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Subtle Activities of Specific Plain Subtalar Joint May Account for Non-injured Ankle Pain: A Case Report

Received: 14 November 2021    Accepted: 1 December 2021    Published: 9 December 2021
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Abstract

Current clinical practice focuses on discovering injuries and then formulating treatment plans. But some injuries have nothing to do with symptoms, including pain, let alone those situations where there is no injury. The ankle, especially the subtalar joint, has a high rate of variation, so the subtle activities of subtalar joint are exactly important in patients who have biomechanical issues, especially in the condition that all check-ups are normal. This paper presented a case report of a 16-year-old teenager who was a professional basketball player in local senior high school. The pain appeared in both of his soles and ankles as long as he played basketball and disappeared immediately after the exercise since his childhood. All the routine tests involving MRI and ultrasound were normal. No impingement condition was found. 3D dynamic reconstruction combined with 3D continuum model was performed. The specific plain subtalar articular surfaces were revealed. The treatment involving dynamic fixation via rigid tape and training lasted for 4 weeks. Before the treatment, the right talus was more stable than the left one (Δ(norm)=0.5126), and the calcaneus was the other way around (Δ(norm)=0.6280). The differences of degrees of freedom between two sides decreased significantly (Δ(norm)=0.0833, 0.000) after treatment. Besides, the steep and tone of both sides of talus and calcaneus revealed relative rotation and translation which indicated that the movement of subtalar joint trended to the balance of stability and mobility. This patient improved his athletic ability and got pain free immediately after the first treatment. Moreover, the pain didn’t appear during the 12-month follow-up. Therefore, we conclude that based on our treatment which focused on the reduction of the subtle activities of subtalar joint, we support that the subtle activities of variable subtalar joint may influence the athletic abilities and cause some symptoms. Therefore, the importance of bone shape which is the chief culprit of abnormal mobility shall be taken seriously. Moreover, in the case calculation based on the mathematical model, stable calcaneus and flexible talus make the better balance of stability and mobility and are necessary for available exercises.

Published in International Journal of Biomedical Engineering and Clinical Science (Volume 7, Issue 4)
DOI 10.11648/j.ijbecs.20210704.15
Page(s) 91-95
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Biomechanical Phenomena, Ankle, Anatomic Variation, Mathematics, Conservative Treatment

