smjournalСпортивная медицина: наука и практикаSports medicine: research and practice2223-25242587-9014NEICON10.47529/2223-2524.2024.1.6smjournal-584Research ArticleСПОРТИВНАЯ ТРАВМАТОЛОГИЯSPORTS TRAUMATOLOGYПлантарный фасциит у спортсменов: современное состояние проблемыPlantar fasciitis in athletes: current state of the problemСливинА. В.SlivinA. V.

Сливин Антон Вячеславович, младший научный сотрудник; аспирант кафедры реабилитации, спортивной медицины и физической культуры педиатрического факультета

121059, Москва, ул. Б. Дорогомиловская, 5

117513, Москва, ул. Островитянова, 1, стр. 6

Anton V. Slivin, junior researcher; postgraduate student of Rehabilitation and Sports Medicine Department

121059, Moscow, B. Dorogomilovskaya str., 5

117513, Moscow, Ostrovityanova str., 1, building 6

anton-slivin@mail.ruПарастаевС. А.ParastaevS. A.

Парастаев Сергей Андреевич, профессор, д.м.н., заместитель директора по научной работе; профессор кафедры реабилитации, спортивной медицины и физической культуры педиатрического факультета

121059, Москва, ул. Б. Дорогомиловская, 5

117513, Москва, ул. Островитянова, 1, стр. 6

Sergey A. Parastaev, M.D., D.Sc. (Medicine), Prof. Deputy Director; Professor of the Department of Rehabilitation, Sports Medicine and Physical Culture

121059, Moscow, B. Dorogomilovskaya str., 5

117513, Moscow, Ostrovityanova str., 1, building 6

sergeyparastaev@gmail.comФГБУ «Федеральный научно-клинический центр спортивной медицины и реабилитации Федерального медико-биологического агентства»; ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава РоссииРоссияFederal Research and Clinical Center of Sports Medicine and Rehabilitation of Federal Medical Biological Agency; Pirogov Russian National Research Medical UniversityRussian Federation2024270220241415064Copyright © Сливин А.В., Парастаев С.А., 20242024Сливин А.В., Парастаев С.А.Slivin A.V., Parastaev S.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.smjournal.ru/jour/article/view/584

Цель исследования: рассмотреть на основе анализа отечественных и иностранных источников основные вопросы эпидемиологии, патогенеза, диагностики и лечения плантарного фасциита у спортсменов.Материалы и методы: проведен анализ данных электронных порталов PubMed-NCBI, Scopus, Академия Google, Cochrane Library и «Научная электронная библиотека eLIBRARY.RU» по запросам: «plantar fasciitis sport», «plantar fasciitis in athletes» «plantar fasciitis physical therapy». В обзоре проведен анализ 103 публикаций, из них 16 посвящено проблематике плантарного фасциита в спорте; включено 34 метаанализа, 39 обзоров, 11 рандомизированных клинических испытаний и 19 иных исследований, построенных на основе принципов надлежащей клинической практики.Результаты: оценена встречаемость плантарного фасциита среди спортсменов, которая составляет от 5,2 до 17,5%. Продемонстрировано, что ведущее морфологическое изменение — дегенерация соединительной ткани, что в сочетании с повторяющейся микротравматизацией может вызывать боль. При этом у спортсменов плантарный фасциит часто сопровождается различными биомеханическими нарушениями и часто ассоциирован с плоскостопием. Отмечено, что ультразвуковое исследование и магнитно-резонансная томография, которые позволяют обнаружить утолщение подошвенного апоневроза и признаки его дегенеративных изменений, а также рентгенография стоп расцениваются как вспомогательные диагностические инструменты. Описан достаточно широкий спектр подходов к лечению плантарного фасциита: медикаментозные методы воздействия, средства физической и реабилитационной медицины, а также хирургическое вмешательство, которые имеют разную степень доказанной эффективности.Заключение: поскольку у спортсменов плантарный фасциит характеризуется достаточно высокой распространенностью и устойчивостью к проводимым терапевтическим мероприятиям, что отражено в ограниченных по количеству исследованиях, то разработка патогенетически обоснованных мероприятий по своевременной диагностике и лечению данного состояния, прежде всего биомеханической направленности, будет способствовать скорейшему возобновлению полноценной тренировочной и соревновательной деятельности спортсмена. Предложены направления дальнейших исследований по проблематике возникновения у спортсменов болей в пяточной области.

Objective: to consider, based on the analysis of domestic and foreign sources, the main issues of epidemiology, pathogenesis, diagnosis, and treatment of plantar fasciitis in athletes.Materials and methods: an analysis of data from electronic portals such as PubMed-NCBI, Scopus, Google Scholar, Cochrane Library, and “Scientific Electronic Library eLIBRARY.RU” was conducted by request: “plantar fasciitis sport”, “plantar fasciitis in athletes”, “plantar fasciitis physical therapy”. The review analyzed 103 publications, of which 16 are devoted to the problems of plantar fasciitis in sports; 34 meta-analyses, 39 reviews, 11 randomized clinical trials and 19 other studies based on the principles of good clinical practice were included.Results: the prevalence of plantar fasciitis among athletes was evaluated, ranging from 5.2 to 17.5%. It has been demonstrated that the leading morphological change is the degeneration of connective tissue, which, in combination with repetitive microtrauma, can cause pain. In athletes, plantar fasciitis is often accompanied by various biomechanical disorders and is frequently associated with flat feet. It has been noted that ultrasound and magnetic resonance imaging, which allow for the detection of thickening of the plantar fascia and signs of its degenerative changes, as well as X-ray examination of the feet, are considered as additional diagnostic tools. A wide range of approaches to the treatment of plantar fasciitis has been described: pharmacological methods of intervention, physical and rehabilitation medicine, as well as surgical intervention, which have varying degrees of proven efficacy.Conclusion: since plantar fasciitis in athletes is characterized by a high prevalence and resistance to ongoing therapeutic measures, which is reflected in limited studies, the development of pathogenic justified measures for timely diagnosis and treatment of this condition, primarily focusing on biomechanics, will contribute to the athlete’s prompt resumption of full training and competitive activities. Directions for further research on the issue of foot pain occurrence in athletes have been proposed.

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The authors declare that there are no conflicts of interest present.