An Overview of Achilles Tendinopathy Management (original) (raw)
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Achilles Tendinopathy Pathogenesis and Management: A Narrative Review
International Journal of Environmental Research and Public Health
The Achilles tendon is the thickest and strongest tendon of the human body, and it is frequently injured during sports activity. The incidence of Achilles tendon pathologies has increased over recent decades, especially in the last few years, because of increased sports participation among the general population and due to the diffusion of competitive sports at a high level. Tendinopathies are common in athletes and in middle-aged overweight patients. The term “tendinopathy” refers to a condition characterised clinically by pain and swelling, with functional limitations of tendon and nearby structures, and consequently to chronic failure of healing response process. Tendinopathies can produce marked morbidity, and at present, scientifically validated management modalities are limited. Despite the constantly increasing interest and number of studies about Achilles tendinopathy (AT), there is still not a consensual point of view on which is the best treatment, and its management is st...
Applied Sciences
Achilles tendinopathy (AT) is the most common injury of the Achilles tendon and represents 55–65% of all Achilles tendon clinical diagnoses. AT is characterized by pain, swelling, and impaired performance. ATs can be divided into two types, according to anatomical location—midportion AT (MAT) and insertional AT (IAT). MAT more often occurs in older, less active, and overweight populations, while IAT usually occurs in the more physically active population. Both types of AT can be treated by different treatments, such as surgery, conservative pharmacological treatments, and conservative nonpharmacological treatments. This umbrella review aims to assemble the evidence from all available systematic reviews and/or meta-analyses to determine which conservative nonpharmacological treatments are most commonly used and have the greatest effects. Three major electronic scientific databases (PubMed, Scopus, and Web of Science) were screened. The reference lists of several recent articles on AT...
Conservative Treatment of Chronic Achilles Tendinopathy: A Systematic Review
Journal of Functional Morphology and Kinesiology
Achilles tendinopathy is a common musculoskeletal disorder. Athletes, runners and jumpers, and the sedentary are frequently affected. Numerous are the therapeutic choices to manage these kinds of disorders. The aim of this review is to analyze the available literature to document the up-to-date evidence on conservative management of Achilles tendinopathy. A systematic review of two medical electronic databases was performed by three independent authors, using the following inclusion criteria: conservative treatment consisted of pharmacologic, physical therapy without operative treatment, with more of 6 months symptoms and a minimum average of 6-months follow-up. Studies of any level of evidence, reporting clinical results, and dealing with Achilles tendinopathy and conservative treatment were searched for. A total of n = 1228 articles were found. At the end of the first screening, following the previously described selection criteria, we selected n = 94 articles eligible for full-te...
Achilles Tendinopathy and Associated Disorders
Foot & Ankle Orthopaedics
Degenerative disorders of the Achilles tendon are common, affecting up to 18% of the adult population. A thorough evaluation including a focused history, physical examination, and diagnostic studies helps in choosing the appropriate treatment. Initial treatment is usually nonoperative, consisting of activity modification, bracing, and physical therapy. Patents who fail nonoperative management may be treated operatively with a wide range of procedures from endoscopic surgery to open debridement and tendon transfer. Understanding a patient's expectations and educating patients about potential treatments and their outcomes enables informed collaborative decision making. This article will review the evaluation and management Achilles tendinopathy and associated disorders.
The Lower Limb Tendinopathies, 2016
Achilles tendinopathy is a common cause of disability. Despite the economic and social relevance of the problem, the causes and mechanisms of Achilles tendinopathy remain unclear. Tendon vascularity, gastrocnemius-soleus dysfunction, age, sex, body weight and height, pes cavus, and lateral ankle instability are considered common risk factors. Currently, intratendinous degenerative changes are considered responsible for tendinopathy and symptoms. Although Achilles tendinopathy has been extensively studied, there is a clear lack of properly conducted scientifi c research to clarify the optimal management option. The management of Achilles tendinopathy lacks evidence-based support, and patients are at risk of long-term morbidity with unpredictable clinical outcome. Most patients respond to conservative management. Eccentric exercises and shockwave provide excellent clinical results both in athletic and sedentary patients, with no reported adverse effects. However, in about 20-45 % of cases, patients do not respond well to conservative treatment, and they need surgery. Both minimally invasive and open surgeries have been described with similar results.
Tendinopathy of the Main Body of the Achilles Tendon
Foot and Ankle Clinics, 2005
Achilles tendon disorders are common in athletes and within the general population . Within the spectrum of Achilles tendon disorders, many different pathologic conditions exist. These conditions may coexist or may occur in isolation; the descriptive terminology used to describe the specific disorders of the Achilles tendon may be confusing and inaccurate. This article reviews chronic tendinopathy of the main body of the Achilles tendon [2], a condition with a combination of tendon pain, swelling, and impaired performance ability. Chronic tendinopathy has been described arbitrarily as the above condition with symptoms that last longer than 6 weeks . The etiology, pathogenesis, anatomy, epidemiology, and natural history of chronic Achilles tendinopathy largely is unknown. Overuse injuries, poor vascularity, genetic makeup, gender, and endocrine or metabolic factors have been cited as possible etiologic factors .
Combined osteopathy and exercise management of Achilles tendinopathy in an athlete: a case report
Mid-portion Achilles tendinopathy is a common injury in sporting populations. There is conflicting evidence about the best approach to conservative management. This report focuses on the rehabilitation of an Achilles tendinopathy utilising osteopathic manual therapy (OMT) and a structured exercise program in a semi-professional volleyballer. The patient presented with a 4-month history of right mid-portion Achilles tendon pain that begun after a lateral inversion sprain of the right ankle. The primary complaint was pain impacting the patients vertical jump performance. The patient complained of pain that was greatest in the morning and at the beginning of a training session prior to warming up. The inventory therapy was a combination of OMT and rehabilitation. The manual therapy was complemented with a rehabilitation program. Outcomes were assessed with the Victorian Institute of Sport Assessment- Achilles (VISA-A), visual analogue scales (VAS), painful arc, London Hospital Test, soleus lunge test and maximum vertical jump. This case presented many challenging management options including a resolving right ankle lateral inversion sprain, a past history of contralateral Achilles tendinopathy and a high training load. The case demonstrated the importance of patien-tcentred practice. It was integral that the patient’s role as a semi-professional athlete on the volleyball court was analyzed closely in order to replicate different facets of his game, so that the rehabilitation program could support a return to performance at the highest level. Once the initial deficits in mobility and strength were addressed, the rehabilitation program focus moved to injury prevention.