Achilles tendinopathy and its contributing pathologies has been a heavily researched topic throughout multiple professions. Although a unified consensus and classification on the underlying pathology is yet to be reached, a shift from the term tendinitis to tendinosis has slowly been adopted, and is now believed to follow a continuum. Previous incorrect belief of an inflammatory pathophysiology has lead to the development of treatment options that are inappropriate and unsuccessful, leaving the tendon unable to adequately heal or strengthen increasing its risk of repetitive re-injury and the development of chronic Achilles tendinopathy. As a result an understanding of the pathophysiology, its effect on lower limb function and biomechanical risk factors contributing to the development of Achilles tendinopathy need to be considered when developing a rehabilitation program to coincide with new research and to address the underlying degeneration and failed healing of the tendon.
Tendinopathy is a generic description that encompasses many pathologies of clinical conditions arising from chronic overuse in and around the tendon such as ruptures/tendinitis, tendinosis and paratendinitis, which can only be classified post histopathological examination (Maffulli, Sharma, & Luscombe, 2004; Khan, Cook, Bonar, Harcourt, & Astrom, 1999). There has been a shift to replace the pathological term ‘tendinitis’ with ‘tendinosis’ as increasing research fails to detect the presence of prostaglandin mediated inflammatory cell infiltration within the pathological tendon (Khan, Cook, & Kannus, 2002; Khan et al. 1999). Achilles tendinosis pathology is now attributed to a failure of the cell matrix to adapt to repetitive trauma. With fiber disorientation, ...
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...ive treatment of chronic achilles tendinopathy. Canadian Medical Association Journal , 1159-1165.
Skjong, C. C., Meininger, A. K., & Ho, S. S. (2012). Tendinopathy treatment: Where is the Evidence? Clinics in Sports Medicine , 31 (2), 329-350.
Sussmilch-Leitch, S. P., Collins, N., Bialocerkowski, A. E., Warden, S. J., & Crossley, K. M. (2012). Physical therapies for achilles tendinopathy: systematic review and meta-analysis. Journal of Foot and Ankle Research , 1-16.
Witvrouw, E., Mahieu, N., Roosen, P., & McNair, P. (2007). The role of stretching in tendon injuries. British journal of Sports Medicine , 224-226.
Yu, J., park, D., & Gyuchang, L. (2013). Effect of eccentric strengthening on pain, muscle strength, endurance, and functional fitness factors in male patients with achilles tendinopathy. American journal of physical medicine and rehabilitation , 92, 68-76.
Studies have shown taping an ankle can limit range of motion if done correctly.1, 5 Another study done by Reut...
When comparing rotator cuff tears from the common people and athletes, they are much more common when a person is physically active in sports. An injury in the rotator ...
This article is about the results of a survey conducted by three PhD’s; Janet Simon, Matthew Donahue, and Carrie Docherty, and was published by the International Journal of Athletic Therapy and Training. The purpose of the survey was to determine Athletic Trainers current utilization of ankle support, and to determine ATs current attitudes towards the use of ankle taping and bracing. It gives some history and benefits of ankle bracing and taping, and how it has become a multimillion dollar industry, considering that 66-73% of all college athletes have reported an ankle sprain. Also, a third of people with ankle sprains will either re-sprain the ankle or report feelings of instability after the initial sprain. Ankle taping has become essential part of sports medicine,
Black D. 2010. Treatment of knee arthrofibrosis and quadriceps insufficiency after patellar tendon repair: a case report including use of the graston technique. International journal of therapeutic massage and bodywork. Volume 3, Issue 2:14-21
Ytterberg, S.R., Mahowald, M.L. & Krug, H.E.(1994) “Exercise for arthritis”, BailliOre' s Clinical Rheumatology, 8(1), pp. 161-189. ScienceDirect [Online]. Available at: http://www.sciencedirect.com/science/article/pii/S0950357905802304 (Accessed: 13th May 2014).
Repair after a muscle is damaged happens through the division of certain cells who then fuse to existing, undamaged muscle fibers to correct the damage. Different muscle types take different amounts of time to heal and regenerate after it has been damaged. Smooth muscle cells can regenerate with the greatest capacity due to their ability to divide and create many more cells to help out. While cardiac muscle cells hardly regenerate at all due to the lack of specialized cells that aid in repair and regeneration. In skeletal muscle, satellite cells aid in helping restoration after injury. Along with muscles, tendons are very important structures within the human body, and they to can be damaged. However, tendon repair involves fibroblast cells cross-linking collagen fibers that aid in not only reinforcing structural support, but also mechanical support as well (“Understanding Tendon Injury,” 2005). While quite different from muscle repair, tendon repair involves the similarity of reestablishing d...
You may think that the Achilles tendon doesn't really have a matter or may not be something important.But, in “The Sports Gene” by David Epstein he talks about how the Achilles tendon can help you jump higher in any sort of sport or activity.Mattis started the bar at 6`6 7`0 and Thomas cleared all of them easily.Thomas did not believe himself he thought there was no way he could do that but after all he did do it and they even invited him to a track meet.Thomas cleared the 6`8.25 on his first attempt which he qualified for the national championships ,then he cleared 7`0.25 for a new Lindenwood University record.After all that wasn't the highest he could jump he cleared the 7`3.25 for a Lantz Indoor Fieldhouse record.But, that when his Coach
High school football players sustain a major proportion of season injuries. A major part of these regions are due to ligament sprains, targeted stretching exercises may be beneficial. The most injured players were those with the position of running back and linebackers. In the 2005-2006 season there were more than half a million injuries nationally of high school football players. This data was collected from over 100 high school football teams.
