Achilles tendinopathy

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.