Skip to main content

Advertisement

Log in

Imaging of plantar fascia and Achilles injuries undertaken at the London 2012 Olympics

  • Review Article
  • Published:
Skeletal Radiology Aims and scope Submit manuscript

Abstract

Plantar fascia and distal Achilles injuries are common in elite athletes. Acute athletic injuries of the plantar fascia include acute plantar fasciopathy and partial or complete tears. Underlying most acute injuries is a background of underlying chronic plantar fasciopathy. Injuries may affect the central or less commonly lateral portions of the fascia and acute tears are generally proximal. Athletic Achilles injuries may occur at the mid tendon or the distal insertion, and there may be an underlying chronic tendinopathy. Acute or chronic paratendinopathy may occur as a separate entity or combined with Achilles injury. In this article, the spectrum of athletic injuries of the plantar fascia and Achilles is described, illustrated by imaging findings from the London 2012 Olympic games.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 10

Similar content being viewed by others

References

  1. Moraes do Carmo C, Fonseca de AlmeidaMelao L, Valle de Lemos Weber M, Trudell T, Resnick D. Anatomical features of plantar aponeurosis: cadaveric study using ultrasonography and magnetic resonance imaging. Skeletal Radiol. 2008;37:929–35.

    Article  PubMed  Google Scholar 

  2. McNally E, Shetty S. Plantar fascia: imaging diagnosis and guided treatment. Semin Musculoskelet Radiol. 2010;14:334–43.

    Article  PubMed  Google Scholar 

  3. Theodorou D, Theodorou S, Kakitsubata Y, Botte M, Resnick D. Fractures of proximal portion of fifth metatarsal bone: anatomic and imaging evidence of a pathogenesis of avulsion of the plantar aponeurosis and the short peroneal muscle tendon. Radiology. 2003;226:857–65.

    Article  PubMed  Google Scholar 

  4. McMillan A, Landorf K, Barrett J, Menz H, Bird A. Diagnostic imaging for chronic plantar heel pain: a systematic review and meta-analysis. J Foot Ankle Res. 2009;2:32–42.

    Article  PubMed  Google Scholar 

  5. Glazer J. An approach to the diagnosis and treatment of plantar fasciitis. Physician Sports Med. 2009;37:74–9.

    Article  Google Scholar 

  6. Middleton J, Kolodin E. Plantar fasciitis—heel pain in athletes. J Athl Train. 1992;27:70–5.

    PubMed  CAS  Google Scholar 

  7. Jeswani T, Morlese J, McNally E. Getting to the heel of the problem: plantar fascia lesions. Clin Radiol. 2009;64:931–9.

    Article  PubMed  CAS  Google Scholar 

  8. Wearing S, Smeathers J, Urry S, Hennig E, Hills A. The pathomechanics of plantar fasciitis. Sports Med. 2006;36:585–611.

    Article  PubMed  Google Scholar 

  9. Lemont H, Ammirati K, Usen N. Plantar fasciitis. A degenerative process (fasciosis) without inflammation. J Am Podiatr Med Assoc. 2003;93:234–7.

    PubMed  Google Scholar 

  10. Ieong E, Afolayan J, Carne A, Solan M. Ultrasound scanning for recalcitrant plantar fasciopathy. Basis of a new classification. Skeletal Radiol. 2013;42:393–8.

    Article  PubMed  Google Scholar 

  11. Leach R, Jones R, Silva T. Rupture of the plantar fascia in athletes. J Bone Joint Surg Am. 1978;60:537–9.

    PubMed  CAS  Google Scholar 

  12. Acevedo J, Beskin J. Complications of plantar fascia rupture associated with corticosteroid injection. Foot Ankle Int. 1998;19:91–7.

    Article  PubMed  CAS  Google Scholar 

  13. Sobhani S, Dekker R, Postema K, Dijkstra P. Epidemiology of ankle and foot overuse injuries in sports: a systematic review. Scand J Med Sci Sports. 2012; epub before print.

  14. Chinn L, Hertel J. Rehabilitation of ankle and foot injuries in athletes. Clin Sports Med. 2010;29:157–67.

    Article  PubMed  Google Scholar 

  15. Saxena A, Fullem B. Plantar fascia ruptures in athletes. Am J Sports Med. 2004;32:662–5.

    Article  PubMed  Google Scholar 

  16. Theodorou D, Theodorou S, Resnick D. MR imaging of abnormalities of the plantar fascia. Semin Musculoskelet Radiol. 2002;6:105–18.

    Article  PubMed  Google Scholar 

  17. McGonagle D, Marzo-Ortega H, O’Connor P, et al. The role of biomechanical factors and HLA-B27 in magnetic resonance imaging-determined bone changes in plantar fascia enthesopathy. Arthritis Rheum. 2002;46:489–93.

