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Tendinopathy And (Physical Therapy Or Exercise Or Manual Therapy)

Alyssa Neph, Kentaro Onishi, James H-C Wang
Tendinopathy carries a large burden of musculoskeletal disorders seen in both athletes and aging population. Treatment is often challenging, and progression to chronic tendinopathy is common. Physical therapy, NSAIDs, and corticosteroid injections have been the mainstay of treatment but are not optimal given that most tendon disorders appear to involve degenerative changes in addition to inflammation. The field of regenerative medicine has taken the forefront, and various treatments have been developed and explored including prolotherapy, platelet rich plasma (PRP), stem cells, and percutaneous ultrasonic tenotomy...
November 14, 2018: American Journal of Physical Medicine & Rehabilitation
Raul Zini, Manlio Panascì
Injuries of the rectus femoris tendon origin could result in a chronic tendinopathy, leading to groin pain and loss of function. Conservative treatment with analgesics and physical therapy is the gold standard, but in some cases excessive bone formation after avulsion injuries, can lead to a post-traumatic heterotopic ossification (PHO) and may benefit from surgical removal. METHODS: Outcome was evaluated in 16 top soccer players (age 24-43 years) affected by calcification of the proximal rectus who underwent arthroscopic excision (6-12 and 24 months)...
November 2018: Injury
Liang Cheng, Shuwan Chang, Li Qian, Yayi Wang, Ming Yang
BACKGROUND: The aim of this study was to explore the efficacy of 16 weeks of extracorporeal shockwave therapy in athletes with patellar tendinopathy. METHODS: Athletes with patellar tendinopathy were matched for age, height and body weight and assigned to the experimental group (n=26) or control group (n=25). Subjects in the experimental group received 16 rounds (once per week) of extracorporeal shockwave therapy (2,000 single shocks; strength, 1.5 to 3.0 bar; shock frequency, 9 to 12 Hz)...
October 1, 2018: Journal of Sports Medicine and Physical Fitness
Collin LaPorte, Marci Vasaris, Leland Gossett, Robert Boykin, Travis Menge
Greater trochanteric pain syndrome (GTPS) is a common clinical condition that can affect a wide range of patients. Historically, the condition has been associated with trochanteric bursitis. More recently, however, a growing body of literature has demonstrated gluteus medius tendinopathy and tearing is present in many cases of GTPS. Pathology of the gluteus medius can result in significant hip pain, loss of motion, and decreased function. Affected patients characteristically have symptoms including lateral hip pain and a Trendelenburg gait, which may be refractory to conservative management such as non-steroidal anti-inflammatory drugs (NSAIDs), physical therapy, and injections...
September 22, 2018: Physician and Sportsmedicine
Nikolaos Mitsimponas, Evangelia Klouva, Dimitrios Tryfonopoulos, Anastasios Grivas, Stamatina Demiri, George Koumakis, Panagiotis Gouveris
Aromatase inhibitors (AIs) are a commonly used antihormonal therapy in the treatment of breast cancer in postmenopausal women, specifically in the treatment of hormone receptor-positive breast cancer. AI-associated tendinopathy and muscle tendon rupture is exceedingly rare. Until now, only one case with AI-associated severe tendinopathy has been reported in the medical literature, and there are no recorded cases of AI-associated muscle tendon rapture. We report three cases of postmenopausal women with hormone receptor-positive breast cancer, who experienced tendinopathy or muscle tendon rupture under antihormonal treatment with letrozole...
May 2018: Case Reports in Oncology
Gali Dar, Einat Mei-Dan
BACKGROUND: Infrapatellar strapping is a treatment technique used in various knee pathologies; however, its effect on pain and functional performance among young athletes has not been studied. OBJECTIVES: To evaluate the effect of infrapatellar strap on pain and jumping performance among young athletes diagnosed with patellar tendinopathy. STUDY DESIGN: Pre-/post-test (within-subject research design). METHODS: A total of 16 young male basketball and volleyball athletes (age range, 12-18 years) diagnosed with patellar tendinopathy were included in the study...
August 13, 2018: Prosthetics and Orthotics International
Chenqi Tang, Yangwu Chen, Jiayun Huang, Kun Zhao, Xiao Chen, Zi Yin, Boon Chin Heng, Weishan Chen, Weiliang Shen
Tendinopathy is a common disease of the musculoskeletal system, particularly in athletes and sports amateurs. In this review, we will present evidence for the critical role of inflammatory mediators and immunocytes in the pathogenesis of tendinopathy and the efficacy of current antiinflammatory therapy and regenerative medicine in the clinic. We hereby propose a hypothesis that in addition to pulling force there may be compressive forces being exerted on the tendon during physical activities, which may initiate the onset of tendinopathy...
