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Review
. 2017 Dec;4(1):18.
doi: 10.1186/s40634-017-0092-6. Epub 2017 May 30.

Current trends in tendinopathy: consensus of the ESSKA basic science committee. Part I: biology, biomechanics, anatomy and an exercise-based approach

F Abat  1 , H Alfredson  2   3   4 , M Cucchiarini  5 , H Madry  6 , A Marmotti  7 , C Mouton  8 , J M Oliveira  9   10 , H Pereira  11   12   13 , G M Peretti  14 , D Romero-Rodriguez  15   16 , C Spang  17 , J Stephen  18   19 , C J A van Bergen  20 , L de Girolamo  21
Affiliations
Review

Current trends in tendinopathy: consensus of the ESSKA basic science committee. Part I: biology, biomechanics, anatomy and an exercise-based approach

F Abat et al. J Exp Orthop. 2017 Dec.

Abstract

Chronic tendinopathies represent a major problem in the clinical practice of sports orthopaedic surgeons, sports doctors and other health professionals involved in the treatment of athletes and patients that perform repetitive actions. The lack of consensus relative to the diagnostic tools and treatment modalities represents a management dilemma for these professionals. With this review, the purpose of the ESSKA Basic Science Committee is to establish guidelines for understanding, diagnosing and treating this complex pathology.

Keywords: Consensus; ESSKA; Eccentric; Tendinopathy; Tendon; Treatment.

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Figures

Fig. 1
Fig. 1
An example of an Achilles tendon loaded to failure in isolation, displaying three distinct regions in response to the tensile loading
Fig. 2
Fig. 2
Insertional patellar tendinopathy confirmed with high definition gray-scale US. Longitudinal (a) and transversal view (b) of an injured patellar tendon. The proximal patellar tendon has hypoechoic zones (*) and the color-doppler analysis shows intensive hypervascularization (arrow)
Fig. 3
Fig. 3
Site of clinical complaints (a) and MRI (b) correlation of most relevant Achilles pathology sites. Mid-portion Achilles tendinopathy (red brackets); retrocalcaneal bursitis (yellow arrow); insertional achilles tendinopathy and superficial bursitis (blue arrow). MRI sagittal view (b) demonstrating Achilles tendon enlargement and signal changings (*)
Fig. 4
Fig. 4
Exercises for a sports player suffering from tendinopathy must introduce actions from general orientation (a) to more functional tasks (b and c). In all these exercises, the load is more concentrated on the patellar tendon, working unilaterally with inertial resistance to emphasize in the eccentric work and the eccentric – concentric transition as well
Fig. 5
Fig. 5
The assessment of the therapeutic and return to play processes must be as specific as possible. Figures (a) and (b) shows the study of leg asymmetries in a change of direction task (c). Jumping action with a contact platform (d) and assessment of speed displacement using photoelectric cells (e) are also examples of functional tests. Data was obtained by using the Chronojump and SmartCoach software packages
See this image and copyright information in PMC

References

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