Achilles
tendinopathy - open debate
Madalina-Victoria
Ovricenco
Sport
Club ,,Dinamo” Bucharest, Department of Sport Medicine
Abstract
Although
Achilles tendon problems are very
common among athletes, the
terminology, etiopathogeny and the correlation between
histopathological alterations, imaging methods and surgical findings
are still subject for debate. Nowadays, the combination of pain,
swelling and impaired performance indicates the clinical diagnosis of
tendinopathy with its histopathological entities peritendinitis and
tendinosis. The chronic form of Achilles tendinopathy is not
an
inflammatory condition. The diagnosis of tendinopathy is assisted by
the presence of imaging abnormalities but can also exist in
athletes without symptoms. Rehabilitation, focused on kinetotherapy,
must be directed at the entire limb and consists of a combination of
strategies concerning limb malalignement, decreased flexibility and
muscle weakness. Eccentric training is superior to concentric
training both in decreasing pain in chronic stages and in direct
counter-attack of the healing response failure by increasing collagen
I formation. Surgery has been considered an acceptable choice among
athletes with chronic Achilles tendinopathy after the attempts for
conservative therapy have failed.
Key
words:
tendinopathy, inflammation,
neovascularisation,
eccentric training.