Abstract
Foot and ankle injuries are one of the most common injuries within the athletic population. For masters athletes, years of repetitive motions inevitably contribute to degeneration of the most dependent structures of the body, the foot and ankle. As a result, competitive activity results in injuries related to stress and fatigue. Particularly, acute rupture of the Achilles tendon and/or chronic tendinopathy can lead to decreased performance and the need for operative intervention. Similarly, the plantar fascia may become irritated and inflamed and require intensive therapy or surgery for the athlete to continue high-level performance. Overuse and persistent load may cause debilitating stress fractures that are difficult to manage. Many of these conditions are managed through conservative measures and an emphasis on maintenance to control the symptoms of the respective condition. However, the masters athlete represents a unique population that may require surgical intervention once all other measures have been exhausted to allow them to continue high-level activity, even in a mature period of life.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Li HY, Hua YH. Achilles tendinopathy: current concepts about the basic science and clinical treatments. Biomed Res Int. 2016;2016:6492597.
Egger AC, Berkowitz MJ. Achilles tendon injuries. Curr Rev Musculoskelet Med. 2017;10(1):72–80.
Saltzman CL, Tearse DS. Achilles tendon injuries. J Am Acad Orthop Surg. 1998;6(5):316–25.
Pedowitz D, Kirwan G. Achilles tendon ruptures. Curr Rev Musculoskelet Med. 2013;6(4):285–93.
Johnston CA, Taunton JE, Lloyd-Smith DR, McKenzie DC. Preventing running injuries. Practical approach for family doctors. Can Fam Physician. 2003;49:1101–9.
Schepsis AA, Jones H, Haas AL. Achilles tendon disorders in athletes. Am J Sports Med. 2002;30(2):287–305.
Maffulli N. The clinical diagnosis of subcutaneous tear of the Achilles tendon. A prospective study in 174 patients. Am J Sports Med. 1998;26(2):266–70.
Reddy SS, Pedowitz DI, Parekh SG, Omar IM, Wapner KL. Surgical treatment for chronic disease and disorders of the Achilles tendon. J Am Acad Orthop Surg. 2009;17(1):3–14.
Kleinman M, Gross AE. Achilles tendon rupture following steroid injection. Report of three cases. J Bone Joint Surg Am. 1983;65(9):1345–7.
Verrall G, Schofield S, Brustad T. Chronic Achilles tendinopathy treated with eccentric stretching program. Foot Ankle Int. 2011;32(9):843–9.
Shalabi A, Kristoffersen-Wilberg M, Svensson L, Aspelin P, Movin T. Eccentric training of the gastrocnemius-soleus complex in chronic Achilles tendinopathy results in decreased tendon volume and intratendinous signal as evaluated by MRI. Am J Sports Med. 2004;32(5):1286–96.
Ohberg L, Lorentzon R, Alfredson H. Eccentric training in patients with chronic Achilles tendinosis: normalised tendon structure and decreased thickness at follow up. Br J Sports Med. 2004;38(1):8–11; discussion 11.
Beyer R, Kongsgaard M, Hougs Kjaer B, Ohlenschlaeger T, Kjaer M, Magnusson SP. Heavy slow resistance versus eccentric training as treatment for Achilles tendinopathy: a randomized controlled trial. Am J Sports Med. 2015;43(7):1704–11.
Munteanu SE, Scott LA, Bonanno DR, et al. Effectiveness of customised foot orthoses for Achilles tendinopathy: a randomised controlled trial. Br J Sports Med. 2015;49(15):989–94.
Roos EM, Engstrom M, Lagerquist A, Soderberg B. Clinical improvement after 6 weeks of eccentric exercise in patients with mid-portion Achilles tendinopathy—a randomized trial with 1-year follow-up. Scand J Med Sci Sports. 2004;14(5):286–95.
Filardo G, Di Matteo B, Kon E, Merli G, Marcacci M. Platelet-rich plasma in tendon-related disorders: results and indications. Knee Surg Sports Traumatol Arthrosc. 2016:1–16.
Bhandari M, Guyatt GH, Siddiqui F, et al. Treatment of acute Achilles tendon ruptures: a systematic overview and metaanalysis. Clin Orthop Relat Res. 2002;400:190–200.
Khan RJ, Carey Smith RL. Surgical interventions for treating acute Achilles tendon ruptures. Cochrane Database Syst Rev. 2010;(9):CD003674.
Gulati V, Jaggard M, Al-Nammari SS, et al. Management of Achilles tendon injury: a current concepts systematic review. World J Orthop. 2015;6(4):380–6.
Zhang YJ, Zhang C, Wang Q, Lin XJ. Augmented versus nonaugmented repair of acute Achilles tendon rupture: a systematic review and meta-analysis. Am J Sports Med. 2017:363546517702872.
