RESEARCH
K-M
Kaufman, K.R., Brodine, S.K., Shaffer, R.A.,
Johnson, C.W., Cullison, T.R. (1999). The effect of foot structure and range of motion
on musculoskeletal overuse injuries. American Journal of
Sports Medicine 27, 585–93. Key
point: injury can be caused by tight inflexible calf
muscles, and either hyper mobile flat feet or high arched
cavus chunk feet.
Note:
This was an especially
important study.
Khan, K.M., Cook,
J.L., Bonar, F., Harcourt, P., Åstrom, M.(1999). Histopathology of common tendinopathies: Update
and implications for clinical management. Sports
Medicine 27, 393–408. Key
points: a) The
vast majority of localized Achilles tendon pain cases are not
due to inflammation (Achilles tendonitis), they are due to
Achilles tendinosis, b) eccentric strengthening of the
calf muscles speeds up the recovery from Achilles tendinosis,
and c) an Achilles tendinosis recovery program should include:
relative rest, eccentric muscle strengthening, physical
therapies, and ice therapy, but not anti-inflammatory
medication or cortisone injections.
D Kader, D., Saxena, A, Movin, T, and Maffulli,
N. (2002) Achilles tendinopathy:
some aspects of basic science and clinical management. British
Journal of Sports Medicine 36, 239-249.
Key points: Achilles tendinopathy is
prevalent and potentially incapacitating in athletes involved
in running sports. It is a degenerative, not an inflammatory,
condition. Most patients respond to conservative measures if
the condition is recognized early. Surgery usually involves
removal of adhesions and degenerated areas and decompression
of the tendon by tenotomy or measures that influence the local
circulation.
Lauer, Harvey. American Sports Data, Inc. A
Comprehensive Study of Sports Injuries in the
U.S.,
2003. Key Point: in 2002 there were an
estimated 232,000 Achilles tendon sports injuries in the
U.S.
for individuals aged six and over. 109,000 prevented sports
participation for between one future occasion and one month.
57,000 prevented participation for at least one month. 66,000
prevented participation for at least one month plus required
emergency room treatment, a hospital stay, surgery, or
therapy.
Ljungqvist, R. (1967).
Subcutaneous partial rupture of
the Achilles tendon. Acta Orthopaedica
Scandinavica (Suppl. 113). Key
point: recognizing Achilles tendon ruptures is
important because immobilization or immediate surgery is
required.
Maffulli, N., Testa, V., Capasso, G., Bifulco,
G., Binfield, P.M.(1997). Results
of percutaneous longitudinal tenotomy for Achilles
tendinopathy in middle- and long-distance runners. American
Journal of Sports Medicine 25, 835–40.
Key point: a simpler and more effective
approach to Achilles tendinosis surgery is to use local
anesthesia, insert a scalpel in the most degenerated part of
the tendon, have the patient extend and flex their ankle, then
repeat the process just above, below, to the left and to the
right of the original incision. 70% of the long distance
runners who underwent this procedure were cured.
Maffulli, N., Barrass, V., Ewen, S.W.B. (2000).
Light microscopic histology of
Achilles tendon ruptures. American Journal of Sports
Medicine 28, 857–63. Key
point: the same degeneration that is present in
tendons with Achilles tendinosis is also present in Achilles
tendons that rupture.
McCrory, J.A., Martin, D.F., Lowery, R.B.,
Cannon, D.W., Curl, W.W., Read, H.M., Hunter, D.M., Craven,
T., Messier, S.P. (1999). Etiologic factors associated with
Achilles tendinitis in
runners. Medicine and Science in Sports and
Exercise 31, 1374–81. Key
points: a) runners with Achilles tendinosis usually
stretch less frequently than runners without Achilles
tendinosis, b) runners with Achilles tendinosis have usually
run for more years and at a faster pace than uninjured
runners, c) runners with Achilles tendinosis pronate more than
uninjured runners, and d) injury can be caused by tight
inflexible calf muscles, and either hyper mobile flat feet or
high arched cavus chunk feet.
Research
A-J Research
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