Unlike many other orthopedic injuries, Achilles tendon injuries are not fully understood, which results in heavily deliberated treatment procedures. Patients often have an unpredictable outcome with respect to return to function. Over the previous fifty years, the evolution of repair surgery for the Achilles tendon has been slow and minimal; furthermore, surgical repair is unpredictable and surrounded by complications5. Regarding surgical versus non-surgical procedures, there are existing studies that propose that conservative treatment not involving surgery give results comparable to surgical repair as long as patients undergo early rehabilitative protocols as well. However, it must be noted that the same studies discuss that the re-rupture …show more content…
Within each treatment group, some of the collected tissue samples were evaluated with histology and others were used for biomechanical testing. To examine and analyze the histology results the researchers developed an JNB Tendon Repair Histologic Scoring Scale because no scale previously existed to cover the proper variables5. Ranging from zero to three, zero being normal and three being the most disorganized poorly healed tissue, the core grades cellularity, collagen fiber organization, vascularity, cell shape, cartilage surrounding suture site, and granulation tissue. As seen in Table 1, Group 4, surgically repaired and receiving doxycycline, showed the lowest histology score at the first time point and more importantly retained a low score at the second collection time point, unlike the other groups5. Since Group 2, unrepaired and receiving doxycycline, showed a high histology score at both time points, it can be concluded that the primary, suture repair is more efficient than conservative repair5. Also when comparing Group 3 - surgically repaired and not receiving doxycycline to Group 4, Group 3 experiences a massive jump in histology score; this demonstrates the effective performance of doxycycline to help with tendon repair5. Regarding biomechanical function, the researchers tested the equilibrium tensile modulus - the …show more content…
For example, the study involving doxycycline discussed earlier was merely a pilot study and, therefore, is supposed to be regarded as a preliminary analysis. This study is meant to provide important information to orient more specific future research studies. As is the case with many biomedical research studies, this experiment is done using non-human subjects to avoid unknown, potentially harmful results to be projected on humans. This fact adds to the mystery surrounding the Achilles tendon; although rats are a good model system for humans, there is a great amount of generalizability done when transferring the data and results from rats to be interpreted for humans. In terms of procedure, noteworthy discrepancies exist in the discussed study. For example, the administration of doxycycline to the rats started one day prior to the induced tendon laceration5. This is a distortion of reality because in humans we do not know when we will receive an injury to our Achilles tendon. Furthermore, the injury to the tendon in the rats was surgically induced using a knife5. Again, this is unrealistic for humans because Achilles tendon injuries do not occur naturally by way of knife but rather are usually traumatic and do not yield the same clean cut that was obtained in this study. This is important to note because the way the injury was induced could impact the healing process
Physical therapy after surgery is best to help heal tendon problems. For more serious surgeries for restorative procedures on the tendon tissue the patient is best advised to delay before going to therapy. Because of this rehabilitation can be slower to allow the tendon to fully heal before too much pressure can be put on the
Surgery may also be recommended for a tendon that is torn due to recent injury or when the tear is not a result of long-standing rotator cuff problems.
Following the cast removal, the patient must undergo a rehabilitation program in order to return to normal movement and function. Heel lifts should be immediately placed in the patient's shoes. The reason why the lifts are placed in both shoes is to relive any pressure or tension in the injured foot and in the non-injured foot to keep the person balanced and not potentially hurt the other side (tendon, hip). Because immobilizing the foot in a cast may cause joint stiffness, muscle atrophy, and blood clots, many doctors recommend an early-motion approach. This approach puts the patient in physical therapy within just a few days after the surgery. Therapy may be needed for up to 4 or 5 months. Ice, massage, and whirlpool treatments may be used at first to control swelling and pain. Massage and ultrasound help heal and strengthen the tendon. Range of motion exercises should begin while in therapy. About 2 weeks after ROM exercises have been used is when the progressive resistance exercises are added. Some of these resistance exercises can be done in the pool. The buoyancy of the water helps people walk and exercise safely without putting too much pressure or tension on the healing tendon. If the patient chooses a splint may be worn while walking for 6 to 8 weeks after the surgery. Then 10 weeks after the surgery aggressive training exercises can
With an ever increasing number of people becoming involved with athletic activities, there is an increasing number of injuries occurring which can be devastating for the individual. Most of the injuries that affect athletes occur in one of four structures in the human body: bones, muscles, tendons, or ligaments. Because ligaments attach bone to bone and play a major part in providing stability for joints, the major stabilizing ligament in the knee, the anterior cruciate ligament (ACL), assists in performing everyday actions of the human body including sitting, standing, walking, running, dancing, and participating in other sports. The injury that specifically affects this ligament is very serious and always
Achilles’ Tendon is the name of a bone in the back of the human leg, and its name comes from the only part of Achilles’ body that was a weak spot.
n ultrasound or MRI can be used to show the presence, location, and severity of the tear(s) of a disrupted tendon and also to diagnose paratenonitis, tendinosis, and bursitis
Most individuals experience one or more of these injuries throughout life according to medical and fitness experts. There are long term consequences each condition can create if the injury is not allowed to heal properly. As both adults and children participate in repetitive activities daily and from time to time damages to muscle, bone or tendons occur. It may be as simple as a strain to the muscle or tendon as a result of overusing or pushing past a certain limit of ability. The good news is most of these injuries have high recovery rates with only a few needing surgery. Like all injuries it’s always a good recommendation to seek a medical health worker for accurate advice on treatment and care.
