COMMON SPORTS MEDICINE CONDITIONS

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Location

The Achilles tendon transmits the muscular force of the calf to the foot, moving the body forward in running, jumping, skipping etc. Excessive and repetitive overload of the Achilles tendon leads to tendinopathy, typically as a result of intense and sustained running in training, recreational or competitive sports such as football in which running is a major element.

Symptoms

There will typically be a gradual increase in pain and stiffness, particularly after sleep, which may reduce with walking or applying heat. The pain may subside during training only to reoccur at rest. Left untreated the problem will progress, becoming persistent and affect everyday living.

Diagnosis

Physical examination will identify palpable tenderness with thickening and sometimes palpable nodules at the Achilles tendon. Diagnosis may be confirmed using Ultrasound or MRI scan. Diagnosis will also involve pain measurement and management.

Treatment

Initially, conservative treatment may be recommended, using a combination of strategies which may control inflammation, identify and help correct limb malalignment, tackle injurious training methods and poor equipment, and strengthen contributory muscle weakness. Orthotics combined with a programme of stretching exercises, for example, can reduce the strain on the Achilles tendon, improving mobility. Corticosteroid and other anti-inflammatory injections may also be helpful but there is a risk of tendon rupture. Cryotherapy may also be useful for short-term pain relief.

If the patient does not respond to conservative management, surgery may be considered. For chronic Achilles tendon injuries, surgery involves incision of the paratenon sheath around the tendon, release of adhesions, removal of any degenerative tissue and repair of partial tears, followed by an individualised rehabilitation programme over several months.

Further help:

Achilles tendon treatments
www.wellingtonfootandankleunit.com/ankle-achilies.asp

Rehabilitation programmes
www.thewellingtonrehabunit.com/conditions-restoration.asp