{"id":1346,"date":"2018-07-06T09:55:39","date_gmt":"2018-07-05T23:55:39","guid":{"rendered":"https:\/\/melbournefootclinic.com.au\/?p=1346"},"modified":"2023-10-27T16:04:47","modified_gmt":"2023-10-27T05:04:47","slug":"tendinopathy","status":"publish","type":"post","link":"https:\/\/melbournefootclinic.com.au\/tendinopathy\/","title":{"rendered":"Lower Limb Tendinopathy \u2013 What You Don\u2019t Know"},"content":{"rendered":"
Lower Limb Tendinopathy is a common problem across a broad age range and a major cause of\u00a0frustration and pain.<\/p>\n
Tendinopathy presents in the lower leg in the Achilles tendon and the Posterior Tibial Tendon.\u00a0 The Plantar Fascia is not strictly a tendon but it can\u00a0behave much like a chronic tendon injury.<\/p>\n
Tendinopathy can be a painful, time consuming and ongoing problem that can limit exercise and work. In the past tendinopathy has been poorly understood by health professionals.\u00a0 This has resulted in several incorrect treatment modalities and management strategies being implemented. The most common misconception is that chronic tendinopathy is an inflammatory issue. Although there may be some inflammatory cells present in a chronically injured tendon, the current research indicates this is not the primary source of pain and loss of function (more on this later).<\/p>\n
The thought that inflammation is present is why you may have heard terms like Achilles Tendonitis and Plantar Fasciitis. Terminology describing something with \u201citis\u201d implies inflammation. So historically, a lot of the failed treatments have focused at treating inflammation as a source. This may include complete rest, icing, ultrasound treatment, frictional massage, stretching and anti-inflammatory medications.<\/p>\n
Tendinopathy can be defined as a condition where overuse and excessive loading causes extensive changes to tendon cells and breakdown of collagen fibres within the tendon. The change in structure of the tendon creates an environment where water molecules are attracted to the tendon.\u00a0 This causes swelling – usually without inflammatory cells.\u00a0 In a chronically overloaded tendon, this can lead to permanent tendon damage and a degenerative tendon can result.<\/p>\n
Factors such as a recent change in activity level \u2013 both increase and\/or decrease in activity, poor biomechanics, footwear, age, medications, medical and injury history can contribute to an increased risk of tendon injury.<\/p>\n
We can see the difference between a normal Achilles tendon (Left) and an Achilles with tendinopathy (Right). The normal one shows well-defined margins and a tight bundle of longitudinal collagen fibres. The tendinopathy image shows the fibres arranged more loosely than a healthy tendon and with visible swelling as water molecules enter the spaces available to them. This arrangement is not as structurally sound compared to a healthy tendon and less likely to handle the demands placed upon it.<\/p>\n