Achilles tendinopathy: some aspects of basic science and clinical management

Abstract

Achilles tendinopathy is prevalent and potentially incapacitating in athletes involved in running sports. It is a degenerative, not an inflammatory, condition. Most patients respond to conservative measures if the condition is recognised early. Surgery usually involves removal of adhesions and degenerated areas and decompression of the tendon by tenotomy or measures that influence the local circulation.

Iontophoresis with or without dexamethazone in the treatment of acute Achilles tendon pain

“…This has to be taken into account during rehabilitation after injury and surgery. The maturation and remodeling phase of tendon healing is reported to occur from 3 weeks to 12 months after tendon rupture (Enwemeka, 1989b, Leadbetter, 1992, Józsa and Kannus, 1997, Kannus et al, 1997c, Kader et al, 2002. A patient with an injury to the Achilles tendon must therefore expect a recovery time of 3 months to a year, and sometimes longer, depending on the severity of the injury.…”

“…The difference appears to be that growing animals respond by increasing the size and weight of tendons, whereas the mature animals respond by improving the structure of the tendon with exercise (Kannus et al, 1997c). However, it has been suggested that physical exercise performed in excess is the main pathological stimulus in overuse damage to the tendon (Leadbetter, 1992, Józsa and Kannus, 1997, Kader et al, 2002, Paavola et al, 2002a. The human Achilles tendon not been studied to the same degree, but found that intensively trained athletes had a greater cross-sectional area of the Achilles tendon compared with controls.…”

“…The healing process following a tendon injury goes through 3 phases ( Figure 6) (Enwemeka, 1989b, Leadbetter, 1992, Józsa and Kannus, 1997, Kader et al, 2002. The acute inflammatory phase lasts for up to 3-7 days after injury.…”

“…The various predisposing risk factors related to Achilles tendinopathy that are suggested as being important in the literature are listed in Table 2 (Clement et al, 1984, Lysholm and Wiklander, 1987, Hess et al, 1989, Kvist, 1991, Haglund-Åkerlind and Eriksson, 1993, Kvist, 1994, DeMaio et al, 1995, Kannus, 1997a, Alfredson et al, 1998a, Kaufman et al, 1999, McCrory et al, 1999, van der Linden et al, 1999, Järvinen et al, 2001, Kader et al, 2002, Paavola et al, 2002a, Khaliq and Zhanel, 2003, Järvinen et al, 2005, Mahieu et al, 2005, Alfredson and Öhberg, 2005c. …”

Movin and Bonar Scores Assess the Same Characteristics of Tendon Histology

“…Painful tendon disorders are a major problem in competitive and recreational sports [10,13,14,18]. Over the last decade, several studies have provided the opportunity to develop novel therapeutic strategies [4-9, 17, 19, 23, 26].…”