Koşucularda Topuk Ağrısının Yaygın Sebebi Plantar Fasiit: Etyolojisi, Değerlendirilmesi ve Tedavisine İlişkin Litaratür Derlemesi

ÖZ Ülkemizin demografik ve sosyoekonomik durumu, gelişmekte olan bir ülke bazında incelendiğinde, günümüz insanının vaktinin çoğunluğu dışarıda geçmektedir. Gerek yürüyerek, gerekse ayakta durarak ayaklara durmaksızın yük binmektedir. Bu durumun rahatlatıcı ya da daha da kötüye gitmesini sağlayan en önemli faktörler ise yürüyüş tarzı, ayakkabılar, pes planus, pes cavus, ayak bileğinin sınırlı dorsifleksiyonu, aşırı eversiyon veya aşırı inversiyon gibi anatomik ve fizyolojik faktörlerdir. Ayak plantar yüzeyinin dermise en yakın bölümünde bulunan aponeurosis plantaris ayağa iletilen yükün önemli bir bölümünü karşılar. Aponeurosis plantaris, ayak plantar yüzeyinde, 4 tabaka kas yapısının en yüzeyelinde bulunan ve calcaneus ile phalanx’lar arasında uzanan bir yapıdır. Deri yüzeyine en yakın yapı olması sebebiyle birincil görevi daha derininde bulunan yapıları korumak gibi görünse de birçok önemli nörovasküler yapı ve kaslar ile olan komşuluğu, bahsedilen yapının topografik anatomisinin önemini göstermektedir. Çalışmamızın amacı, bu yapının en önemli ve en sık görülen patolojisi olan plantar fasiit’in etiyolojik faktörleri, ilgili patolojileri, fizyoterapi, çeşitli enjeksiyonlar, ekstrakorporeal şok dalgası tedavisi ve ortezler gibi konservatif ve cerrahi tedavi yöntemlerinin incelenmesidir.

Plantar Fasciitis, a Common Cause of Heel Pain in Runners: Literature Review on Etiology, Evaluation and Treatment

When the demographic and socioeconomic situation of our country is analyzed on the basis of a developing country, today's people spend most of their time outside. The feet are constantly burdened by walking and standing. The most important factor that relieves or worsens this situation is undoubtedly anatomical and physiological factors such as gait style, shoes, pes planus, pes cavus, limited dorsiflexion of the ankle, excessive eversion or excessive inversion. It is the aponeurosis plantaris, which covers a significant part of the load transmitted to the foot and is located in the part of the foot plantar surface closest to the dermis. This structure is located on the plantar surface of the foot, the most superficial of the 4 layers of musculature, and lies between the calcaneus and the phalanx. Although its primary task seems to be to protect the structures located deeper, since it is the closest structure to the skin surface, its proximity to many important neurovascular structures and muscles shows the importance of the topographic anatomy of the mentioned structure. The aim of our study is to examine the etiological factors, related pathologies, conservative and surgical treatment methods such as physiotherapy, various injections, extracorporeal shock wave therapy and orthoses of plantar fasciitis, which is the most important and most common pathology of this structure.

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  • Standring S. Gray’s Anatomy-The Anatomical Basis of Clinical Practice. 41th ed. Standring S, editor: Elsevier; 2015 25th September. 1419-1439p.
  • Kelikian AS. Sarrafian’s anatomy of the foot and ankle: Descriptive, topographic, functional: 3rd ed. 2012. 1-736 p.
  • Shahid S, Ghosh S, Chakraborty AS, Maiti S, Sadhukhan S, Koley M, Saha S. Efficacy of Individualized Homeopathic Medicines in Plantar Fasciitis: Doubleblind, Randomized, Placebo-Controlled Clinical Trial. Homeopathy. 2022 Feb;111(1):22-30. doi: 10.1055/s-0041- 1731383
  • Khurana A, Dhankhar V, Goel N, Gupta R, Goyal A. Comparison of midterm results of Platelet Rich Plasma (PRP) versus Steroid for plantar fasciitis: A randomized control trial of 118 patients. J Clin Orthop Trauma. 2021;13:9-14. doi: 10.1016/j. jcot.2020.09.002
  • Maslieurat-Lagémard. De l’anatomie descriptive and chirurgicale des aponevroses et des synoviales du pied: de leur appliction à la therapeutique ve à la médecine operatoire. Gaz Med Paris. 1840;274.
