28 Aug

Achilles Tendonopathy

Achilles tendonopathy is one of the most common things you will see in a sports clinic, it is extremely common in running athletes due to the repetitive loading used in a running action. The pain and symptoms you will seen from this injury are very specific and will normally present with pain into the back of the heel and leg, relative stiffness in the tendon, moderate swelling and tenderness around the tendon and a possible cracking or crepitus around the ankle. 

However the BMJ has recently publish an article giving 9 risk factors that can predispose a individual to suffering with this injury:

(1) prior lower limb tendinopathy or fracture

(2) use of ofloxacin antibiotics

(3) an increased time between heart transplantation and initiation of quinolone treatment for infectious disease

(4) moderate alcohol use

(5) training during cold weather

(6) decreased isokinetic plantar flexor strength

(7) abnormal gait pattern with decreased forward progression of propulsion

(8) more lateral foot roll-over at the forefoot flat phase

(9) creatinine clearance of <60 mL/min in heart transplant patients. 

26 other commonly accepted risk factors were not found to be associated with Achilles tendinopathy, these included the being overweight, static foot posture and physical activity level.

In terms of treatment for the condition NICE guidelines state, rehabilitation has been shown to have the most evidence behind it with eccentric loading to be the gold standard with correct body alignment and biomechanics. Corticosteroid injection into the tendon are not recommended they do not seem to help pain reduction and have been shown to have adverse reactions such as Achilles tendon atrophy and rupture being reported. 

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