July 2018: Journal of Orthopaedic Translation
Anthony Beutler
Physical therapy (PT) modalities are a diverse group of treatments for musculoskeletal pain. Iontophoresis, phonophoresis, kinesiology taping, laser therapy, and myofascial release are some of the most commonly used and are best considered as adjuncts to exercise. Each modality is relatively safe, but none is supported by high-quality evidence in the management of most musculoskeletal conditions. Individual patient response to such modalities is variable. Neither iontophoresis nor phonophoresis has been shown to have greater benefits for neck or back pain than supervised PT...
July 2018: FP Essentials
Soo-Hong Han, Hyung Kyung Kim, Jong-Ho Ahn, Dong Hyeon Lee, Minjung Baek, Geunhee Ye, Joong-Myung Lee, Kyunghoon Min, Chihoon Oh, Soonchul Lee
Tendinopathy, a painful condition that develops in response to tendon degeneration, is on the rise in the developed world due to increasing physical activity and longer life expectancy. Despite its increasing prevalence, the underlying pathogenesis still remains unclear, and treatment is generally symptomatic. Recently, numerous therapeutic options, including growth factors, stem cells, and gene therapy, were investigated in hopes of enhancing the healing potency of the degenerative tendon. However, the majority of these research studies were conducted only on animal models or healthy human tenocytes...
June 9, 2018: Journal of Visualized Experiments: JoVE
Amy W McDevitt, Suzanne J Snodgrass, Joshua A Cleland, Mary Becky R Leibold, Lindsay A Krause, Paul E Mintken
OBJECTIVES: To describe the outcomes of 10 patients with chronic biceps tendinopathy treated by physical therapy with the novel approach of dry needling (DN), eccentric-concentric exercise (ECE), and stretching of the long head of the biceps tendon (LHBT). METHODS: Ten individuals reporting chronic anterior shoulder symptoms (> 3 months), pain with palpation of the LHBT, and positive results on a combination of tests including active shoulder flexion, Speed's, Hawkins Kennedy, Neer, and Yergason's tests participated in this case series...
June 22, 2018: Physiotherapy Theory and Practice
Robroy L Martin, Ruth Chimenti, Tyler Cuddeford, Jeff Houck, J W Matheson, Christine M McDonough, Stephen Paulseth, Dane K Wukich, Christopher R Carcia
The Orthopaedic Section of the American Physical Therapy Association (APTA) has an ongoing effort to create evidence-based practice guidelines for orthopaedic physical therapy management of patients with musculoskeletal impairments described in the World Health Organization's International Classification of Functioning, Disability, and Health (ICF). The purpose of these revised clinical practice guidelines is to review recent peer-reviewed literature and make recommendations related to midportion Achilles tendinopathy...
May 2018: Journal of Orthopaedic and Sports Physical Therapy
A Notarnicola, G Maccagnano, M F Gallone, L Mastromauro, F Rifino, V Pesce, I Covelli, B Moretti
The physiotherapy treatment of low back pain (LBP) with physical stimulation offers different possibilities of application. Until now, the physical therapies used in LBP are laser therapy, ultrasonotherapy and currents. We conducted a clinical trial in order to verify whether shockwave therapy, which is very effective in treating tendinopathies and fracture consolidation delays, leads to clinical and electromyographic improvement in patients affected by LBP. We randomized thirty patients affected by LBP treated with shock waves (shockwave group) or a standard protocol characterized by rehabilitative exercises (control group)...
March 2018: Journal of Biological Regulators and Homeostatic Agents
Erieta Dimitrije Nikolikj-Dimitrova, Cvetanka Gjerakaroska-Savevska, Valentina Koevska, Biljana Mitrevska, Marija Gocevska, Maja Manoleva, Biljana Kalchovska-Ivanovska
BACKGROUND: Achilles tendinopathy (AT) is a pathological state resulting from repetitive loading or stress on the tendon. The article aims to evaluate the effects of the low - energy radial extracorporeal shockwave therapy (RESWT) in the treatment of the adult with chronic insertional Achilles tendinopathy (AT) after the unsuccessful conservative treatment, with 18 months follow - up evaluation. CASE REPORT: We report the case of a 55 years - old male suffering from severe right posterior heel pain for 4 months...
