* This podcast is AI-generated. I offer it to you because it presents the content in a casual conversational way. I hope you enjoy listening to it… and learn. 😊
– Dr. Joe Muscolino .
Purchase the E-booklet HERE.
To access complete education content on the Achilles Tendon Disorder
CLICK HERE!
Study Guide
Short-Answer Quiz:
- What muscles make up the triceps surae group, and what is their primary action?
- Explain how both overuse and overstretching can contribute to Achilles tendinitis.
- What is the difference between Achilles tendinitis and Achilles tendinosus?
- Describe the location and function of the subcutaneous and subtendinous bursae in relation to the Achilles tendon.
- What factors increase the likelihood of an Achilles tendon rupture?
- Describe the signs and symptoms a patient might present with if they have Achilles tendinitis.
- Explain the Achilles tendon pinch test and what a positive result indicates.
- What does the triceps surae squeeze test (Thompson test) assess, and how is it performed?
- Summarize the manual therapy treatment protocol for Achilles tendinitis during the acute stage.
- What self-care advice should be given to a patient with Achilles tendinitis?
Short-Answer Quiz: Answer Key
- The triceps surae group consists of the gastrocnemius (with its medial and lateral heads) and the soleus muscles. Their primary action is plantarflexion of the foot at the ankle joint.
- Overuse, like excessive walking or running, causes repetitive micro-traumas to the tendon, leading to inflammation. Overstretching, particularly during activities like squatting with heavy weight, strains the tendon fibers.
- Achilles tendinitis is characterized by inflammation of the tendon, while Achilles tendinosus involves degeneration of the tendon’s collagen matrix without significant inflammation.
- The subcutaneous bursa lies between the skin and the Achilles tendon, while the subtendinous bursa sits between the tendon and the calcaneus. Both bursae reduce friction during movement.
- Factors include: Age (middle-aged individuals), lack of flexibility, inadequate warm-up, degenerated collagen (tendinosus), and a previous history of Achilles tendinitis or tendinosus.
- Pain at the Achilles tendon (especially during activity or palpation), swelling, warmth, crepitus, decreased dorsiflexion range of motion, pain with resisted plantarflexion, and potential antalgic gait.
- The therapist pinches the Achilles tendon above the bursae. Pain indicates a positive test, suggesting tendinitis, paratendinitis, or potentially bursitis if performed lower.
- It assesses for Achilles tendon rupture. With the patient prone and the foot relaxed, the therapist squeezes the calf muscles. Absence of plantarflexion suggests a rupture.
- The focus is on reducing inflammation: RICE (Rest, Ice, Compression, Elevation), gentle distal-to-proximal effleurage, and possibly light stretching depending on severity.
- RICE during the acute phase, gentle stretching of the calf muscles (both gastrocnemius and soleus), proper warm-up before activities, and gradual reintroduction of activity.
Essay Questions:
- Discuss the role of biomechanics in the development of Achilles tendon disorders, considering factors like gait cycle, footwear, and muscle imbalances.
- Compare and contrast the treatment approaches for Achilles tendinitis, tendinosus, and tendon rupture, highlighting the rationale behind each method.
- Explain the concept of neural cross-over and its application in the management of Achilles tendon disorders.
- Describe the importance of patient education in the prevention and management of Achilles tendon disorders, outlining key advice for activity modification, footwear, and self-care.
- Analyze the potential long-term consequences of untreated or poorly managed Achilles tendon disorders, considering the impact on mobility, function, and quality of life.
Glossary of Key Terms:
- Achilles Tendinitis: Inflammation of the Achilles tendon, commonly caused by overuse or repetitive strain.
- Achilles Tendinosus: Degenerative condition of the Achilles tendon, characterized by collagen breakdown and a lack of inflammation.
- Achilles Tendon Rupture: Complete or partial tear of the Achilles tendon, often due to sudden, forceful contraction.
- Antalgic Gait: Altered walking pattern to avoid pain, often characterized by a limp.
- Bursa: Fluid-filled sac that reduces friction between tendons, muscles, and bones.
- Calcaneus: Heel bone.
- Collagen: A fibrous protein that provides strength and structure to connective tissues like tendons.
- Crepitus: Grating, crackling, or popping sound and/or sensation felt during movement.
- Dorsiflexion: Bending the foot upwards towards the shin.
- Eccentric Contraction: Muscle lengthening under tension.
- Effleurage: A type of massage involving long, gliding strokes.
- Fibroblasts: Cells that produce collagen and other fibers, crucial for tissue repair.
- Gastrocnemius: Calf muscle with two heads, responsible for plantarflexion and knee flexion.
- Hypertonicity: Excessive muscle tension or tightness.
- Inflammation: The body’s natural response to injury or irritation, characterized by redness, swelling, pain, and heat.
- Joint Mobilization: Manual therapy techniques to restore joint movement and reduce pain.
- Myofascial Trigger Point: Hyperirritable spot in a muscle that refers pain to other areas.
- NSAIDs (Non-Steroidal Anti-Inflammatory Drugs): Medications like ibuprofen that reduce pain and inflammation.
- Paratenon: Connective tissue sheath surrounding the tendon.
- Paratendinitis: Inflammation of the paratenon.
- Plantarflexion: Pointing the foot downwards.
- RICE (Rest, Ice, Compression, Elevation): Standard acute injury management protocol.
- Soleus: Calf muscle located beneath the gastrocnemius, responsible for plantarflexion.
- Subcutaneous: Located beneath the skin.
- Subtendinous: Located beneath a tendon.
- Tendon: A tough band of fibrous tissue that connects muscle to bone.
- Triceps Surae: Collective term for the gastrocnemius and soleus muscles.
- Triceps Surae Squeeze Test (Thompson Test): Test for Achilles tendon rupture.