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Critical Reviews™ in Physical and Rehabilitation Medicine

Publication de 4  numéros par an

ISSN Imprimer: 0896-2960

ISSN En ligne: 2162-6553

SJR: 0.141 SNIP: 0.129 CiteScore™:: 0.6 H-Index: 18

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Chronic Achilles Tendinosis

Volume 12, Numéro 2, 2000, pp. 103-117
DOI: 10.1615/CritRevPhysRehabilMed.v12.i2.20
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RÉSUMÉ

Chronic achilles tendinosis is characterized by a tendon pathology showing increased amounts of inter-fibrillar GAGs (glycosaminoglycans) and changes in the collagen fiber structure and arrangement, but there are no inflammatory cells. Recently investigation with microdialysis technique confirmed the absence of inflammation. The etiology and pathogenesis are unknown. It is a condition considered to be associated with overuse, however, it is also seen in patients with a sedentary lifestyle. The occurrence of Achilles tendinosis is most often, but not always, associated with pain during loading of the Achilles tendon. It is considered a troublesome injury to treat, and it has been stated that, in general, in about 25% of patients nonsurgical treatment is not successful. Most commonly nonsurgical treatment includes a combination of rest, NSAIDs, correction of malalignements, stretching, and strengthening exercises. However, the scientific evidence supporting the use of most proposed treatment regimens is sparse. Surgical treatment most often show very good short-term results, but there are signs of a possible deterioration with time in the few studies with long-term follow ups. After surgical treatment, it has been shown to take a long time to recover calf-muscle strength, and also a prolonged progressive calcaneal bone loss has been shown on the operated side up to 1 year after operation. In a recent prospective study on patients with tendinosis located in the midportion of the Achilles tendon, nonsurgical treatment with heavy-load eccentric calf-muscle training showed very promising results and may possibly minimize the need for surgical treatment of tendinosis at that level of the tendon. However, further research in order to clarify the pain mechanism and the role of neuropeptides, opioids, and other neurotransmitters is needed.

CITÉ PAR
  1. Danielson Patrik, Andersson Gustav, Alfredson Håkan, Forsgren Sture, Marked sympathetic component in the perivascular innervation of the dorsal paratendinous tissue of the patellar tendon in arthroscopically treated tendinosis patients, Knee Surgery, Sports Traumatology, Arthroscopy, 16, 6, 2008. Crossref

  2. Lee Jung-hoon, Yoo Won-gyu, Treatment of chronic Achilles tendon pain by Kinesio taping in an amateur badminton player, Physical Therapy in Sport, 13, 2, 2012. Crossref

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