March 15, 2018: Open Access Macedonian Journal of Medical Sciences
José Palma, Eduardo Díaz, Sergio Islas, Julio Silva, Sergio Mella
Monoarticular tuberculosis of the wrist is a rare presentation of primary tuberculosis, being more common skeletal forms involving the spine. Extraspinal tuberculous osteomyelitis is rare and comprises only 2 to 3% of all cases of osteoarticular Mycobacterium tuberculosis infections. We present a case of a 49 years old female patient, who worked as an hospital cleaning employed without other comorbidity. After a low energy injury of the wrist she suffered pain syndrome diagnosticated as a flexor tendinopathy, managed with nonsteroidal antiinflammatory drugs and physical therapy...
October 2017: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
Guy W Nicolette, Katherine M Edenfield, Charlie Michaudet, Peter J Carek
Chronic ankle pain is relatively common in family medicine. Sequelae from lateral ankle sprains are the most common cause. Other etiologies include peroneal tendinopathy or subluxation, osteochondral injury, lateral ankle impingement, sinus tarsi syndrome, cuboid syndrome, bony stress injury, and other unusual factors. A thorough history focusing on the mechanism of injury (if traumatic) and the nature of the pain along with a targeted physical examination typically will provide the information needed to make the diagnosis...
February 2018: FP Essentials
Vito Chianca, Domenico Albano, Carmelo Messina, Federico Midiri, Giovanni Mauri, Alberto Aliprandi, Michele Catapano, Lorenzo Carlo Pescatori, Cristian Giuseppe Monaco, Salvatore Gitto, Anna Pisani Mainini, Angelo Corazza, Santi Rapisarda, Grazia Pozzi, Antonio Barile, Carlo Masciocchi, Luca Maria Sconfienza
Rotator cuff calcific tendinopathy (RCCT) is a very common condition caused by the presence of calcific deposits in the rotator cuff (RC) or in the subacromial-subdeltoid (SASD) bursa when calcification spreads around the tendons. The pathogenetic mechanism of RCCT is still unclear. It seems to be related to cell-mediated disease in which metaplastic transformation of tenocytes into chondrocytes induces calcification inside the tendon of the RC. RCCT is a frequent finding in the RC that may cause significant shoulder pain and disability...
January 19, 2018: Acta Bio-medica: Atenei Parmensis
Patric Scheidegger, Lukas Weisskopf, Anja Hirschmüller
Issue: Lower extremity tendon injuries often occur in physically active individuals. Most ruptures not involving great force are diagnosed in patients presenting underlying tendon degenerations. This also applies to patients taking medications because of a disease. We have observed several cases of bilateral Achilles tendon ruptures in patients who have been taking cortisone for a long period. We treated a healthy colleague (neurologist) in our clinic who sustained ruptures of the Achilles tendon on the left side (2012) and the peroneus brevis tendon on left side (2015) and right side (2016) after minimal traumata...
2017: SAGE Open Medical Case Reports
Emily B Beyer, Elena J Jelsing, Wendy J Hurd
A 40-year-old man presented to a physician for knee pain when squatting and in resisted knee extension. The initial diagnosis was patellar tendinopathy. Following physical therapy treatment, a sports medicine physician was consulted for a second opinion. Radiography, diagnostic ultrasound, and magnetic resonance imaging were performed, confirming the original diagnosis and revealing Hoffa's fat pad impingement secondary to an ununited ossicle. J Orthop Sports Phys Ther 2017;47(11):885. doi:10.2519/jospt.2017...
November 2017: Journal of Orthopaedic and Sports Physical Therapy
Rachel J Shakked, Steven M Raikin
Insertional Achilles tendinopathy is a degenerative enthesopathy associated with pain and dysfunction. Nonsurgical management is first attempted for a period of 3 to 6 months and may consist of physical therapy with eccentric training and other modalities. Surgical treatment can be successful with a variety of approaches. A thorough debridement through a midline tendon-splitting approach is associated with high satisfaction rates. Flexor hallucis longus transfer to augment the repair is considered in older, heavier patients or if more than 50% of the tendon was debrided...
December 2017: Foot and Ankle Clinics
J Weber, T Buchhorn
Although the incidence of midportion Achilles tendinopathy is under 1% in the general population, it is quite a common disease in runners that is characterized by the symptom triad of pain, swelling and impaired physical performance. Pain and swelling are located in the area 2 to 7 cm proximal the tendon insertion onto the calcaneus.Diagnosis is made by adequate clinical symptoms and corresponding findings in sonography and/or magnetic resonance imaging scans. Histopathologically, mostly degenerative changes in the tendon structure are found, sometimes accompanied by intra- and paratendinous inflammation...
December 2017: Der Unfallchirurg
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