{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T06:41:07Z","timestamp":1780555267975,"version":"3.54.1"},"reference-count":53,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2024,7,14]],"date-time":"2024-07-14T00:00:00Z","timestamp":1720915200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Plantar fasciopathy is a very common musculoskeletal complaint that leads to reduced physical activity and undermines the quality of life of patients. It is associated with changes in plantar fascia structure and biomechanics which are most often observed between the tissue\u2019s middle portion and the calcaneal insertion. Sonographic measurements of thickness and shear wave (SW) elastography are useful tools for detecting such changes and guide clinical decision making. However, their accuracy can be compromised by variability in the tissue\u2019s loading history. This study investigates the effect of loading history on plantar fascia measurements to conclude whether mitigation measures are needed for more accurate diagnosis. The plantar fasciae of 29 healthy participants were imaged at baseline and after different clinically relevant loading scenarios. The average (\u00b1standard deviation) SW velocity was 6.5 m\/s (\u00b11.5 m\/s) and it significantly increased with loading. Indicatively, five minutes walking increased SW velocity by 14% (95% CI: \u22121.192, \u22120.298, t(27), p = 0.005). Thickness between the calcaneal insertion and the middle of the plantar fascia did not change with the tissues\u2019 loading history. These findings suggest that preconditioning protocols are crucial for accurate SW elastography assessments of plantar fasciae and have wider implications for the diagnosis and management of plantar fasciopathy.<\/jats:p>","DOI":"10.3390\/s24144552","type":"journal-article","created":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T14:15:49Z","timestamp":1721052949000},"page":"4552","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The Importance of Preconditioning for the Sonographic Assessment of Plantar Fascia Thickness and Shear Wave Velocity"],"prefix":"10.3390","volume":"24","author":[{"given":"Conor","family":"Costello","sequence":"first","affiliation":[{"name":"Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke-on-Trent ST4 2DF, UK"},{"name":"Tameside and Glossop Integrated Care NHS Foundation Trust, MSK Podiatry Clinic, Ashton Primary Care Centre, 193 Old Street, Ashton-under-Lyne OL6 7SR, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panagiotis","family":"Chatzistergos","sequence":"additional","affiliation":[{"name":"Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke-on-Trent ST4 2DF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Branthwaite","sequence":"additional","affiliation":[{"name":"Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke-on-Trent ST4 2DF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7072-1271","authenticated-orcid":false,"given":"Nachiappan","family":"Chockalingam","sequence":"additional","affiliation":[{"name":"Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke-on-Trent ST4 2DF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1302\/2058-5241.3.170080","article-title":"Plantar Fasciopathy: A Current Concepts Review","volume":"3","author":"Monteagudo","year":"2018","journal-title":"EFORT Open Rev."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1016\/j.mporth.2011.02.003","article-title":"\u201cNot Plantar Fasciitis\u201d: The Differential Diagnosis and Management of Heel Pain Syndrome","volume":"25","author":"Hossain","year":"2011","journal-title":"Orthop. Trauma"},{"key":"ref_3","first-page":"909","article-title":"Diagnosis of Heel Pain","volume":"84","author":"Tu","year":"2011","journal-title":"Am. Fam. Physician"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"P40","DOI":"10.1186\/1757-1146-4-S1-P40","article-title":"Diagnostic Imaging for Chronic Plantar Heel Pain: A Systematic Review and Meta-Analysis","volume":"4","author":"McMillan","year":"2011","journal-title":"J. Foot Ankle Res."