Prevalence and incidence rate of lower-extremity tendinopathies in a Danish general practice: a registry-based study

Riel, Henrik; Lindstrøm, Cassandra Frydendal; Rathleff, Michael Skovdal; Jensen, Martin Bach; Olesen, Jens Lykkegaard

doi:10.1186/s12891-019-2629-6

Cited by 98 publications

(83 citation statements)

References 23 publications

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“…Tendinopathy is a common injury, with the incidence of lower limb tendinopathies estimated at 7.9-10.52/ 1000 patients per year (Albers et al, 2016;Riel et al, 2019).…”

Section: What Is Tendinopathy?mentioning

confidence: 99%

Diagnosis and management of tendinopathies in primary care

Fitzpatrick

2020

InnovAiT: Education and inspiration for general practice

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“…Tendinopathy is a common injury, with the incidence of lower limb tendinopathies estimated at 7.9-10.52/ 1000 patients per year (Albers et al, 2016;Riel et al, 2019).…”

Section: What Is Tendinopathy?mentioning

confidence: 99%

Diagnosis and management of tendinopathies in primary care

Fitzpatrick

2020

InnovAiT: Education and inspiration for general practice

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“…One in ten persons will develop plantar fasciopathy (PF) [1, 2]. The condition accounts for 8% of all running-related injuries but is also common in the general population [3–5]. A high running volume is associated with a higher risk of developing PF, and despite a lack of prospective studies to identify risk factors among non-runners, a high body mass index is thought to be a risk factor [6].…”

Section: Introductionmentioning

confidence: 99%

Corticosteroid injection plus exercise versus exercise, beyond advice and a heel cup for patients with plantar fasciopathy: protocol for a randomised clinical superiority trial (the FIX-Heel trial)

Riel

Vicenzino

Olesen

et al. 2020

Trials

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BackgroundPlantar fasciopathy has a lifetime prevalence of 10%. Patients experience sharp pain under the heel, often for several months or years. Multiple treatments are available, but no single treatment appears superior to the others. A corticosteroid injection offers short-term pain relief but is no better than placebo in the longer term (> 8 weeks). Heavy-slow resistance training has shown potentially positive effects on long-term outcomes (> 3 months), and combining exercises with an injection may prove to be superior to exercises alone. However, the effect of heavy-slow resistance training compared with a simpler approach of patient advice (e.g., load management) and insoles is currently unknown. This trial compares the efficacy of patient advice with patient advice plus heavy-slow resistance training and with patient advice plus heavy-slow resistance training plus a corticosteroid injection in improving the Foot Health Status Questionnaire pain score after 12 weeks in patients with plantar fasciopathy.MethodsIn this randomised superiority trial, we will recruit 180 patients with ultrasound-confirmed plantar fasciopathy and randomly allocate them to one of three groups: (1) patient advice and an insole (n = 60); (2) patient advice, an insole, and self-dosed heavy-slow resistance training consisting of heel raises (n = 60); or (3) patient advice, an insole, heavy-slow resistance training, and an ultrasound-guided corticosteroid injection (n = 60). All participants will be followed for 1 year, with the 12-week follow-up considered the primary endpoint. The primary outcome is the Foot Health Status questionnaire pain domain score. Secondary outcomes include the remaining three domains of the Foot Health Status Questionnaire, a 7-point Global Rating of Change, the Pain Self-Efficacy Questionnaire, physical activity level, health-related quality of life measured by the EQ-5D-5L, and Patient Acceptable Symptom State, which is the point at which participants feel no further need for treatment. Additionally, a health economic evaluation of the treatments will be carried out.DiscussionThis trial will test if adding heavy-slow resistance training to fundamental patient advice and an insole improves outcomes and if a corticosteroid injection adds even further to that effect in patients with plantar fasciopathy.Trial registrationClinicalTrials.gov, NCT03804008. Prospectively registered on January 15, 2019.

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“…Pain at the calcaneal attachment of the plantar fascia, referred to as plantar fasciopathy, is a common cause of chronic heel pain and is prevalent in both athletic and general populations [1][2][3]. Patients often complain of a pain when getting out of bed in the morning that improves with ambulation [4].…”

Section: Introductionmentioning

confidence: 99%

Stretching and relaxing the plantar fascia may change plantar fascia thickness but not pressure pain thresholds: a cross-sectional study of patients with plantar fasciopathy

Ostermann

Olesen

Holden

et al. 2020

BMC Musculoskelet Disord

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Background Despite the established relevance of ultrasonography and assessment of pressure pain thresholds in patients with plantar fasciopathy, patient and probe positioning has been mostly ignored and are not necessarily reported in research. The primary aim of this study was to compare plantar fascia thickness in stretched and relaxed positions in patients with plantar fasciopathy. The secondary aim was to compare plantar heel pressure pain thresholds in these positions. Methods In this cross-sectional study, we measured the plantar fascia thickness with ultrasonography, and localised pressure pain thresholds using pressure algometry of 20 patients with plantar fasciopathy. These were assessed bilaterally, with the plantar fascia in both a stretched and relaxed position. In the stretched position, toes were maximally dorsiflexed, while in the relaxed position participants’ feet were hanging freely over the end of the table. Results The plantar fascia of the most symptomatic foot was significantly thicker when stretched compared with the relaxed position (sagittal: mean difference 0.2 mm, 95%CI: 0.1–0.4, P = 0.013; frontal: mean difference − 0.27, 95%CI: − 0.49 to − 0.06, P = 0.014). The plantar fascia was significantly thinner in the frontal plane compared with the sagittal plane in both positions (stretched: mean difference − 0.2 mm, 95%CI: − 0.42 to − 0.03, P = 0.025; relaxed: mean difference − 0.3 mm, 95%CI:-0.49 to − 0.08, P = 0.008). There was no difference between pressure pain thresholds in stretched or relaxed positions in either foot (P > 0.4). Conclusions The plantar fascia was significantly thicker in a stretched compared with a relaxed position and in the sagittal compared with the frontal plane, but differences were smaller than the standard deviation. Pressure pain thresholds were not different between the positions. These results highlight the importance of how ultrasonography is performed and reported in research to allow for replication. Trial registration The study was pre-registered September 25th, 2017 on ClinicalTrials.gov (NCT03291665).

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Prevalence and incidence rate of lower-extremity tendinopathies in a Danish general practice: a registry-based study

Cited by 98 publications

References 23 publications

Diagnosis and management of tendinopathies in primary care

Diagnosis and management of tendinopathies in primary care

Corticosteroid injection plus exercise versus exercise, beyond advice and a heel cup for patients with plantar fasciopathy: protocol for a randomised clinical superiority trial (the FIX-Heel trial)

Stretching and relaxing the plantar fascia may change plantar fascia thickness but not pressure pain thresholds: a cross-sectional study of patients with plantar fasciopathy

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