  • Henkel A. Die Aponeurosis Plantaris. Arch für Anat und Physio Anat Abt. 1913;113:113-123.
  • Bojsen-Møller F, Flagstad KE. Plantar aponeurosis and ve internal architecture of the ball off the foot. J Anat. 1976;121:599.
  • Crim JR, Manaster BJ, Rosenberg ZS. Imaging Anatomy: Knee, Ankle, Foot (Second Edition). Elsevier; 2017. p. 446- 67.
  • Apaydin N. Lumbosacral Plexus. Bergman’s Comprehensive Encyclopedia of Human Anatomic Variation 2016. p. 1113-29. doi:10.1002/9781118430309
  • Chen, D., Li, B., Aubeeluck, A., Yang, Y., Huang, Y., Zhou, J., & Yu, G. (2014). Anatomy and Biomechanical Properties of the Plantar Aponeurosis: A Cadaveric Study. PLoS ONE, 9(1), e84347. doi:10.1371/ journal.pone.0084347
  • Arangio GA, Chen C, Kim W. Effect of Cutting the Plantar Fascia on Mechanical Properties of the Foot. 1997;339:227-31. doi: 10.1097/00003086-199706000-00031
  • Kelley LL, Petersen C. Sectional Anatomy for Imaging Professionals-EBook: Elsevier Health Sciences; 2018. 734p.
  • Thomas, J. L., Christensen, J. C., Kravitz, S. R., Mendicino, R. W., Schuberth, J. M., Vanore, J. V., … Baker, J. (2010). The Diagnosis and Treatment of Heel Pain: A Clinical Practice Guideline–Revision 2010. The Journal of Foot and Ankle Surgery, 49(3), S1–S19. doi:10.1053/j. jfas.2010.01.001
  • Pearce CJ, Seow D, Lau BPJF, International A. Correlation Between Gastrocnemius Tightness and Heel Pain Severity in Plantar Fasciitis. 2021;42(1):76- 82. doi: 10.1177/1071100720955144
  • Balius R, Bossy M, Pedret C, Porcar C, Valle X, Corominas H. Heel fat pad syndrome beyond acute plantar fascitis. Foot (Edinb). 2021;48:101829. doi: 10.1016/j.foot.2021.101829
  • Riddle DL, Pulisic M, Pidcoe P, Johnson RE. Risk factors for plantar fasciitis: a matched case-control study. J Bone Joint Surg Am. 2003;85(5):872-877. doi:10.2106/00004623-200305000-00015
  • Hill CL, Gill TK, Menz HB, Taylor AW. Prevalence and correlates of foot pain in a population-based study: the North West Adelaide health study. J Foot Ankle Res. 2008;1(1):2. doi:10.1186/1757-1146-1-2
  • Riel H, Cotchett M, Delahunt E, et al. Is ‘plantar heel pain’ a more appropriate term than ‘plantar fasciitis’? Time to move on. Br J Sports Med. 2017;51(22):1576-1577. doi:10.1136/bjsports-2017-097554
  • Irving DB, Cook JL, Menz HB. Factors associated with chronic plantar heel pain: a systematic review. J Sci Med Sport. 2006;9(1-2):11-22. doi:10.1016/j. jsams.2005.03.009
  • Pohl MB, Hamill J, Davis IS. Biomechanical and anatomic factors associated with a history of plantar fasciitis in female runners. Clin J Sport Med. 2009;19(5):372-376. doi:10.1097/ JSM.0b013e3181b8aeb7
  • Buchanan BK, Kushner D. Plantar Fasciitis. 2022 May 30. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 28613727.
  • Landorf KB. Plantar heel pain and plantar fasciitis. BMJ Clin Evid. 2015 Nov 25;2015:1111. PMID: 26609884; PMCID: PMC4661045.
  • Goff JD, Crawford R. Diagnosis and treatment of plantar fasciitis. Am Fam Physician. 2011 Sep 15;84(6):676-82. PMID: 21916393
  • Sever O, Ciğerci Ae, Ridvan K, Baykal C, Kishali N, Ipekoğlu G, et al. Koşu Biyomekaniği. Spor Eğitim Dergisi. 2021;5(1):71-96.
