2022
DOI: 10.5435/jaaos-d-21-00679
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Management of Insertional Achilles Tendinopathy

Abstract: Insertional Achilles tendinopathy is a common condition that can lead to chronic, debilitating heel pain in athletes and nonathletes alike. Conservative treatment options include activity and shoe wear modification, physical therapy, injections, and extracorporeal shock wave therapy. When nonsurgical treatment fails, surgical treatment is recommended. Although there are options aimed at preserving the tendon and débriding the retrocalcaneal bursa and excess bone formation, others are aimed at detaching the Ach… Show more

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Cited by 11 publications
(13 citation statements)
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“…7,8 Although the exact pathophysiology of IAT is not well understood, in the athletic population it is thought to be due to repetitive and excessive load on the Achilles tendon. 7,8 In those with a sedentary lifestyle, obesity, or metabolic/endocrine comorbidities, it is thought to be secondary to altered microvascularity. 14 Diminished microvascular flow to end organs leads to limited healing capability of damaged tissues, including the Achilles tendon.…”
Section: Introductionmentioning
confidence: 99%
See 1 more Smart Citation
“…7,8 Although the exact pathophysiology of IAT is not well understood, in the athletic population it is thought to be due to repetitive and excessive load on the Achilles tendon. 7,8 In those with a sedentary lifestyle, obesity, or metabolic/endocrine comorbidities, it is thought to be secondary to altered microvascularity. 14 Diminished microvascular flow to end organs leads to limited healing capability of damaged tissues, including the Achilles tendon.…”
Section: Introductionmentioning
confidence: 99%
“…Commonly, patients develop a traction heel spur at the Achilles insertion site or calcific deposition within the distal tendon substance leading to the term insertional calcific Achilles tendinopathy (ICAT). 7…”
Section: Introductionmentioning
confidence: 99%
“…Achilles tendinopathy (AT) occurs in approximately 1.85 per 1000 people and presents with functional restriction, pain and swelling at the calcaneal insertion (insertional AT) or 2–6 cm proximal to the calcaneal insertion (non-insertional AT) [ 9 , 19 , 24 , 26 ]. While the exact aetiology of AT is not clear, it is believed to involve degeneration or failed adaptation of the Achilles tendon to activity [ 9 , 10 , 24 ].…”
Section: Introductionmentioning
confidence: 99%
“…First line management for AT is non-operative; however, after 6 months of non-operative treatment, up to 45.5% of patients may remain symptomatic and undergo operative intervention [ 1 , 9 , 21 , 28 , 41 , 43 ]. Surgical strategies may include: debridement of fibrotic adhesions and regions of failed healing, controlled longitudinal incisions to the tendon to restore vascularity and stimulate a healing response, graft augmentation and removal of neovessels and associated nerves [ 25 , 31 , 34 ].…”
Section: Introductionmentioning
confidence: 99%
“…Conservative treatment, including physical therapy, injection and extracorporeal shock wave, is usually suggested as the first-line management [ 9 ]. Corticosteroid is one of the most common agents in local injection and showed its short-term therapeutic effects compared with other treatments [ 10 , 11 , 12 ].…”
Section: Introductionmentioning
confidence: 99%