus thickness (p = 0.001) and CSA (p = 0.001) were increased for the tendinopathy group with respect the healthy group. Linear regression prediction models (R2 = 0.260 − 0.494; p < 0.05) for the IRD, RA, EO, and IO thickness (R2 = 0.494), as well as multifidus CSA and thickness were determined by weight, height, BMI and AT presence. Conclusions: EO, IO, TrAb, and RA thickness was reduced and IRD, multifidus thickness and CSA were increased in patients with AT.

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Ultrasonography Features of the Plantar Fascia Complex in Patients with Chronic Non-Insertional Achilles Tendinopathy: A Case-Control Study

Cited by 19 publications

References 37 publications

Eccentric Exercise for Achilles Tendinopathy: A Narrative Review and Clinical Decision-Making Considerations

Eccentric Exercise for Achilles Tendinopathy: A Narrative Review and Clinical Decision-Making Considerations

Does Function Determine the Structure? Changes in Flexor Hallucis Longus Muscle and the Associated Performance Related to Dance Modality: A Cross-Sectional Study

Ultrasound Imaging of the Abdominal Wall and Trunk Muscles in Patients with Achilles Tendinopathy versus Healthy Participants

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