mesЭкстремальная биомедицинаExtreme Medicine3033-89643033-8972Centre for Strategic Planning of the Federal Medical and Biological Agency10.47183/mes.2025-270mes-270Research ArticleСПОРТИВНАЯ МЕДИЦИНАSPORTS MEDICINEЭффективность консервативных методов лечения плантарного фасциита у спортсменовEffectiveness of conservative methods for plantar fasciitis treatment in athleteshttps://orcid.org/0000-0003-2107-6525СливинА. В.SlivinA. V.

Сливин Антон Вячеславович

Москва

Anton V. Slivin

Moscow

anton-slivin@mail.ruhttps://orcid.org/0000-0002-1971-4420КармазинВ. В.KarmazinV. V.

Кармазин Валерий Вячеславович - канд. мед. наук

Москва

Valerii V. Karmazin

Moscow

vkarma@mail.ruhttps://orcid.org/0009-0005-0957-1840ШлыковК. А.ShlykovK. A.

Шлыков Кирилл Алексеевич

Москва

Kirill A. Shlykov

Moscow

kirill@drshlykov.ruhttps://orcid.org/0000-0002-2281-9936ПарастаевС. А.ParastaevS. A.

Парастаев Сергей Андреевич - д-р. мед. наук

Москва

Sergey A. Parastaev

Moscow

ParastaevSA@sportfmba.ruФедеральный научно-клинический центр спортивной медицины и реабилитации Федерального медико-биологического агентства; Российский национальный исследовательский медицинский университет им. Н.И. ПироговаРоссияFederal Research and Clinical Center of Sports Medicine and Rehabilitation; Pirogov Russian National Research Medical UniversityRussian FederationФедеральный научно-клинический центр спортивной медицины и реабилитации Федерального медико-биологического агентстваРоссияFederal Research and Clinical Center of Sports Medicine and RehabilitationRussian FederationКлиника остеопатии и классической медицины «Остеополиклиник»РоссияOsteopathy and Classical Medicine Clinic OsteopolyclinicRussian Federation202524032025271115123Copyright © Сливин А.В., Кармазин В.В., Шлыков К.А., Парастаев С.А., 20252025Сливин А.В., Кармазин В.В., Шлыков К.А., Парастаев С.А.Slivin A.V., Karmazin V.V., Shlykov K.A., Parastaev S.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.extrememedicine.ru/jour/article/view/270Введение

Введение. Плантарный фасциит (ПФ) — многофакторная патология, ограничивающая тренировочную и соревновательную деятельность спорт­смена, а в некоторых случаях обусловливающая преждевременное завершение спортивной карьеры. Поиск оптимальных методов консервативного воздействия, которые позволят повысить эффективность лечения, является важной задачей спортивной медицины.

Цель

Цель. Разработка дифференцированного подхода к консервативному лечению спортсменов с ПФ с учетом биомеханических особенностей заболевания.

Материалы и методы

Материалы и методы. В исследовании приняли участие 82 спортсмена (37 мужчин и 45 женщин, медиана возраста — 30 (23; 34) лет) с односторонним ПФ, которые были разделены на 4 группы в зависимости от типа терапевтического воздействия: группа 1 — ударно-волновая терапия (УВТ), группа 2 — вибрационное воздействие в сочетании с миофасциальным релизом мышц задней группы бедра и голени, группа 3 — индивидуальные ортезы стоп, группа 4 — комплекс вибрационного воздействия, миофасциального релиза, индивидуальных ортезов стоп. Терапевтические мероприятия оценивались по динамике болевого синдрома, результатам бароподометрического обследования, выраженности напряжения мышц бедра и голени, изменению толщины подошвенного апоневроза.

Результаты

Результаты. Все исследуемые методы воздействия показали различную степень эффективности в отношении снижения боли (p < 0,001), уменьшения толщины подошвенного апоневроза (p < 0,05) и нормализации подошвенного давления заднего и переднего отделов пораженной стопы (p < 0,05), повышения постуральной устойчивости спортсменов по объективным показателям (p < 0,05). Наиболее выраженное снижение болевого синдрома было отмечено при использовании УВТ. В группах 2 (вибрационное воздействие и миофасциальный релиз) и 3 (индивидуальные ортезы стоп) отмечено статистически значимое снижение напряжения мышц задней группы голени (p < 0,05); кроме того, в группе 2 значимо увеличивался угол дорсифлексии голеностопного сустава (p < 0,05). Группа 4 (комплексное воздействие), по данным объективных показателей, характеризовалась лучшей биомеханической стабильностью.

Выводы

Выводы. В купировании выраженного острого процесса высокую эффективность демонстрирует УВТ. При наличии у спортсмена биомеханических нарушений / деформаций стопы целесообразно использовать ортезы стоп, а в случае напряжения мышц голени и ограничения дорсифлексии — вибрационное воздействие в сочетании с миофасциальным релизом.

Introduction

Introduction. Plantar fasciitis (PF) is a multifactorial pathology that restricts an athlete’s training and competitive activities, leading to premature termination of a sports career in some cases. The search for optimal conservative treatment methods that may improve the overall therapy effectiveness represents an important task of sports medicine.

Objective

Objective. Development of a differentiated approach to conservative treatment of athletes suffering from PF, taking the biomechanical features of the disease into account.

Materials and methods

Materials and methods. The study involved 82 athletes, including 37 men and 45 women suffering from unilateral PF with a median age of 30 (23; 34) years. The participants were divided into four groups depending on the type of therapeutical action: Group 1 — shock wave therapy (ESWT); Group 2 — vibration therapy combined with myofascial release of the muscles of the posterior thigh and shin; Group 3 — individual orthoses of the feet; Group 4 — a combination of vibration therapy, myofascial release, individual orthoses of the feet. The tested therapeutic measures were assessed by the dynamics of pain syndrome, the results of baropodometry, the severity of tension in the thigh and shin muscles, and changes in the thickness of plantar aponeurosis.

Results

Results. All the studied treatment methods showed varying degrees of effectiveness in reducing pain (p < 0.001), reducing the thickness of plantar aponeurosis (p < 0.05), normalizing plantar pressure in the posterior and anterior parts of the affected foot (p < 0.05), and increasing the postural stability of athletes according to objective indicators (p < 0.05). The use of ESWT resulted in the most pronounced reduction in pain. In Groups 2 (vibration therapy and myofascial release) and 3 (individual foot orthoses), a statistically significant decrease in muscle tension in the posterior shin group was observed (p < 0.05). In addition, in Group 2, the angle of dorsiflexion of the ankle joint increased significantly (p < 0.05). Group 4 (combined treatment) demonstrated the highest level of biomechanical stability.

Conclusions

Conclusions. ESWT demonstrates a high effectiveness in relieving a pronounced acute process. In cases where an athlete experiences some biomechanical disorders or deformities of the foot, orthoses of the feet are advisable. In case of tension of the shin muscles and limitation of dorsiflexion, vibration therapy combined with myofascial release is recommended.

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