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Journal of Athletic Training May 2020Achilles tendinopathy is a painful overuse injury that is extremely common in athletes, especially those who participate in running and jumping sports. In addition to... (Review)
Review
Achilles tendinopathy is a painful overuse injury that is extremely common in athletes, especially those who participate in running and jumping sports. In addition to pain, Achilles tendinopathy is accompanied by alterations in the tendon's structure and mechanical properties, altered lower extremity function, and fear of movement. Cumulatively, these impairments limit sport participation and performance. A thorough evaluation and comprehensive treatment plan, centered on progressive tendon loading, is required to ensure full recovery of tendon health and to minimize the risk of reinjury. In this review, we will provide an update on the evidence-based evaluation, outcome assessment, treatment, and return-to-sport planning for Achilles tendinopathy. Furthermore, we will provide the strength of evidence for these recommendations using the Strength of Recommendation Taxonomy system.
Topics: Achilles Tendon; Athletic Injuries; Conservative Treatment; Cumulative Trauma Disorders; Exercise Therapy; Humans; Pain; Return to Sport; Running; Tendinopathy
PubMed: 32267723
DOI: 10.4085/1062-6050-356-19 -
Journal of Athletic Training Jul 2022Patellar tendinopathy is a common yet misunderstood condition that afflicts a variety of patient populations. This lack of understanding affects the ability of... (Review)
Review
Patellar tendinopathy is a common yet misunderstood condition that afflicts a variety of patient populations. This lack of understanding affects the ability of clinicians to provide effective treatment interventions. Patients with tendinopathy often report long-term and low to moderate levels of pain, diminished flexibility, and reduced strength, as well as decreased physical function. Load-management strategies combined with exercise regimens focused on progressive tendon loading are the most effective treatment options for patients with patellar tendinopathy. This review will provide an evidence-based approach to patellar tendinopathy, including its pathoetiology, evaluation, and treatment strategies.
Topics: Humans; Patellar Ligament; Tendinopathy; Patella; Treatment Outcome; Pain
PubMed: 34623447
DOI: 10.4085/1062-6050-0049.21 -
Journal of Orthopaedic Research :... Jun 2015Tendinopathy and tendon rupture are common and disabling musculoskeletal conditions. Despite the prevalence of these injuries, a limited number of investigators are... (Review)
Review
Tendinopathy and tendon rupture are common and disabling musculoskeletal conditions. Despite the prevalence of these injuries, a limited number of investigators are conducting fundamental, basic science studies focused on understanding processes governing tendinopathies and tendon healing. Development of effective therapeutics is hindered by the lack of fundamental guiding data on the biology of tendon development, signal transduction, mechanotransduction, and basic mechanisms underlying tendon pathogenesis and healing. To propel much needed progress, the New Frontiers in Tendon Research Conference, co-sponsored by NIAMS/NIH, the Orthopaedic Research Society, and the Icahn School of Medicine at Mount Sinai, was held to promote exchange of ideas between tendon researchers and basic science experts from outside the tendon field. Discussed research areas that are underdeveloped and represent major hurdles to the progress of the field will be presented in this review. To address some of these outstanding questions, conference discussions and breakout sessions focused on six topic areas (Cell Biology and Mechanics, Functional Extracellular Matrix, Development, Mechano-biology, Scarless Healing, and Mechanisms of Injury and Repair), which are reviewed in this special issue and briefly presented in this review. Review articles in this special issue summarize the progress in the field and identify essential new research directions.
