Chronic midportion Achilles tendinopathy: an update on research and treatment

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Terminology

Painful conditions in the Achilles tendon have been given many names, and the definition of the same condition is often different in different studies. The nomenclature for the chronic painful condition often does not reflect the pathology of the tendon disorder [5], making it difficult to evaluate scientific articles and to compare the results of different treatment regimens. Quite often, the terms “tendinitis” and “tendonitis” are used [19], [20], [21], [22], despite the absence of scientific

Recent research on pathogenesis

It is well known that in vivo investigations of metabolic events in human tendons are difficult to perform, and therefore, there is relatively sparse knowledge about the normal and injured tendon. In situ microdialysis has been shown to be a useful technique to study metabolism of substances in different types of human tissue [27], [28], but the method had, to our knowledge, never before been used in human tendon tissue. The microdialysis technique allows continuous measurements of

Treatment

A chronic painful condition in the Achilles tendon is associated with a huge variety of proposed treatment regimens. It is important to know that there is sparse scientific evidence for most of the conservative and surgical treatments proposed and used. The few scientific prospective studies, and the absence of studies comparing different types of conservative and surgical treatment regimens in a randomized manner, are major disadvantages when evaluating the effects of specific treatment

Summary

Chronic painful midportion Achilles tendinosis has been known as a difficult condition to treat, and surgical treatment was often needed. In recent scientific studies, however, treatment with painful eccentric calf muscle training has shown very good short-term clinical results and significantly reduced the need for surgical treatment. Also, very recently, a new method consisting of sclerosing of neovessels in the area with painful tendinosis showed promising short-term results. Ongoing and

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    • Physical modalities with eccentric exercise are no better than eccentric exercise alone in the treatment of chronic achilles tendinopathy: A systematic review and meta-analysis

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      The encouraging results of PMEE might have been due to the proactive resolution and downregulation of inflammatory bio-markers found in chronic AT [3,17]. Physical modalities and eccentric exercises have been regularly used in the management of individuals with AT as an effective approach owing to its non-invasive nature and fast recovery potential [11,13]. Various systematic reviews have shown the effectiveness of eccentric exercises in mid-portion AT, evidence is still lacking if physical modalities can serve as an ideal adjunct for all types of AT [18,19,20].

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      Achilles Tendinopathy (AT) was described as a common overuse injury of the lower limb and one of the most prevalent conditions in athletes as well as in the general population (Hakan Alfredson, 2003).

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