Sharp pain in a normal Achilles tendon of a professional female football player was related to a plantaris tendon in a rare position: a case report.

Achilles tendon pain Case report Plantaris tendon Plantaris tendon removal Tendinopathy

Journal

Journal of medical case reports
ISSN: 1752-1947
Titre abrégé: J Med Case Rep
Pays: England
ID NLM: 101293382

Informations de publication

Date de publication:
18 Oct 2021
Historique:
received: 01 02 2021
accepted: 28 09 2021
entrez: 18 10 2021
pubmed: 19 10 2021
medline: 21 10 2021
Statut: epublish

Résumé

Plantaris tendinopathy and plantaris-associated Achilles tendinopathy can be responsible for chronic pain in the Achilles tendon midportion, often accompanied by medial tenderness. As conservative treatments are less successful for this patient group, proper diagnosis is important for decision making. This report presents a case with plantaris tendinopathy in a rare (superficial) location. This article describes a pain history and treatment timeline of a professional Swedish female soccer player (32 years old, Northern European ethnicity, white) who suffered from sharp pain in the Achilles tendon midportion and tenderness on the medial and superficial side for about 2 years. Conservative treatments, including eccentric exercises, were not successful and, to some extent, even caused additional irritation in that region. Ultrasound showed a wide and thick plantaris tendon located on the superficial side of the Achilles tendon midportion. The patient was surgically treated with local removal of the plantaris tendon. After surgery there was a relatively quick (4-6 weeks) rehabilitation, with immediate weight bearing, gradual increased loading, and return to running activities after 4 weeks. At follow-up at 8 weeks, the patient was running and had not experienced any further episodes of sharp pain during change of direction or sprinting. The plantaris tendon should be considered as a possible source of Achilles tendon pain. This case study demonstrates that the plantaris tendon can be found in unexpected (superficial) positions and needs to be carefully visualized during clinical and imaging examinations.

Sections du résumé

BACKGROUND BACKGROUND
Plantaris tendinopathy and plantaris-associated Achilles tendinopathy can be responsible for chronic pain in the Achilles tendon midportion, often accompanied by medial tenderness. As conservative treatments are less successful for this patient group, proper diagnosis is important for decision making. This report presents a case with plantaris tendinopathy in a rare (superficial) location.
CASE PRESENTATION METHODS
This article describes a pain history and treatment timeline of a professional Swedish female soccer player (32 years old, Northern European ethnicity, white) who suffered from sharp pain in the Achilles tendon midportion and tenderness on the medial and superficial side for about 2 years. Conservative treatments, including eccentric exercises, were not successful and, to some extent, even caused additional irritation in that region. Ultrasound showed a wide and thick plantaris tendon located on the superficial side of the Achilles tendon midportion. The patient was surgically treated with local removal of the plantaris tendon. After surgery there was a relatively quick (4-6 weeks) rehabilitation, with immediate weight bearing, gradual increased loading, and return to running activities after 4 weeks. At follow-up at 8 weeks, the patient was running and had not experienced any further episodes of sharp pain during change of direction or sprinting.
CONCLUSIONS CONCLUSIONS
The plantaris tendon should be considered as a possible source of Achilles tendon pain. This case study demonstrates that the plantaris tendon can be found in unexpected (superficial) positions and needs to be carefully visualized during clinical and imaging examinations.

Identifiants

pubmed: 34657632
doi: 10.1186/s13256-021-03131-7
pii: 10.1186/s13256-021-03131-7
pmc: PMC8522164
doi:

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

513

Informations de copyright

© 2021. The Author(s).

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Auteurs

Håkan Alfredson (H)

Department of Community Medicine and Rehabilitation, Sports Medicine Unit, Umeå University, 901 87, Umeå, Sweden.
Institute of Sports Exercise and Health, University College Hospital London, London, UK.

Lorenzo Masci (L)

Institute of Sports Exercise and Health, University College Hospital London, London, UK.
Sports and Exercise Medicine, Queen Mary University of London, London, UK.

Christoph Spang (C)

Department of Integrative Medical Biology, Anatomy Section, Umeå University, Umeå, Sweden. christoph.spang@umu.se.
Private Orthopaedic Spine Center Dr. Alfen, Schürerstraße 5, 97080, Würzburg, Germany. christoph.spang@umu.se.

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