Topics: Animals; Humans; Tendinopathy; Tendon Injuries; Tendons; Wound Healing
PubMed: 25764524
DOI: 10.1002/jor.22869 -
BioMed Research International 2019Extracorporeal shock wave therapy (ESWT) is among the conservative treatments for Achilles tendinopathy. Unfortunately, no optimal application parameters have been... (Review)
Review
Extracorporeal shock wave therapy (ESWT) is among the conservative treatments for Achilles tendinopathy. Unfortunately, no optimal application parameters have been determined that would ensure ESWT effectiveness in this condition. The aim of the paper is to use research reports on ESWT in patients with Achilles tendinopathy to help practising physiotherapists establish the most effective intervention parameters. A search was conducted using the following databases: PubMed, Scopus, EBSCOhost, and Web of Science. The papers were checked for relevant content and were included based on the following criteria: full-text article published in English and including comprehensive description of shock wave application. Twenty-two articles met the inclusion criteria. Most studies on the effectiveness of ESWT for Achilles tendinopathy included in this narrative review were randomized controlled trials. Two case-control studies, a case series study, prospective audit, clinical trial protocol, and a pilot study were also considered. The majority were prospective studies. Only a few authors presented the findings from retrospective observations. The two modalities of shock wave therapy used for Achilles tendinopathy are focused shock waves and radial shock waves. The literature contains reports presenting mainly beneficial effects of ESWT in patients with Achilles tendinopathy.
Topics: Achilles Tendon; Extracorporeal Shockwave Therapy; High-Energy Shock Waves; Humans; Tendinopathy; Treatment Outcome
PubMed: 31950037
DOI: 10.1155/2019/3086910 -
Journal of Physiotherapy Sep 2014
Review
Topics: Disease Management; Female; Humans; Male; Patellar Ligament; Physical Therapy Modalities; Prevalence; Prognosis; Risk Factors; Tendinopathy; Treatment Outcome
PubMed: 25092419
DOI: 10.1016/j.jphys.2014.06.022 -
Journal of Rehabilitation Medicine Oct 2019To conduct a systematic review and meta-analysis to identify risk and associated factors for symptomatic rotator cuff tendinopathy. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To conduct a systematic review and meta-analysis to identify risk and associated factors for symptomatic rotator cuff tendinopathy.
DATA SOURCES
PubMed, CINAHL and Scopus were searched from inception to June 2017.
STUDY SELECTION
Participants presented with signs and symptoms suggestive of rotator cuff tendinopathy/tendinosis/tendinitis, shoulder impingement syndrome, or subacromial bursitis diagnosed by clinical tests and/or conventional imaging.
DATA EXTRACTION
Screening, quality assessment and data extraction were carried out by 2 reviewers.
DATA SYNTHESIS
Sixteen studies were included in this review. Overall, 22 factors were identified and 5 factors were explored using meta-analysis. Pooled analyses provided strong evidence that age above 50 years (odds ratio (OR)?=?3.31, 95% confidence interval (95% CI)?=?2.304.76, I2?=?0%, p<0.001) and diabetes (OR?=?2.24, 95% CI?=?1.373.65, I2?=?0%, p?=?0.001) were associated with increased risk of rotator cuff tendinopathy. In addition, moderate evidence showed that work with the shoulder above 90° was associated with increased risk of rotator cuff tendinopathy (OR?=?2.41, 95% CI?=?1.314.45, I2=?83%, p?=?0.005).
CONCLUSION
Age above 50 years, diabetes and overhead activities were associated with increased risk of rotator cuff tendinopathy.
Topics: Female; Humans; Male; Middle Aged; Risk Factors; Rotator Cuff; Tendinopathy
PubMed: 31489438
DOI: 10.2340/16501977-2598 -
Acta Bio-medica : Atenei Parmensis Jan 2018Rotator cuff calcific tendinopathy (RCCT) is a very common condition caused by the presence of calcific deposits in the rotator cuff (RC) or in the... (Review)
Review
Rotator cuff calcific tendinopathy (RCCT) is a very common condition caused by the presence of calcific deposits in the rotator cuff (RC) or in the subacromial-subdeltoid (SASD) bursa when calcification spreads around the tendons. The pathogenetic mechanism of RCCT is still unclear. It seems to be related to cell-mediated disease in which metaplastic transformation of tenocytes into chondrocytes induces calcification inside the tendon of the RC. RCCT is a frequent finding in the RC that may cause significant shoulder pain and disability. It can be easily diagnosed with imaging studies as conventional radiography (CR) or ultrasound (US). Conservative management of RCCT usually involves rest, physical therapy, and oral NSAIDs administration. Imaging-guided treatments are currently considered minimally-invasive, yet effective methods to treat RCCT with about 80% success rate. Surgery remains the most invasive treatment option in chronic cases that fail to improve with other less invasive approaches.
