Many patients present to their physician's office with the chief complaint of pain at the Achilles tendon. This review discusses the pathology, diagnosis, and treatment of Achilles tendinopathy. Achilles tendinopathy is generally caused by chronic stress to the tendon, leading to a defective arrangement of collagen fibers in the Achilles tendon. This then results in pain and limited function. Ultrasound imaging can help identify the abnormal portion of the tendon. Various treatments are available for Achilles tendinopathy, the most current of which are discussed in this article. Appropriate treatment can potentially lead to a full recovery.
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Clin Orthop Relat Res
December 2024
Federal University of Bahia, Salvador, Brazil.
Background: Several meta-analyses have evaluated the use of platelet-rich plasma (PRP) in the treatment of Achilles tendinopathy. Although they generally did not find PRP to be effective, an updated meta-analysis containing all the available, high-quality randomized trial evidence that addresses the methodological shortcomings identified in earlier meta-analyses needs to be performed.
Question/purposes: This systematic review and meta-analysis aimed to evaluate the efficacy of PRP in improving (1) pain and function as assessed using the Victorian Institute of Sports Assessment-Achilles (VISA-A) score 3 months, 6 months, and 1 year after treatment and (2) VAS pain scores 3 months after treatment in patients with chronic Achilles tendinopathy.
J Orthop Sports Phys Ther
January 2025
Midportion tendinopathy is a common overuse lower extremity injury, with a prevalence of 4% to 7%. Achilles tendinopathy especially affects people who participate in activities that load the Achilles tendon, such as running. The Victorian Institute of Sport Assessment-Achilles (VISA-A) questionnaire has been the go-to patient-reported outcome measure of the perceived impact of Achilles tendinopathy.
View Article and Find Full Text PDFJ Orthop Res
December 2024
McKay Orthopaedic Laboratory, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Exercise influences clinical Achilles tendon health in humans, but animal models of exercise-related Achilles tendon changes are lacking. Moreover, previous investigations of the effects of treadmill running exercise on rat Achilles tendon demonstrate variable outcomes. Our objective was to assess the functional, structural, cellular, and biomechanical impacts of treadmill running exercise on rat Achilles tendon with sensitive in and ex vivo approaches.
View Article and Find Full Text PDFJ Anat
December 2024
Institute of Anatomy and Cell Biology, Paracelsus Medical University, Nuremberg, Germany.
Diabetes mellitus type 2 (DMT2) promotes Achilles tendon (AS) degeneration and exercise could modulate features of DMT2. Hence, this study investigated whether tenocytes of non DMT2 and DMT2 rats respond differently to normo- (NG) and hyperglycemic (HG) conditions in the presence of tumor necrosis factor (TNF)α or cyclic stretch. AS tenocytes, isolated from DMT2 (fa/fa) or non DMT2 (lean, fa/+) adult Zucker Diabetic Fatty (ZDF) rats, were treated with 10 ng/mL TNFα either under NG or HG conditions (1 g/L vs.
View Article and Find Full Text PDFClin Rehabil
December 2024
Department of Physiotherapy, School of Primary Health Care, Monash University, Frankston, Victoria, Australia.
Objectives: To investigate the efficacy of adding radial extracorporeal shockwave therapy or sham to exercise for people with insertional Achilles tendinopathy.
Design: A two-armed, parallel-group, explanatory, single-centre, randomised controlled trial within a superiority framework.
Setting: Private clinic.
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