    Article  PubMed  Google Scholar 

  18. Theodorou D, Theodorou S, Kakitsubata Y, et al. Plantar fasciitis and fascial rupture: MR imaging findings in 26 patients supplemented with anatomic data in cadavers. Radiographics. 2000;20:S181–97.

    PubMed  Google Scholar 

  19. Narvaez J, Narvaez J, Ortega R, Aguilera C, Sanchez A, Andia E. Painful heel: MR imaging findings. Radiographics. 2000;20:333–52.

    PubMed  CAS  Google Scholar 

  20. Karabay N, Toros T, Hurel C. Ultrasonographic evaluation in plantar fasciitis. J Foot Ankle Surg. 2007;46:442–6.

    Article  PubMed  Google Scholar 

  21. Sabir N, Demirlenk S, Yagci B, Karabulut N, Cubukcu S. Clinical utility of sonography in diagnosing plantar fasciitis. J Ultrasound Med. 2005;24:1041–8.

    PubMed  Google Scholar 

  22. Walther M, Radke S, Kirschner S, Ettl V, Gohlke F. Power Doppler findings in plantar fasciitis. Ultrasound Med Biol. 2004;30:435–40.

    Article  PubMed  Google Scholar 

  23. Schepsis A, Jones H, Haas A. Achilles tendon disorders in athletes. Am J Sports Med. 2002;30:287–305.

    PubMed  Google Scholar 

  24. Sayana M, Maffulli N. Insertional Achilles tendinopathy. Foot Ankle Clin N Am. 2005;10:309–20.

    Article  Google Scholar 

  25. Calleja M, Connell D. The Achilles tendon. Semin Musculoskeletal Radiol. 2010;3:307–22.

    Article  Google Scholar 

  26. Elias D, McKinnon E. The role of ultrasound imaging in acute rupture of the Achilles tendon. Ultrasound. 2011;19:70–5.

    Article  Google Scholar 

  27. Kader D, Saxena A, Movin T, Maffulli N. Achilles tendinopathy: some aspects of basic science and clinical management. Br J Sports Med. 2002;36:239–49.

    Article  PubMed  CAS  Google Scholar 

  28. Schweitzer M, Karasick D. MR imaging of disorders of the Achilles tendon. AJR. 2000;175:613–25.

    Article  PubMed  CAS  Google Scholar 

  29. Maffulli N, Sharma P, Luscombe K. Achilles tendinopathy: aetiology and management. J R Soc Med. 2004;97:472–6.

    Article  PubMed  Google Scholar 

  30. Comin J, Cook J, Malliaras P, et al. The prevalence and clinical significance of sonographic tendon abnormalities in asymptomatic ballet dancers: a 24-month longitudinal study. Br J Sports Med. 2013;47:89–92.

    Article  PubMed  Google Scholar 

  31. Hirschmuller A, Konstantinidis L, Baur H, Dickhuth H, Sudkamp N, Helwig P. Prognostic value of Achilles tendon Doppler sonography in asymptomatic runners. Med Sci Sports Exerc. 2012;44:199–205.

    Article  PubMed  Google Scholar 

  32. Benjamin M, Rufai A, Ralphs J. The mechanism of formation of bony spurs (enthesophytes) in the Achilles tendon. Arthritis Rheum. 2000;43:576–83.

    Article  PubMed  CAS  Google Scholar 

  33. Irwin T. Current concepts review: insertional Achilles tendinopathy. Foot Ankle Int. 2010;31:933–9.

    Article  PubMed  Google Scholar 

  34. Longo U, Ronga M, Maffulli N. Acute ruptures of the Achilles tendon. Sports Med Arthroscopic Rev. 2009;17:127–38.

    Article  Google Scholar 

  35. Duerden J, Keeling J. Disorders of the Achilles tendon. Curr Orthop Practice. 2008;19:253–9.

    Article  Google Scholar 

  36. van Dijk C, van Sterkenburg M, Wiegerinck J, Karlsson J, Maffulli N. Terminology for Achilles tendon-related disorders. Knee Surg Sports Traumatol Arthrosc. 2011;19:835–41.

    Article  PubMed  Google Scholar 

  37. Haims A, Schweitzer M, Patel R, Hecht P, Wapner K. MR imaging of the Achilles tendon: overlap of findings in symptomatic and asymptomatic individuals. Skeletal Radiol. 2000;29:640–5.

    Article  PubMed  CAS  Google Scholar 

Download references

Conflicts of interest

The authors declare that they have no conflicts of interest.

Funding/grants

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Philip O’Connor.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Elias, D.A., Carne, A., Bethapudi, S. et al. Imaging of plantar fascia and Achilles injuries undertaken at the London 2012 Olympics. Skeletal Radiol 42, 1645–1655 (2013). https://doi.org/10.1007/s00256-013-1689-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00256-013-1689-1

Keywords

Navigation