Riddle DL, Schappert SM. Volume of ambulatory care visits and patterns of care for patients diagnosed with plantar fasciitis: a national study of medical doctors. Foot Ankle Int. 2004;25(5):303–10.
Kindred J, Trubey C, Simons SM. Foot injuries in runners. Curr Sports Med Rep. 2011;10(5):249–54.
Digiovanni BF, Nawoczenski DA, Malay DP, et al. Plantar fascia-specific stretching exercise improves outcomes in patients with chronic plantar fasciitis. A prospective clinical trial with two-year follow-up. J Bone Joint Surg Am. 2006;88(8):1775–81.
Neufeld SK, Cerrato R. Plantar fasciitis: evaluation and treatment. J Am Acad Orthop Surg. 2008;16(6):338–46.
Gill LH, Kiebzak GM. Outcome of nonsurgical treatment for plantar fasciitis. Foot Ankle Int. 1996;17(9):527–32.
Knobloch K, Grasemann R, Spies M, Vogt PM. Midportion Achilles tendon microcirculation after intermittent combined cryotherapy and compression compared with cryotherapy alone: a randomized trial. Am J Sports Med. 2008;36(11):2128–38.
Pfeffer G, Bacchetti P, Deland J, et al. Comparison of custom and prefabricated orthoses in the initial treatment of proximal plantar fasciitis. Foot Ankle Int. 1999;20(4):214–21.
Bonanno DR, Landorf KB, Menz HB. Pressure-relieving properties of various shoe inserts in older people with plantar heel pain. Gait Posture. 2011;33(3):385–9.
Acevedo JI, Beskin JL. Complications of plantar fascia rupture associated with corticosteroid injection. Foot Ankle Int. 1998;19(2):91–7.
Kim C, Cashdollar MR, Mendicino RW, Catanzariti AR, Fuge L. Incidence of plantar fascia ruptures following corticosteroid injection. Foot Ankle Spec. 2010;3(6):335–7.
Ahmad J, Ahmad SH, Jones K. Treatment of plantar fasciitis with botulinum toxin. Foot Ankle Int. 2017;38(1):1–7.
Gollwitzer H, Saxena A, DiDomenico LA, et al. Clinically relevant effectiveness of focused extracorporeal shock wave therapy in the treatment of chronic plantar fasciitis: a randomized, controlled multicenter study. J Bone Joint Surg Am. 2015;97(9):701–8.
Behrens SB, Deren ME, Matson A, Fadale PD, Monchik KO. Stress fractures of the pelvis and legs in athletes: a review. Sports Health. 2013;5(2):165–74.
Robertson GA, Wood AM. Lower limb stress fractures in sport: optimising their management and outcome. World J Orthop. 2017;8(3):242–55.
Boden BP, Osbahr DC. High-risk stress fractures: evaluation and treatment. J Am Acad Orthop Surg. 2000;8(6):344–53.
Beck BR, Matheson GO, Bergman G, et al. Do capacitively coupled electric fields accelerate tibial stress fracture healing? A randomized controlled trial. Am J Sports Med. 2008;36(3):545–53.
Mallee WH, Weel H, van Dijk CN, van Tulder MW, Kerkhoffs GM, Lin CW. Surgical versus conservative treatment for high-risk stress fractures of the lower leg (anterior tibial cortex, navicular and fifth metatarsal base): a systematic review. Br J Sports Med. 2015;49(6):370–6.
Mann JA, Pedowitz DI. Evaluation and treatment of navicular stress fractures, including nonunions, revision surgery, and persistent pain after treatment. Foot Ankle Clin. 2009;14(2):187–204.
Greaney RB, Gerber FH, Laughlin RL, et al. Distribution and natural history of stress fractures in U.S. Marine recruits. Radiology. 1983;146(2):339–46.
Saxena A, Fullem B, Hannaford D. Results of treatment of 22 navicular stress fractures and a new proposed radiographic classification system. J Foot Ankle Surg. 2000;39(2):96–103.
Shakked RJ, Walters EE, O’Malley MJ. Tarsal navicular stress fractures. Curr Rev Musculoskelet Med. 2017;10(1):122–30.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG, part of Springer Nature
About this chapter
Cite this chapter
Chambers, M.C., LaBaze, D., Raszeswki, J., Hogan, M.V. (2018). Foot and Ankle: Conservative Management, Operative Management, and Return to Sport. In: Wright, V., Middleton, K. (eds) Masterful Care of the Aging Athlete. Springer, Cham. https://doi.org/10.1007/978-3-319-16223-2_12
Download citation
DOI: https://doi.org/10.1007/978-3-319-16223-2_12
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-16222-5
Online ISBN: 978-3-319-16223-2
eBook Packages: MedicineMedicine (R0)