References
[1] Cao W, Yu H, Meng Q, Chen W, Li S. Plantar pressure analysis of above-knee amputee with a developed microprocessor-controlled prosthetic knee. Acta Bioeng Biomech. 2018; 20 (4): 33-40. PMID: 30821287.
[2] Cleland JA, Abbott JH, Kidd MO, et al. Manual physical therapy and exercise versus electrophysical agents and exercise in the management of plantar heel pain: a multicenter randomized clinical trial. J Orthop Sports Phys Ther. 2009; 39 (8): 573- 585. doi: 10.2519/jospt.2009.3036.
[3] Dennis DA, Mahfouz MR, Komistek RD, Hoff W. In vivo determination of normal and anterior cruciate ligament-deficient knee kinematics. J Biomech. 2005; 38 (2): 241-253. doi: 10.1016/j.jbiomech.2004.02.042.
[4] Haddas R, Ju KL, Belanger T, Lieberman IH. The use of gait analysis in the assessment of patients afflicted with spinal disorders. Eur Spine J. 2018; 27 (8): 1712-1723. doi: 10.1007/s00586-018-5569-1.
[5] Hyland MR, Webber-Gaffney A, Cohen L, Lichtman PT. Randomized controlled trial of calcaneal taping, sham taping, and plantar fascia stretching for the short-term management of plantar heel pain. J Orthop Sports Phys Ther. 2006; 36 (6): 364-371. doi: 10.2519/jospt.2006.2078.
[6] Li L, Yang L, Yu F, et al. 3D printing individualized heel cup for improving the self-reported pain of plantar fasciitis. J Transl Med. 2018; 16 (1): 167. doi: 10.1186/s12967-018-1547-y.
[7] Li W, Xu S, Liu Y, Zhou Y, Qu L, Yang X. Application of Static Characteristics of Plantar Pressure Distribution in the Assessment of Knee Joint Injury. Zhongguo Yi Liao Qi Xie Za Zhi. 2018; 42 (6): 395-399. doi: 10.3969/j.issn.1671-7104.2018.06.002.
[8] Menzel A. A fibre reorientation model for orthotropic multiplicative growth. Configurational driving stresses, kinematics-based reorientation, and algorithmic aspects. Biomech Model Mechanobiol. 2007; 6 (5): 303-320. doi: 10.1007/s10237-006-0061-y.
[9] Miura N, Nagai K, Tagomori K, et al. Plantar pressure distribution during standing in women with end-stage hip osteoarthritis. Gait Posture. 2020; 76: 39-43. doi: 10.1016/j.gaitpost.2019.10.026.
[10] Mueske NM, Õunpuu S, Ryan DD, et al. Impact of gait analysis on pathology identification and surgical recommendations in children with spina bifida. Gait Posture. 2019; 67: 128-132. doi: 10.1016/j.gaitpost.2018.10.003.
[11] Nasseri A, Khataee H, Bryant AL, Lloyd DG, Saxby DJ. Modelling the loading mechanics of anterior cruciate ligament. Comput Methods Programs Biomed. 2020; 184: 105098. doi: 10.1016/j.cmpb.2019.105098.
[12] Petraglia F, Scarcella L, Pedrazzi G, Brancato L, Puers R, Costantino C. Inertial sensors versus standard systems in gait analysis: a systematic review and meta-analysis. Eur J Phys Rehabil Med. 2019; 55 (2): 265-280. doi: 10.23736/S1973-9087.18.05306-6.
[13] Renan-Ordine R, Alburquerque-Sendín F, de Souza DP, Cleland JA, Fernández-de-las-Peñas C. Effectiveness of myofascial trigger point manual therapy combined with a self-stretching protocol for the management of plantar heel pain: a randomized controlled trial. J Orthop Sports Phys Ther. 2011; 41 (2): 43-50. doi: 10.2519/jospt.2011.3504.
[14] Scharnweber B, Adjami F, Schuster G, et al. Influence of dental occlusion on postural control and plantar pressure distribution. Cranio. 2017; 35 (6): 358-366. doi: 10.1080/08869634.2016.1244971.
[15] Shashua A, Flechter S, Avidan L, Ofir D, Melayev A, Kalichman L. The Effect of Additional Ankle and Midfoot Mobilizations on Plantar Fasciitis: A Randomized Controlled Trial. J Orthop Sports Phys Ther. 2015; 45 (4): 265-272. doi: 10.2519/jospt.2015.5155.
[16] Xu R, Wang Z, Ma T, Ren Z, Jin H. Effect of 3D Printing Individualized Ankle-Foot Orthosis on Plantar Biomechanics and Pain in Patients with Plantar Fasciitis: A Randomized Controlled Trial. Med Sci Monit. 2019; 25: 1392-1400. doi: 10.12659/MSM.915045.
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  • APA Style

    Shenxing Du, Lihong Wei. (2021). Subtle Activities of Specific Plain Subtalar Joint May Account for Non-injured Ankle Pain: A Case Report. International Journal of Biomedical Engineering and Clinical Science, 7(4), 91-95. https://doi.org/10.11648/j.ijbecs.20210704.15

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    ACS Style

    Shenxing Du; Lihong Wei. Subtle Activities of Specific Plain Subtalar Joint May Account for Non-injured Ankle Pain: A Case Report. Int. J. Biomed. Eng. Clin. Sci. 2021, 7(4), 91-95. doi: 10.11648/j.ijbecs.20210704.15

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    AMA Style

    Shenxing Du, Lihong Wei. Subtle Activities of Specific Plain Subtalar Joint May Account for Non-injured Ankle Pain: A Case Report. Int J Biomed Eng Clin Sci. 2021;7(4):91-95. doi: 10.11648/j.ijbecs.20210704.15

