BACKGROUND: Neovascularisation is associated with pain in Achilles tendinopathy (AT). The anatomical relationship between ultrasound (US)-defined indicators of tendinopathy and clinically determined pain sites has not been investigated. PURPOSE: To measure the spatial correlation between the sites of maximum palpated tenderness, site of patient-indicated pain, maximum US-determined neovascularisation and maximum antero-posterior tendon thickness in patients with chronic recalcitrant AT (CRAT). METHODS: A custom-designed measuring apparatus and clinical examination were used to measure the sites of maximum tenderness and subjectively defined pain on 29 tendons from patients diagnosed with mid-tendon CRAT. All tendons had been previously non-responsive to eccentric loading. Maximal neovascularisation and tendon thickness were measured by US scanning in conjunction with the measuring device. RESULTS: A significant association exists between clinically determined pain and neovascularisation (r = 0.85, p < 0.001), patient reported pain (r = 0.91, p < 0.001), maximal tendon thickness (r = 0.91, p < 0.001), maximal thickness and maximal neovascularisation (r = 0.86, p < 0.001). CONCLUSION: Sites of subjectively defined pain, clinically palpated tenderness, tendon thickness and neovascularisation are anatomically associated. Palpation can be reliably used as a clinical guide when planning interventions in patients with CRAT. Copyright 2010 Elsevier Ltd. All rights reserved.
BACKGROUND: Neovascularisation is associated with pain in Achilles tendinopathy (AT). The anatomical relationship between ultrasound (US)-defined indicators of tendinopathy and clinically determined pain sites has not been investigated. PURPOSE: To measure the spatial correlation between the sites of maximum palpated tenderness, site of patient-indicated pain, maximum US-determined neovascularisation and maximum antero-posterior tendon thickness in patients with chronic recalcitrant AT (CRAT). METHODS: A custom-designed measuring apparatus and clinical examination were used to measure the sites of maximum tenderness and subjectively defined pain on 29 tendons from patients diagnosed with mid-tendon CRAT. All tendons had been previously non-responsive to eccentric loading. Maximal neovascularisation and tendon thickness were measured by US scanning in conjunction with the measuring device. RESULTS: A significant association exists between clinically determined pain and neovascularisation (r = 0.85, p < 0.001), patient reported pain (r = 0.91, p < 0.001), maximal tendon thickness (r = 0.91, p < 0.001), maximal thickness and maximal neovascularisation (r = 0.86, p < 0.001). CONCLUSION: Sites of subjectively defined pain, clinically palpated tenderness, tendon thickness and neovascularisation are anatomically associated. Palpation can be reliably used as a clinical guide when planning interventions in patients with CRAT. Copyright 2010 Elsevier Ltd. All rights reserved.
Authors: Karin Grävare Silbernagel; Peter Malliaras; Robert-Jan de Vos; Shawn Hanlon; Mitchel Molenaar; Håkan Alfredson; Inge van den Akker-Scheek; Jarrod Antflick; Mathijs van Ark; Kenneth Färnqvist; Zubair Haleem; Jean-Francois Kaux; Paul Kirwan; Bhavesh Kumar; Trevor Lewis; Adrian Mallows; Lorenzo Masci; Dylan Morrissey; Myles Murphy; Richard Newsham-West; Richard Norris; Seth O'Neill; Koen Peers; Igor Sancho; Kayla Seymore; Patrick Vallance; Arco van der Vlist; Bill Vicenzino Journal: Sports Med Date: 2021-11-19 Impact factor: 11.136
Authors: Otto Chan; Sarah Morton; Mel Pritchard; Tina Parkes; Peter Malliaras; Tom Crisp; Nat Padhiar; Nicola Maffulli; John King; Dylan Morrissey Journal: Muscles Ligaments Tendons J Date: 2017-05-10