Noninsertional Achilles Tendinopathy

Hennessy, Michael S.; Molloy, Andy; Sturdee, Simon

doi:10.1016/j.fcl.2007.07.006

Cited by 18 publications

(9 citation statements)

References 92 publications

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“…The natural action of the Achilles tendon induces gliding between adjacent tendon fascicles as they spiral towards the calcaneal insertion, and thus creates shear force in the tendon. The twisting produces an area of concentrated stress in the tendon . The greatest stress is estimated to occur 2–6 cm above the calcaneal insertion.…”

Section: Discussionmentioning

confidence: 99%

Lubricin in human achilles tendon: The evidence of intratendinous sliding motion and shear force in achilles tendon

Sun

Zhuang

Zhao

et al. 2015

Journal Orthopaedic Research

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Achilles tendon is one of the most commonly injured tendons. Mechanical force is regarded as a major causative factor. However, the biomechanics of Achilles tendon and mechanical mechanism of the injuries are unclear. Lubricin expresses at regions exposed to sliding motion and shear force in a number of tissues. This study investigated the distribution and concentration of lubricin in human Achilles tendons for better understanding the biomechanics of Achilles tendon. Achilles tendons were harvested from nine cadavers. Lubricin was extracted from various locations proximal to the calcaneal insertion and quantified with ELISA. The distribution of lubricin was investigated with immunohistochemistry. Lubricin was mainly identified at the interfaces of tendon fascicles, especially in the mid-portion of the tendon. The concentration of lubricin in Achilles tendons varied by individual and the distance from its calcaneal insertion. The distal portion of the tendon had a higher concentration of lubricin than the proximal regions of the tendon. This study suggests the presence of intratendinous sliding motion of fascicles and shear force at interfaces of fascicles in human Achilles tendon. Shear force could be an important mechanical factor for the development of Achilles tendinopathy and rupture.

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Section: Discussionmentioning

confidence: 99%

Lubricin in human achilles tendon: The evidence of intratendinous sliding motion and shear force in achilles tendon

Sun

Zhuang

Zhao

et al. 2015

Journal Orthopaedic Research

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“…Achilles tendinopathy has been attributed to a number of possible intrinsic and extrinsic factors including age, weight, height and BMI [17,24,[26][27][28][29][30]. A study by Longo et al (2009) suggested that there may be no in uence of age, weight and height on the occurrence of Achilles tendinopathy [31].…”

Section: Discussionmentioning

confidence: 99%

The Limited Effectiveness of a Home-Based Eccentric Training for Treatment of Achilles Tendinopathy

Ram

Meeuwisse²,

Patel³

et al. 2013

CIM

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Purpose: Objective was to evaluate the outcome of a standardized heavy load eccentric training program in adults with chronic painful Achilles tendinopathy, and the presence of increased Colour Doppler activity in diseased and non-diseased adults. e hypothesis was that patient satisfaction would fall within the range of average satisfaction present in the literature (60 to 90%).Methods: Twenty patients were instructed on a training program based on the Alfredson protocol of straight leg followed by bent knee heel drops and raises. Patient satisfaction was recorded as the primary outcome. Secondary outcomes included the VISA-A and Tegner scales. Twenty one subjects without present or history of lower extremity pain and seven patients presenting at the clinic but without Achilles tendinopathy were included as controls.Results: Patient satisfaction was signi cantly lower when compared to the literature as two patients reported that they were satis ed with the treatment while the remaining 15 reported that they were unsatis ed. ree patients were excluded from the analysis as they were unable to complete the exercises. Increased Colour Doppler activity was present in only one participant without the disease and in all patients with the disease at the end of the study (increased Colour Doppler activity was present in 40% of patients with the disease at the beginning of the study). Conclusion:Although some patients' symptoms improved over time, eccentric training did not satisfy patient expectations of improvement following treatment despite compliance with the home based program. Although it is a mainstay of treatment, other options, which are both e cacious and e ective, need to be provided for patients who prefer a conservative and relatively non-invasive treatment option from the start.

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“…lateral epicondylitis). [10][11][12][13] Other therapies, including extracorporeal shock wave therapy (ESWT), 14,15 glyceril trinitrate patch, 16 percutaneous tenotomy, 17 and injection of substances such as autologous blood, 18 corticosteroid, 19 prolotherapy, 20 or platelet-rich plasma (PRP) 21 may be considered if patients do not respond to the mentioned treatments and remain limited significantly in function or activity due to pain. 22 The failed healing response which apparently underlies tendinopathy has been proposed to be counteracted by eccentric exercise (EE) through promoting collagen fiber cross-linkage formation within the tendon, thereby facilitating tendon remodeling.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of the eccentric exercise therapy in physically active adults with symptomatic shoulder impingement or lateral epicondylar tendinopathy: A systematic review

Ortega-Castillo

Medina-Porqueres

2016

Journal of Science and Medicine in Sport

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Noninsertional Achilles Tendinopathy

Cited by 18 publications

References 92 publications

Lubricin in human achilles tendon: The evidence of intratendinous sliding motion and shear force in achilles tendon

Lubricin in human achilles tendon: The evidence of intratendinous sliding motion and shear force in achilles tendon

The Limited Effectiveness of a Home-Based Eccentric Training for Treatment of Achilles Tendinopathy

Effectiveness of the eccentric exercise therapy in physically active adults with symptomatic shoulder impingement or lateral epicondylar tendinopathy: A systematic review

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