Topics: Arthroscopy; Calcinosis; Conservative Treatment; Extracorporeal Shockwave Therapy; Humans; Rotator Cuff; Tendinopathy
PubMed: 29350647
DOI: 10.23750/abm.v89i1-S.7022 -
Seminars in Musculoskeletal Radiology Oct 2022Rotator cuff pathology is a commonly encountered clinical and radiologic entity that can manifest as tendinopathy or tearing. Magnetic resonance imaging (MRI) and...
Rotator cuff pathology is a commonly encountered clinical and radiologic entity that can manifest as tendinopathy or tearing. Magnetic resonance imaging (MRI) and ultrasonography offer similar sensitivity and specificity for the evaluation of the native rotator cuff, and the chosen modality may vary, depending on local practice and accessibility. MR arthrography is frequently used in the postoperative setting as a problem-solving tool. Key findings to include in the preoperative MRI report include the size and location of the tear, thickness of the tendon involved (partial versus full thickness), and overall tendon quality. The report should also address features associated with poor surgical outcomes, such as fatty atrophy, a decreased acromiohumeral interval, and evidence of rotator cuff arthropathy. Musculoskeletal radiologists should be familiar with the various surgical techniques and expected postoperative imaging appearance of rotator cuff repairs. Imaging also plays a role in identifying recurrent tearing, graft failure, hardware loosening, infection, and other complications.
Topics: Humans; Rotator Cuff Injuries; Rotator Cuff; Magnetic Resonance Imaging; Tendons; Tendinopathy; Treatment Outcome
PubMed: 36535594
DOI: 10.1055/s-0042-1756167 -
Journal of Orthopaedics and... Mar 2016Calcific tendinitis is a painful shoulder disorder characterised by either single or multiple deposits in the rotator cuff tendon. Although the disease subsides... (Review)
Review
Calcific tendinitis is a painful shoulder disorder characterised by either single or multiple deposits in the rotator cuff tendon. Although the disease subsides spontaneously in most cases, a subpopulation of patients continue to complain of pain and shoulder dysfunction and the deposits do not show any signs of resolution. Although several treatment options have been proposed, clinical results are controversial and often the indication for a given therapy remains a matter of clinician choice. Herein, we report on the current state of the art in the pathogenesis, diagnosis and treatment of calcific tendinitis of the rotator cuff.
Topics: Arthroscopy; Calcinosis; Diagnostic Imaging; Humans; Rotator Cuff; Shoulder Joint; Tendinopathy; Tendons
PubMed: 26163832
DOI: 10.1007/s10195-015-0367-6 -
Journal of Foot and Ankle Research Sep 2020Tendinopathies are challenging conditions frequent in athletes and in middle-aged overweight patients with no history of increased physical activity. The term... (Review)
Review
Tendinopathies are challenging conditions frequent in athletes and in middle-aged overweight patients with no history of increased physical activity. The term "tendinopathy" refers to a clinical condition characterised by pain, swelling, and functional limitations of tendons and nearby structures, the effect of chronic failure of healing response. Tendinopathies give rise to significant morbidity, and, at present, only limited scientifically proven management modalities exist. Achilles and patellar tendons are among the most vulnerable tendons, and among the most frequent lower extremity overuse injuries. Achilles and patellar tendinopathies can be managed primarily conservatively, obtaining good results and clinical outcomes, but, when this approach fails, surgery should be considered. Several surgical procedures have been described for both conditions, and, if performed well, they lead to a relatively high rate of success with few complications. The purpose of this narrative review is to critically examine the recent available scientific literature to provide evidence-based opinions on these two common and troublesome conditions.
Topics: Achilles Tendon; Arthroscopy; Disease Management; Humans; Patellar Ligament; Tendinopathy
PubMed: 32993702
DOI: 10.1186/s13047-020-00418-8