Structure and Function:

 

• Two muscles in calf joint (gastrocnemius and soleus; gastro goes across two joints – knee and ankle)
• Ankle-plantar function
• Elastic structure
• Key function: absorbs force and recoils
  

Pathology

• Rupture
  • Acute injury
  • Possible pre-existing pathology
  • History – feels like somebody kicked them
  • Examination
  • Investigation – if examined immediately then can feel the tear, but then blood clot will fill it.
  • Treatment
    • Surgical – mixed results for stitching
    • Conservative
  • Rehab
    • Pathology/procedure
    • Degree of atrophy
    • Commitment to rehab
    • Very hard to get back to the same standard after achilles tendon damage
  • Tendonopathy
    • Also known as tendonitis but this is false as it suggests inflammation, but anti-inflammatory tablets will do nothing.
    • Pathology
      • Pathology is a continuum
      • Reactive tendinopathy
      • Tendon disrepair
      • Tendon degeneration
    • Symptoms
    • Investigation
    • Underlying causes
    • Role of Pain
      • Occurs at any point – normal looking ones can hurt
      • 2/3rds of ruptures have no pain

Treatment:

• With so many treatments available, none can be gold standard

Unloading	Eccentric loading	Strengthening	NSAIDs
Massage	Surgery	Orthotics	GTN patches
Acupuncture	ESWT	Dry needling	Various injections