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Onishi, K., Fredericson, M., and Dragoo, J.L. (2021). Plantar Fascia. Tendinopathy: From Basic Science to Clinical Management, Springer International Publishing.","DOI":"10.1007\/978-3-030-65335-4"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1007\/s13244-016-0533-2","article-title":"Imaging of Plantar Fascia Disorders: Findings on Plain Radiography, Ultrasound and Magnetic Resonance Imaging","volume":"8","author":"Draghi","year":"2017","journal-title":"Insights Imaging"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"101849","DOI":"10.1016\/j.foot.2021.101849","article-title":"Ultrasonographic Measurements of Plantar Fascia Thickness and Echogenicity in Individuals with and without Plantar Fasciitis: Reliability and Group Differences","volume":"49","author":"Salehi","year":"2021","journal-title":"Foot"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"727","DOI":"10.2519\/jospt.2013.4774","article-title":"Association Between Plantar Fascia Vascularity and Morphology and Foot Dysfunction in Individuals With Chronic Plantar Fasciitis","volume":"43","author":"Chen","year":"2013","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2325967118757983","DOI":"10.1177\/2325967118757983","article-title":"Long-Term Prognosis of Plantar Fasciitis: A 5- to 15-Year Follow-up Study of 174 Patients With Ultrasound Examination","volume":"6","author":"Hansen","year":"2018","journal-title":"Orthop. J. Sports Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1007\/s40477-022-00770-4","article-title":"Shear-Wave Elastography of the Plantar Fascia: A Systematic Review and Meta-Analysis","volume":"26","author":"Albano","year":"2023","journal-title":"J. Ultrasound"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"110495","DOI":"10.1016\/j.ejrad.2022.110495","article-title":"Ultrasound Elastography for the Evaluation of Plantar Fasciitis: A Systematic Review and Meta-Analysis","volume":"155","author":"Wu","year":"2022","journal-title":"Eur. J. Radiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"546","DOI":"10.2106\/00004623-200403000-00013","article-title":"Dynamic Loading of the Plantar Aponeurosis in Walking","volume":"86","author":"Erdemir","year":"2004","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1111\/joa.12111","article-title":"Plantar Fascia Anatomy and Its Relationship with Achilles Tendon and Paratenon","volume":"223","author":"Stecco","year":"2013","journal-title":"J. Anat."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1016\/j.aanat.2014.07.003","article-title":"Changes in Length of the Plantar Aponeurosis during the Stance Phase of Gait--an in Vivo Dynamic Fluoroscopic Study","volume":"196","author":"Fessel","year":"2014","journal-title":"Ann. Anat."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Chen, D., Li, B., Aubeeluck, A., Yang, Y., Huang, Y., Zhou, J., and Yu, G. (2014). Anatomy and Biomechanical Properties of the Plantar Aponeurosis: A Cadaveric Study. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0084347"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.gaitpost.2013.05.022","article-title":"Reliability of Ultrasound for Measurement of Selected Foot Structures","volume":"39","author":"Crofts","year":"2014","journal-title":"Gait Posture"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1016\/j.gaitpost.2018.01.022","article-title":"Contributions of Foot Muscles and Plantar Fascia Morphology to Foot Posture","volume":"61","author":"Angin","year":"2018","journal-title":"Gait Posture"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1016\/j.jbiomech.2019.01.014","article-title":"Site- and Sex-Differences in Morphological and Mechanical Properties of the Plantar Fascia: A Supersonic Shear Imaging Study","volume":"85","author":"Shiotani","year":"2019","journal-title":"J. Biomech."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1490","DOI":"10.1002\/pmrj.12771","article-title":"Hyaluronan Homeostasis and Its Role in Pain and Muscle Stiffness","volume":"14","author":"Amir","year":"2022","journal-title":"PM R"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Mifsud, T., Chatzistergos, P., and Maganaris, C. (2023). Supersonic Shear Wave Elastography of Human Tendons Is Associated with in Vivo Tendon Stiffness over Small Strains Medial Gastrocnemius Musculotendinous Junction Soleus Tendon Junction Whole. J. Biomech., 152.","DOI":"10.1016\/j.jbiomech.2023.111558"},{"key":"ref_21","first-page":"114","article-title":"Shear Wave Elastography Can Assess the In-Vivo Nonlinear Mechanical Behavior of Heel-Pad","volume":"28","author":"Chatzistergos","year":"2018","journal-title":"J. Biomech."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1293","DOI":"10.1016\/j.jdiacomp.2016.06.003","article-title":"Differences in the Mechanical Characteristics of Plantar Soft Tissue between Ulcerated and Non-Ulcerated Foot","volume":"30","author":"Naemi","year":"2016","journal-title":"J. Diabetes Complicat."