AN 3203 -DISORDERS OF THE TIBIA TEST
QUESTIONS AND ANSWERS
T or F:
There is inflammation with Achilles Tendonosis - ANSWER FALSE
Achilles Tendonosis:
-Tendon _______ has a normal glistening appearance.
-Biopsy reveals _______ and _______ collagen fibres.
-_______ _______ is also altered with proliferation of _______ cells. -
ANSWER -Tendon loses it's normal glistening appearance.
-Biopsy reveals disorganized and degenerate collagen fibres.
-Ground substance is also altered with the proliferation of scar cells.
List the 4 Mechanisms of Injury for Achilles Tendonosis - ANSWER
1.Soleus portion which wraps around the gastroc portion "strangles" the
tendon and injures it.
2.Poor blood supply prevents healing. Then neovascularization results in
pain because of nerve infiltration that accompanies the vessels.
3.Whipping (bowstringing) action caused by overpronation or
oversupination.
4.Rapid eccentric action (heelstrike) followed by rapid concentration
action (toe-off).
List the Potential Clinical Causes of Achilles Tendonosis - ANSWER -
Running in heel-less spikes or low-heeled shoes (racing flats) (< 12-15
mm)
-Running shoes that are worn out
-Excessive pronation (they land more inverted, pronate more and faster)
-Take-off supination
-Very stiff sole that doesn't bend at the forefoot
-Wearing high heels all day, then running in running shoes
-Blood Group ABO?
, Highlighted Clinical Causes:
-Runners that put on more _______ per week and had run for a
_______ number of _______ (Haglund-Akerlind and Eriksson, 1993)
-Runners at a _______ pace (McCrory, 1999)
-_______ is a factor (peak at _______-_______ years) - ANSWER -
Runners that put on more mileage per week and had run for a greater
number of years (Haglund-Akerlind and Eriksson, 1993)
-Runners at a faster pace (McCrory, 1999)
-Age is a factor (peak at 30-50 years)
Conservative Approach to Treatment for Achilles Tendonosis -
ANSWER -STOP RUNNING! For at least 7-21 days.
-Do other exercises (gentle cycling, swimming, run in water with
floatation device) if you need to stay in shape.
-ICE (30 minutes 3X per day)
-STRETCH
-STRENGTHEN
Strengthen and Stretch for Achilles Tendonosis:
-Stretch should be done for ____-____ minutes per day (on a stair). Very
painful to begin with.
-_______ heel lowering to strengthen
-_______ on the eccentric portion not on the heel raise.
-Add _______ eventually as pain permits. - ANSWER -Stretch should
be done for 10-20 minutes per day (on a stair). Very painful to begin
with.
-Eccentric heel lowering to strengthen
-Concentrate on the eccentric portion not on the heel raise.
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