There are many injuries in general, but sports injuries? Sprains and Strains are the most common injuries in sports. “Sprains are injuries to ligaments, the tough bands connecting in a joint. Suddenly stretching ligaments past their limits deforms or tears them” (Hoffman 1). Ligaments are like springs in a sense that when you stretch a spring, it will return to it’s normal state unless they are
Anterior knee pain plagues the athletic community, the most common being runner’s knee or patellofemoral pain syndrome (PFPS). One point or another in an athlete’s career they have experienced this kind of pain. When comparing between male and female athletes and who has the higher chance of knee pain, female athletes have a higher prevalence than male athletes (Dolak KL). There are several different mechanisms of patellofemoral pain a few being: pes planus,an increased Q angle, weak, tight or an imbalance in the quadriceps or hip muscles. Recently in my clinic site as the spring sports such as, baseball, soccer and track and field the athlete’s perform a lot of squatting, running, and kneeling which load the patellofemoral joint. We are now starting to see several and treat several athletes with patellofemoral knee pain. Each of them experiencing the pain from a different mechanism. As an athletic trainer we want to treat not only the symptoms, but the mechanism of injury to prevent further injuries down the road. If patellofemoral pain syndrome is not properly treated it can develop into chronic diseases such as chondromalacia or arthritis, maybe eventually leading to a total knee plan. (Lee SE) Treatment while the athletes are young and symptoms aren’t severe is key to preventing further injury.
The solution to this problem is located in the lab. Researchers across the country are working day in and day out to come up with a solution to accelerate the healing of soft tissues. They have come up with many solutions, from vibration therapy, to personalized rehab plans, but none of these are yielding truly significant results. I believe the solution lies at the molecular level. I believe that we can observe the healing of these soft connective tissues and learn from it. Then we can design a method from the observations to accelerate the production of the fibrils and collagen that will go on to make up the soft connective tissue. I have begun to take the beginning steps in solving this problem through my mentorship with Dr. Weinhold. Our research goals go hand in hand, which has led us to beginning research on the release of an angiogenic growth factor through a gelatin that will coat sutures. In theory, this angiogenic growth factor, once released from the crosslinking with the gelatin will stimulate the development of blood vessels around the recently repaired collagenous tissue. This, in turn, will allow the tendon/ligament to have a better oxygen supply and allow for quicker
Stretching may also help manage stress of daily living. Adequate ROM is considered to be important because it may be involved in long-term injury prevention. Those with poor flexibility may risk exceeding the extensibility limits of the musculoskeletal unit. Stretching could also play an important role in maintaining flexibility, which declines with age. One study found joint ROM is improved transiently and chronically after flexibility exercise after approximately 3-4 weeks of stretching 2-3 times per week. Unfortunately, stretching may be lacking in too many ways. Stretching is contraindicated in the recovery process and found to decrease blood flow, capillary region oxygenation, and velocity of red blood cells contrary to popular belief. Research has found no positive effect on muscle soreness relief (DOMS). Furthermore, stretching, whether conducted before, after, or before and after exercise, does not produce clinically important reductions in muscle soreness. No studies have been able to consistently link regular flexibility exercise and reduction in musuclotendinous injuries, or prevention of lower back pain. Additionally, muscle strength and muscle power have been shown to decrease by 5.5% and 2%, respectively, when holding a stretch longer than 30 seconds. Therefore, static stretching before a workout may be counterproductive. There is no agreement in the scientific literature on whether static stretching prior to endurance exercise is helpful, though, it’s theorized that greater flexibility does impair performance in sports where a high degree of flexibility isn’t required. In conclusion, more evidence is needed to analyze the effect of stretching duration, and how different stretches affect muscle performance. Current consensus states major flexibility exercise programs should come after resistance
Tendonitis- Repetitive strain on a tendon can aggravate the tendon causing pain, inflammation, and complications with movement involving the muscle. Unfortunately, tendons have an insufficient blood supply; consequently, it takes an extensive time to heal, usually six weeks or more.
Tendon disorders and injuries comprise 30% to 50% of all activity-related injuries; chronic degenerative tendon disorders (tendinopathy) occur frequently and are difficult to treat (Vos 144). What PRP does is release the growth factor into the degenerative tendons while intentionally inflaming your muscles and tendons, to encourage healing. In an experiment conducted by Doctor Vos and his colleagues, they examined whether a PRP injection would actually improve the outcome in chronic mid-portion Achilles tendinopathy. The control group was given a placebo while the others were given the PRP injections. At the conclusio...
Medical study is a combination of clinical experience and scientific research, which requires proof and evidence. These two components can help physiotherapists with diagnosis, provide treatments for patients and making clinical decision. However, what are the ways for individuals to testify the effectiveness of these methods and treatments? Is there scientific evidence proving the information is correct and up to date? How helpful and appropriate are these methods and treatments to the patients? Hence evidence-based practice is necessary. It has a strong impact in physiotherapy, to ensure researches are more focused and relevant to physiotherapists and as a guiding principle to practice and treatment of patients.