  • Campillo-Recio D, Ibañez M, Martin- Dominguez LA, Comas-Aguilar M, Fernandez-Morales M, Alberti-Fito G. Local Percutaneous Radiofrequency for Chronic Plantar Fasciitis. Arthrosc Tech. 2021;10(5):e1315-e20. doi: 10.1016/j. eats.2021.01.031
  • Choudhary R, Kunal K. Modifiable Risk Factors of Plantar Fasciitis in Non-Athletic Patients and Proposal of a New Objective Assessment System - RKISP. Rev Bras Ortop (Sao Paulo). 2021;56(3):368-71. doi: 10.1055/s-0040-1716762
  • Bolton NR, Smith KE, Pilgram TK, Mueller MJ, Bae KT. Computed tomography to visualize and quantify the plantar aponeurosis and flexor hallucis longus tendon in the diabetic foot. Clin Biomech (Bristol, Avon). 2005;20(5):540- 6. doi: 10.1016/j.clinbiomech.2004.12.007
  • Garrett TR, Neibert PJ. The effectiveness of a gastrocnemius-soleus stretching program as a therapeutic treatment of plantar fasciitis. J Sport Rehabil. 2013 Nov;22(4):308-12. doi: 10.1123/jsr.22.4.308
  • Lopes AD, Hespanhol Júnior LC, Yeung SS, Costa LO. What are the main running-related musculoskeletal injuries? A Systematic Review. Sports Med. 2012 Oct 1;42(10):891-905. doi: 10.1007/ BF03262301
  • Shim DW, Sung SY, Chung WY, Kang KY, Park SJ, Lee JW, et al. Superior pedal function recovery of newly designed three spike insole over total contact insole in refractory plantar fasciitis: A randomized, double-blinded, non-inferiority study. PloS one. 2021;16(7):e0255064. https://doi. org/10.1371/journal.pone.0255064
  • Reissig LF, Lang C, Schuh C, Weninger WJ, Kaipel M. Effects and risks of performing a single incision endoscopic plantar fasciotomy - An anatomical study. Foot Ankle Surg. 2022 Jul 1;28(5):663–6. doi: 10.1016/j.fas.2021.08.004
  • Maes R, Safar A, Ghistelinck B, Labadens A, Hernigou J. Percutaneous plantar fasciotomy: radiological evolution of medial longitudinal arch and clinical results after one year. Int Orthop. 2022 Apr;46(4):861-866. doi: 10.1007/s00264- 021-05186-z
  • Kalia RB, Singh V, Chowdhury N, Jain A, Singh SK, Das L. Role of Platelet Rich Plasma in Chronic Plantar Fasciitis: A Prospective Study. Indian J Orthop. 2021;55(Suppl 1):142-8. doi: 10.1007/ s43465-020-00261-w
  • Lemont H, Ammirati KM, Usen N. Plantar Fasciitis: A Degenerative Process (Fasciosis) Without Inflammation. J Am Podiatr Med Assoc. 2003;93(3):234-7. doi: 10.7547/87507315-93-3-234
  • Kesikburun S, Uran Şan A, Kesikburun B, Aras B, Yaşar E, Tan AK. Comparison of Ultrasound-Guided Prolotherapy Versus Extracorporeal Shock Wave Therapy in the Treatment of Chronic Plantar Fasciitis: A Randomized Clinical Trial. J Foot Ankle Surg. 2022 Jan-Feb;61(1):48-52. doi: 10.1053/j.jfas.2021.06.007
  • Wiegand K, Tandy R, Freedman Silvernail J. Plantar fasciitis injury status influences foot mechanics during running. Clin Biomech (Bristol, Avon). 2022;97:105712. doi: 10.1016/j. clinbiomech.2022.105712
  • Bağcıer F, Onaç O, Külcü D. A Rare Cause of Ankle Pain: Plantar Fibromatosis. Turk J Osteoporos. 2018;24:36-7.
  • Taunton, J. E. (2002). A retrospective case-control analysis of 2002 running injuries. British Journal of Sports Medicine, 36(2), 95–101. doi:10.1136/bjsm.36.2.95
  • Huffer, D., Hing, W., Newton, R., & Clair, M. (2017). Strength training for plantar fasciitis and the intrinsic foot musculature: A systematic review. Physical Therapy in Sport, 24, 44–52. doi:10.1016/j. ptsp.2016.08.008