Virtual Didactic - Achilles Tendinopathy: From Basic Tendon Concepts to Novel Treatments presented by Stephen Schaaf, MD-Virtual Didactic-Achilles Tendinopathy: From Basic Tendon Concepts to Novel Treatments Led by Stephen Schaaf, MD

Virtual Didactic-Achilles Tendinopathy: From Basic Tendon Concepts to Novel Treatments Led by Stephen Schaaf, MD

Video Transcription

Video Summary

In this video, Dr. Steve Schaaf discusses Achilles tendinopathy from basic tendon concepts to novel treatments. He explains that tendinopathy is a clinical syndrome of tendon-related pain and impaired performance. It can be further broken down into tendinitis and tendinosis, with tendinosis being the more common form. Risk factors for Achilles tendinopathy include training errors, such as sudden increases in mileage or intensity, biomechanical malalignments like forefoot hyperpigmentation, and extrinsic factors like improper footwear. The diagnosis of Achilles tendinopathy is made based on clinical presentation, including pain in the Achilles tendon area worsened by loading, and findings on physical examination, such as thickening and tenderness of the tendon. Imaging modalities, including x-ray, MRI, and ultrasound, can help confirm the diagnosis and estimate severity. The standard of care for Achilles tendinopathy is eccentric heavy loading physical therapy, which encourages healing and improves tendon fiber orientation and muscle strength. This involves three sets of 15 slow repetitions of eccentric unilateral loading, performed twice a day for three months. Dr. Schaaf also discusses other treatment options such as topical nitroglycerin patches, extracorporeal shockwave therapy, interventional techniques like percutaneous sonographically guided tendon scraping, high volume image-guided injections, and percutaneous ultrasonic tenotomy. Surgical options are also available if conservative treatments fail. Dr. Schaaf concludes by providing a few board-relevant questions and answering them. He also invites viewers to contact him for any further questions or discussion.

Keywords

Achilles tendinopathy

tendon-related pain

impaired performance

tendinitis

tendinosis

risk factors

diagnosis

imaging modalities

treatment options

surgical options