The Achilles tendon is known to be one of the largest tendons in the body. It stretches from your calf muscle to your heel bone. It allows you to walk, run, jump and extend your foot to point your toes to the floor. The Achilles is a common injured area that can withstand a large amount of stress, but with too much stress can lead to Achilles tendonitis.
Proprioceptive rehabilitation methods look to return the ankle to its previous risk factor level, and return it to its previous function level. Scott et. al (1997) says that afferent feedback to the brain and spinal pathways is mediated by skin, articular, and muscle mechanoreceptors. Rehabilitation aims to re-establish those spinal pathways so that movements can be performed fully again. Scott et. al (1997) believes that rehabilitation programs should be designed to include a proprioceptive component that addresses the following three levels of motor control: spinal reflexes, cognitive programming, and brainstem activity. A program which is set out in this way is highly recommended to promote and return dynamic joint and functional stability. Another study, conducted by Lephart (1995), examined the role of proprioceptive training in the treatment of injuries, and also looked at recent developments in the area of proprioceptive rehabilitation methods. Lephart (1995) notes that ligaments play a major role in normal joint kinematics, providing mechanical restraint to abnormal joint movement when a stress is placed on the joint. Following injury to these tissues there is a loss of mechanical stability to the joint, resulting in changes to normal kinematics. Management of these sport-related injuries focuses on restoring joint kinematics by enhancing muscular stabilisation through rehabilitation. By restoring joint stability through rehabilitation, the athlete should be able to return to playing sport, while the chance of re-injury will be reduced. Some believe that rehabilitation of ankle injuries should be set and individualised for each athlete as no athlete or injury is the same, and react differently to different exercises. Carl (2002) said that in the acute phase, the focus should be on controlling the inflammation and once pain is gone and
Tendinopathy is defined as the enlargement of the tendon with the absence of inflammation (Andia). The symptoms of tendinopathy manifest when the rate of healthy tenocyte proliferation and extracellular matrix (ECM) formation is surpassed by the rate of tissue degeneration. Because of its prevalence among athletes and non-athletes alike, tendinopathy is widely studied with the leading research focused on cell apoptosis, angiogenesis that has escaped cell control, or inflammation and pain (joseph).2 Despite these efforts, very few effective treatments exist for it.
Achilles tendonitis is an overuse injury caused by inflammation. This injury is not to be confused with Achilles tendon rupture, which is a much more painful and sudden injury that requires immediate medical attention. Other causes of Achilles tendonitis are poor bike fit and improper position of shoe cleats.
The article I read discussed the differing methods of treating muscle, tendon, joint, and ligament injuries in athletes. It highlighted four different techniques that have become more popular in the last 30 years.
The surgical management of acute Achilles tendon rupture includes percutaneous repair or open repair and is typically the preference of the orthopedic surgeon and the patient (Longo, Petrillo, Maffulli, & Denaro, 2013). Surgical repair of the Achilles tendon permits the surgeon to physically reduce the distance between the ruptured tendon ends, which allows for decreased scar tissue formation and increased tendon healing (Cooper, 2015). For the past two decades, surgical repair has been mainly reserved for athletes, patients who are younger in age, and patients who delayed seeking treatment for a previous rupture (Longo, Petrillo, Maffulli, & Denaro, 2013). It is recommended that physicians be judicious with surgical treatment in patients with diabetes, neuropathy, and peripheral vascular disease
There are twenty-three different sports injuries. the first one on the list would be an achilles tendon injury. The achilles is the biggest tendon in your body, it is very common for this tendon to get injured. The tendon gets injured in the following sports such as basketball, baseball, softball, football, soccer, tennis, volleyball, running, dancing, and gymnastics.
Foot injuries are very common in athletics as well as in everyday life. It’s very debilitating to have a foot injury since we use our feet in all of our daily activities. Research published in "Medicine and Science in Sports and Exercise” indicates that the average adult takes between 5,000 to 7,000 steps a day. Some sports require the most dedicated athletes spend multiple hours a day pounding their feet on the turf or pavement. Most injuries that occur in the foot require a person to try and stay off of it or completely immobilize it. Since this is very difficult for a person to do, a large percentage of foot injuries often have a very high chance of reoccurring. The severity of some injuries that can be deceiving as well. Often times a nagging pain is ignored and eventually becomes a much bigger problem.