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Lower Limb Tendinoptahy

  • What do we know?
    • Tendinopathy is the new term for “tendonitis” as it has been found not to be inflammatory
    • Tendon problems are common andup to 10% of the running population may get Achilles tendinopathy
    • It is not an inflammatory condition. It is a degenerative overuse condition
    • It requires patience and persistence to resolve the tendinopathy
  • History?
    • Initially it is a problem in the morning and at the beginning of activity. As the condition worsens, the pain will interfere with and ultimately limit activity
    • The factors that lead to overuse include exercise load, poor technique/equipment and abnormal biomechanics, thus any management program must look at these factors
  • Rehabilitation
    • Eccentric exercise has been shown to be effective
    • Muscle strength/flexibility imbalance must be restored
    • Footwear and biomechanical assessment
  • Medications
    • Green tea
    • Nitrate patches
  • Adjuvant therapies
    • Polidocanol injections
    • Prolotherapy injections
    • Shockwave therapy
  • Surgery
    • 70-90% success rates. Not recommended in the initial phase of treatment
  • Don’t forget
    • Tendon problems are common to get on both sides, so treatment of the other side at the same time is recommended