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1148\/radiol.11101665","article-title":"Sonoelastography of the Plantar Fascia","volume":"259","author":"Wu","year":"2011","journal-title":"Radiology"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"6047","DOI":"10.1038\/s41598-022-10011-7","article-title":"An In-Vivo Model For Overloading-Induced Soft Tissue Injury","volume":"12","author":"Chatzistergos","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"144","DOI":"10.14366\/usg.19035","article-title":"Elasticity of Torn Supraspinatus Tendons Measured by Shear Wave Elastography: A Potential Surrogate Marker of Chronicity?","volume":"39","author":"Yoo","year":"2020","journal-title":"Ultrasonography"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Baur, D., Schwabl, C., Kremser, C., Taljanovic, M.S., Widmann, G., Sconfienza, L.M., Sztankay, J., Feuchtner, G., and Klauser, A.S. (2021). Shear Wave Elastography of the Plantar Fascia: Comparison between Patients with Plantar Fasciitis and Healthy Control Subjects. J. Clin. Med., 10.","DOI":"10.3390\/jcm10112351"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1007\/s40477-020-00474-7","article-title":"Evaluation of Plantar Fasciopathy Shear Wave Elastography: A Comparison between Patients and Healthy Subjects","volume":"24","author":"Schillizzi","year":"2021","journal-title":"J. Ultrasound"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1016\/j.acra.2019.04.009","article-title":"Shear Wave Elastography (SWE) for the Evaluation of Patients with Plantar Fasciitis","volume":"27","author":"Gatz","year":"2020","journal-title":"Acad. Radiol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1177\/02841851211058928","article-title":"Is 2D SWE Sufficient as Clinical Diagnosis in Patients with Plantar Fasciitis?","volume":"64","year":"2023","journal-title":"Acta Radiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"399","DOI":"10.11152\/mu-1976","article-title":"Elastosonographic Evaluation after Extracorporeal Shockwave Treatment in Plantar Fasciopathy","volume":"21","author":"Alviti","year":"2019","journal-title":"Med. Ultrason."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1016\/j.fas.2023.01.003","article-title":"Effect of Plantar Fascia-Specific Stretching and Achilles Tendon Stretching on Shear Wave Elasticity of the Plantar Fascia in Healthy Subjects","volume":"29","author":"Sugino","year":"2023","journal-title":"Foot Ankle Surg."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2571","DOI":"10.1038\/s41598-020-59464-8","article-title":"Sonoelastographic Evaluation of Plantar Fascia after Shock Wave Therapy for Recalcitrant Plantar Fasciitis: A 12-Month Longitudinal Follow-up Study","volume":"10","author":"Wu","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"3529","DOI":"10.1016\/j.ultrasmedbio.2021.08.013","article-title":"Sources of Variability in Shear Wave Speed and Dispersion Quantification with Ultrasound Elastography: A Phantom Study","volume":"47","author":"Nambiar","year":"2021","journal-title":"Ultrasound Med. Biol."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Sadeghi, S., and Cortes, D.H. (2020). Measurement of the Shear Modulus in Thin-Layered Tissues Using Numerical Simulations and Shear Wave Elastography. J. Mech. Behav. Biomed. Mater., 102.","DOI":"10.1016\/j.jmbbm.2019.103502"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1088\/0031-9155\/59\/3\/505","article-title":"In Vivo Evaluation of the Elastic Anisotropy of the Human Achilles Tendon Using Shear Wave Dispersion Analysis","volume":"59","author":"Brum","year":"2014","journal-title":"Phys. Med. Biol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.jbiomech.2019.04.013","article-title":"Ultrasound Elastographic Assessment of Plantar Fascia in Runners Using Rearfoot Strike and Forefoot Strike","volume":"89","author":"Chen","year":"2019","journal-title":"J. Biomech."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"9260","DOI":"10.1038\/s41598-021-88883-4","article-title":"Track Distance Runners Exhibit Bilateral Differences in the Plantar Fascia Stiffness","volume":"11","author":"Shiotani","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1360","DOI":"10.1111\/sms.13690","article-title":"Acute Effects of Long-Distance Running on Mechanical and Morphological Properties of the Human Plantar Fascia","volume":"30","author":"Shiotani","year":"2020","journal-title":"Scand. J. Med. Sci. Sports"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2813","DOI":"10.1016\/j.jbiomech.2009.08.023","article-title":"Dynamic Creep and Pre-Conditioning of the Achilles Tendon in-Vivo","volume":"42","author":"Hawkins","year":"2009","journal-title":"J. Biomech."