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DPT Spring 2024 > Achilles Tendinopathy > Flashcards

Achilles Tendinopathy Flashcards

1
Q

Prevalence

Most frequently with ______/______

A

overuse/injury

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2
Q

Most common in…

  1. _______/_______ activities
  2. _________ > competition
  3. ___-____ year olds
    10-20% of _______
A

recreational/competitive
training
30; 50
runners

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3
Q

Risk Factors and Etiology
- Limited calf ________
- Calf ________ could lead to under supply/overuse
- Biological _____ and family _____
- Excessive ________

A

flexibility
weakness
males; hx
pronation

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4
Q

Overuse may occcur with _____ ______ control, which includes ______ _______ deficits and ______ deficits

A

impaired LQ
hip neuromuscular
balance

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5
Q

Excessive Pronation is a earlier extended and or excessive combination of ____/_____/_____

A

DF; ABD; EV

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6
Q

Excessive pronation can become excessive if there is ______/_______ present

More commonly:
_______ or _________

Impaired ______ _____- top down influence

Less commonly: ______ or medial ______ hypermobility

A

hypermobility; instability

tibfib; talocrural

LQ control

subtalar; knee

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7
Q

Excessive pronation may become excessive if ______ ________ hypombility is present

Ex:
Limited ______ _______ may lead to midfoot and forefoot excessively EV and ABD

Limited _____ ______ may lead to excessive ankle DF

A

adjacent joint

talocrural DF

knee EXT

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8
Q

Risk Factors and Etilology

Abnormal _______ structure and prior _______

______ age (more plastic)

Also consider… _____ errors, _______ factors, and improper _________

________- overuse

Systemic dz with persistent _______ and poor _______ _______

A

tendon; injury
older
training; environmental; shoes
obesity
inflammation; blood supply

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9
Q

Pathomechanics

Repetitive ______ with _______ from limited ____ and or excessive _______

Collagen fibril ________/_________ and fibroblast death from altered fluid movement leads to _______, ________ nitric acid with persistent ___________

A

lengthening; compression
DF; EV
thinning; disorganization
overheating; increased; inflammation

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10
Q

Pathomechanics

Thickened but _______ tendon from:
increase of ____-______ matrix

fat _________

________ force transfer

Impaired _______ _________

A

weaker
non-collagen
deposition
ineffective
motor control

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11
Q

Symptoms

_______ onset that limits ______ activity

Localized _____ and _______

Particurarly after __________

Lessens with _____ bout of activity and increases with _____ to ______ activity

A

gradual; WB
pain; stiffness
inactivity
mild; moderate; severe

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12
Q

Signs
Observation- Achilles _______
Possibly impaired ____ _____ and or excessive _______

ROM- possible P! and limitation with ______

Resisted/MMT: Possible pain with _____, may be _____
possibly ____/______ weakness

Accessory Motion- possible _______ hypomobility for _______

Palpation- TTP 2-6 cm proximal to ______ (higher seas) area of less _____ ______

More _____ achilles P! indicates plantaris involved

Achilles _______ (high spec)

A

thickening
LQ control
pronation
DF
PF; weak
hip; knee
talar; DF
insertion; blood supply
medial
crepitus

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13
Q

Special Tests

  1. _____ ____ (high spec)
  2. _____ _____ Test (high spec)
  3. ________ Tests
  4. _______ _______ _______
  5. M. length- shortened ______
A

Arc Sign
Royal London
Stability
Single Heel Raise
Gastrocs

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14
Q

PT Rx
_______ NOT indicated

_______ stress is BEST within appropiate P! levels

______ management

______ wear

Timeline: ____-_____ wks

Prognosis: ______%

POLICED

A

Rest
Optimal
Weight
Shoe
8; 12
80

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15
Q

PT Rx
Modalities
LASER: ___________

Ionto: dexamethasone helpful for ____ function

Shockwave Therapy: support for P! relief with ADLs when added to ____ weeks of exercise

NO indication on ______ changes or return to sport

A

contradictory

P!

4

structure

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16
Q

PT Rx
Bracing: _______ sleeves on involved mm.- anecdotal

Night Splint: NOT _____ and NO ______

A

Neoprene
beneficial; support

17
Q

PT Rx
Taping, including kinesiotape along tendon to reduce P! is found to be ______ and _______

Arch taping/foot orthotics- ______ evidence
- ______ taping may help predict orthotic benefit
- ______ absorbing orthotic decreases rate of injury

A

anecdotal ; conflicting

limited

arch; shock

18
Q

PT Rx
Heel Lift
- _____ support
- both _______

A

mixed
shoes

19
Q

PT Rx
Dry Needling can be helpful for _____ when added to ______

STM- mostly _______

Gentle Stretching: _____ and may be contraindicated due to ______/_______ on tendon

JMs for ______ and _______

A

pain; exercise

anecdotal

weak; compression; tendon

mobility; function

20
Q

MET Purpose: ________ and ________ (hip and lumbar)

__-___ sets; ___-____ reps; _____ load

Varied _____ actions (BEST evidence) how may seconds?

A

proliferation; stabilization

2; 3
10; 15
heavy

muscle

3

21
Q

Exercise progressions

  1. _______ loading w/o _______ from lengthening
  2. _______ loading w/o ________ from lengthening
  3. ________ loading with _______ from lengthening
  4. ________ loading in ______- (CC Hip ABD/ER/EXT)
  5. ________ loading
A

isometric; compression
isotonic; compression
isotonic; compression
isometric; WBing
Plyometric

22
Q

Best exercises for achilles tendinopathy

A

Unilateral heel raises; 3x3 secs m. actions

23
Q

With achilles tendionapthy, you want to progress _______ and activity with ≤ _____ symptoms for at least ___/wk and keep up for ____-_____ weeks

A

resistance; mild
2
6; 12

24
Q

Prognosis
Mostly normalized tendon _____ and ______

Improved ______ proporties as well as cortical function

_____ weeks to recovery

____% fully recovered within ___-_____ months of progressive loading @ 5 year follow up

Eccentric exercises- 82-100% ___-____ tendinopathy in athletes

60%- _______ individuals

≤32%- _______ tendon

_______ P! may remain (20-45%)

A

structure; thickness

mechanical

12

80

3; 6

mid; portion

sedentary

insertional

mild

25
Q

MD Rx
Injections
______-_______-: insufficient evidence for Cortisone

_______: guided Cortisone effective for P! and function (non-athletic population)

Achilles _______
Remove _______

A

mid- portion
insertional
debridement
plantaris

DPT Spring 2024 (30 decks)

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