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  • @article{10.11648/j.ijbecs.20210704.15,
      author = {Shenxing Du and Lihong Wei},
      title = {Subtle Activities of Specific Plain Subtalar Joint May Account for Non-injured Ankle Pain: A Case Report},
      journal = {International Journal of Biomedical Engineering and Clinical Science},
      volume = {7},
      number = {4},
      pages = {91-95},
      doi = {10.11648/j.ijbecs.20210704.15},
      url = {https://doi.org/10.11648/j.ijbecs.20210704.15},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijbecs.20210704.15},
      abstract = {Current clinical practice focuses on discovering injuries and then formulating treatment plans. But some injuries have nothing to do with symptoms, including pain, let alone those situations where there is no injury. The ankle, especially the subtalar joint, has a high rate of variation, so the subtle activities of subtalar joint are exactly important in patients who have biomechanical issues, especially in the condition that all check-ups are normal. This paper presented a case report of a 16-year-old teenager who was a professional basketball player in local senior high school. The pain appeared in both of his soles and ankles as long as he played basketball and disappeared immediately after the exercise since his childhood. All the routine tests involving MRI and ultrasound were normal. No impingement condition was found. 3D dynamic reconstruction combined with 3D continuum model was performed. The specific plain subtalar articular surfaces were revealed. The treatment involving dynamic fixation via rigid tape and training lasted for 4 weeks. Before the treatment, the right talus was more stable than the left one (Δ(norm)=0.5126), and the calcaneus was the other way around (Δ(norm)=0.6280). The differences of degrees of freedom between two sides decreased significantly (Δ(norm)=0.0833, 0.000) after treatment. Besides, the steep and tone of both sides of talus and calcaneus revealed relative rotation and translation which indicated that the movement of subtalar joint trended to the balance of stability and mobility. This patient improved his athletic ability and got pain free immediately after the first treatment. Moreover, the pain didn’t appear during the 12-month follow-up. Therefore, we conclude that based on our treatment which focused on the reduction of the subtle activities of subtalar joint, we support that the subtle activities of variable subtalar joint may influence the athletic abilities and cause some symptoms. Therefore, the importance of bone shape which is the chief culprit of abnormal mobility shall be taken seriously. Moreover, in the case calculation based on the mathematical model, stable calcaneus and flexible talus make the better balance of stability and mobility and are necessary for available exercises.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - Subtle Activities of Specific Plain Subtalar Joint May Account for Non-injured Ankle Pain: A Case Report
    AU  - Shenxing Du
    AU  - Lihong Wei
    Y1  - 2021/12/09
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    DO  - 10.11648/j.ijbecs.20210704.15
    T2  - International Journal of Biomedical Engineering and Clinical Science
    JF  - International Journal of Biomedical Engineering and Clinical Science
    JO  - International Journal of Biomedical Engineering and Clinical Science
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    EP  - 95
    PB  - Science Publishing Group
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    UR  - https://doi.org/10.11648/j.ijbecs.20210704.15
    AB  - Current clinical practice focuses on discovering injuries and then formulating treatment plans. But some injuries have nothing to do with symptoms, including pain, let alone those situations where there is no injury. The ankle, especially the subtalar joint, has a high rate of variation, so the subtle activities of subtalar joint are exactly important in patients who have biomechanical issues, especially in the condition that all check-ups are normal. This paper presented a case report of a 16-year-old teenager who was a professional basketball player in local senior high school. The pain appeared in both of his soles and ankles as long as he played basketball and disappeared immediately after the exercise since his childhood. All the routine tests involving MRI and ultrasound were normal. No impingement condition was found. 3D dynamic reconstruction combined with 3D continuum model was performed. The specific plain subtalar articular surfaces were revealed. The treatment involving dynamic fixation via rigid tape and training lasted for 4 weeks. Before the treatment, the right talus was more stable than the left one (Δ(norm)=0.5126), and the calcaneus was the other way around (Δ(norm)=0.6280). The differences of degrees of freedom between two sides decreased significantly (Δ(norm)=0.0833, 0.000) after treatment. Besides, the steep and tone of both sides of talus and calcaneus revealed relative rotation and translation which indicated that the movement of subtalar joint trended to the balance of stability and mobility. This patient improved his athletic ability and got pain free immediately after the first treatment. Moreover, the pain didn’t appear during the 12-month follow-up. Therefore, we conclude that based on our treatment which focused on the reduction of the subtle activities of subtalar joint, we support that the subtle activities of variable subtalar joint may influence the athletic abilities and cause some symptoms. Therefore, the importance of bone shape which is the chief culprit of abnormal mobility shall be taken seriously. Moreover, in the case calculation based on the mathematical model, stable calcaneus and flexible talus make the better balance of stability and mobility and are necessary for available exercises.
    VL  - 7
    IS  - 4
    ER  - 

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Author Information
  • Department of Rehabilitation, Dongyang People’s Hospital, Dongyang City, China

  • Department of Orthopedics, Dongyang People’s Hospital, Dongyang City, China

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