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1384","DOI":"10.1152\/japplphysiol.00075.2011","article-title":"Conditioning of the Achilles Tendon via Ankle Exercise Improves Correlations between Sonographic Measures of Tendon Thickness and Body Anthropometry","volume":"110","author":"Wearing","year":"2011","journal-title":"J. Appl. Physiol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1016\/j.jelekin.2015.02.005","article-title":"Muscle Shear Elastic Modulus Is Linearly Related to Muscle Torque over the Entire Range of Isometric Contraction Intensity","volume":"25","author":"Hug","year":"2015","journal-title":"J. Electromyogr. Kinesiol."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Miller, K.S., Edelstein, L., Connizzo, B.K., and Soslowsky, L.J. (2012). Effect of Preconditioning and Stress Relaxation on Local Collagen Fiber Re-Alignment: Inhomogeneous Properties of Rat Supraspinatus Tendon. J. Biomech. Eng., 134.","DOI":"10.1115\/1.4006340"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"6643","DOI":"10.1038\/s41598-020-63730-0","article-title":"Influence of Different Knee and Ankle Ranges of Motion on the Elasticity of Triceps Surae Muscles, Achilles Tendon, and Plantar Fascia","volume":"10","author":"Liu","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1177\/1071100717702463","article-title":"Effects of Body Mass Index on Mechanical Properties of the Plantar Fascia and Heel Pad in Asymptomatic Participants","volume":"38","author":"Bek","year":"2017","journal-title":"Foot Ankle Int."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.clinbiomech.2018.11.003","article-title":"Effect of Toe Dorsiflexion on the Regional Distribution of Plantar Fascia Shear Wave Velocity","volume":"61","author":"Chino","year":"2019","journal-title":"Clin. Biomech."},{"key":"ref_46","first-page":"663","article-title":"Ultrasonography, An Effective Tool in Diagnosing Plantar Fasciitis: A Systematic Review of Diagnostic Trials","volume":"11","author":"Radwan","year":"2016","journal-title":"Int. J. Sports Phys. Ther."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1080\/14763140802629966","article-title":"Significant and Meaningful Effects in Sports Biomechanics Research","volume":"8","author":"Knudson","year":"2009","journal-title":"Sports Biomech."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"175","DOI":"10.3758\/BF03193146","article-title":"G*Power 3: A Flexible Statistical Power Analysis Program for the Social, Behavioral, and Biomedical Sciences","volume":"39","author":"Faul","year":"2007","journal-title":"Behav. Res. Methods"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1177\/011542650802300176","article-title":"Biostatistics Primer: Part 2","volume":"23","author":"Overholser","year":"2008","journal-title":"Nutr. Clin. Pract."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/j.jbiomech.2018.05.032","article-title":"Biomechanical and Mechanical Behavior of the Plantar Fascia in Macro and Micro Structures","volume":"76","author":"Guo","year":"2018","journal-title":"J. Biomech."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"530242","DOI":"10.1155\/2014\/530242","article-title":"Constitutive Modeling of Time-Dependent Response of Human Plantar Aponeurosis","volume":"2014","author":"Pavan","year":"2014","journal-title":"Comput. Math. Methods Med."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1007\/s11517-015-1316-5","article-title":"A Mathematical Method for Quantifying in Vivo Mechanical Behaviour of Heel Pad under Dynamic Load","volume":"54","author":"Naemi","year":"2015","journal-title":"Med. Biol. Eng. Comput."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"S39","DOI":"10.1098\/rsbl.2003.0004","article-title":"Tendon Conditioning: Artefact or Property?","volume":"270","author":"Maganaris","year":"2003","journal-title":"Proc. Biol. Sci."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/24\/14\/4552\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:16:32Z","timestamp":1760109392000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/24\/14\/4552"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,14]]},"references-count":53,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2024,7]]}},"alternative-id":["s24144552"],"URL":"https:\/\/doi.org\/10.3390\/s24144552","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,14]]}}}