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Orthopaedic

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Sports Medicine

Question
15 out of 26
 

Most common cause of insertional tendinitis of tendo Achilles is?



A Improper shoe wear
B Runners and jumpers

C Chronic overuse
D Intralesional steroid inj

Ans. C

Chronic overuse

INSERTIONAL TENDONITIS

a. The tendo Achilles has a broad insertion on the middle one-third of the posterior calcaneus and sends fibers around the undersurface of the calcaneus to unite with the plantar fascia.

b. Non Insertional tendonitis occurs due to repetitive stress and strains in athletes.

c. Insertional Achilles tendonitis is a separate condition occurring at the tendon/bone interface.

d. It occurs more frequently among older athletes in their 50s and 60s, and these patients tend to be overweight. often, but not always, you'll find this condition is associated with a retrocalcaneal bursitis, superficial bursitis and a Haglund's deformity.

e. The bony prominence predisposes the anterior aspect of tendon to irritation It is thought that the combination of chronic overuse with the retrocalcaneal bursitis and bony impingement creates a chronic inflammatory response with chemical degradation and mechanical abrasion of the Achilles with subsequent calcification in the tendon proper

f. Typically, you can pinpoint the pain to the posterolateral aspect of the interface. The patient may complain of posterior heel pain when running uphill and note the pain gradually reduces after stretching.

g. Conservative treatment of insertional Achilles tendonitis is similar to that of non insertional tendinitis. You would pursue antiinflammatory measures such as NSAIDs, ice massage, electrostimulation, iontophoresis and contact bathing.

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