Biomechanics: Achilles Tendinopathy Essay

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Achilles tendinopathy and its contributing pathologies has been a heavily researched topic throughout multiple professions. Although a unified consensus and classification on the underlying pathology is yet to be reached, a shift from the term tendinitis to tendinosis has slowly been adopted, and is now believed to follow a continuum. Previous incorrect belief of an inflammatory pathophysiology has lead to the development of treatment options that are inappropriate and unsuccessful, leaving the tendon unable to adequately heal or strengthen increasing its risk of repetitive re-injury and the development of chronic Achilles tendinopathy. As a result an understanding of the pathophysiology, its effect on lower limb function and biomechanical …show more content…
2004). Healing and re-injury is believed to follow a continuum, with a chronic overuse tendon classified as being in the disrepair and/or degenerative tendinopathy stages. These two stages will display similar pathophysiology, with the level of damage and disruption being the distinguishing marker (Cook & Purdam, 2009).

The disrepair stage is described as the tendons attempt to heal its self during continual excessive loading. During this stage breakdown of the matrix occurs as increased numbers of chondrocytic and assomemyofibroblast cells appear resulting in increased cartilage and protein production, this can result in separation of collagen fibers further disorganizing the matrix. Tendons in this stage are thick with increasing stiffness. These changes can appear in very localized areas of then tendon and not necessary encompass the whole tendon. Some reversibility from this pathology is possible (Cook & Purdam, 2009).

During the degenerative stage there is greater amounts of ground substance and further destruction to the matrix with disruption of parallel collagen bundles and their hierarchical arrangement. Vascularization, matrix breakdown products and small amounts of collagen begin to fill areas of cell death. When the tendon reaches this stage of degeneration there is a greater risk of rupture due to its lack of tensile strength. These tendons may display generalised thickening with one or more focal

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