ReviewKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2011
Mid-portion Achilles tendinopathy: why painful? An evidence-based philosophy.
Review in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
39 citing papers in PubMed, 3 syntheses or guidelines pooled it, 122 citations in OpenAlex.
- Surgical treatment for midportion Achilles tendinopathy: a systematic review.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2017Pooled it
- Injection therapies for Achilles tendinopathy.The Cochrane database of systematic reviews · 2015Pooled it
- The sympathetic nervous system and tendinopathy: a systematic review.Sports medicine (Auckland, N.Z.) · 2015Pooled it
- Ultrasonography effectiveness of the vibration vs cryotherapy added to an eccentric exercise protocol in patients with chronic mid-portion Achilles tendinopathy: A randomised clinical trial.International wound journal · 2019Trial
- Ultrasound-guided dry needling with percutaneous paratenon decompression for chronic Achilles tendinopathy.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2016Trial
- Both Radiofrequency Microtenotomy and Physical Therapy Provide Significant Improvements in Patients With Chronic Midportion Achilles Tendinopathy at a Minimum 5-Year Follow-Up.Arthroscopy, sports medicine, and rehabilitation · 2026Article
- The role of tendon and ligament vasculature in ageing and injury.Biogerontology · 2026Review
- Different clinical presentations of Achilles tendinopathy: a cross-sectional study.Rheumatology international · 2024Article
- Is Chronic Tendon Pain Caused by Neuropathy? Exciting Breakthroughs may Direct Potential Treatment.Current pain and headache reports · 2024Review
- Percutaneous Bioelectric Current Stimulation in the Treatment of Chronic Achilles Tendinopathy: Protocol for a Double-Blind, Placebo-Controlled Randomized Multicenter Trial.JMIR research protocols · 2022Article
- Novel insights into the pathogenesis of tendon injury: mechanotransduction and neuroplasticity.Neural regeneration research · 2022Article
- Anatomical Classification for Plantaris Tendon Insertion and Its Clinical Implications: A Cadaveric Study.International journal of environmental research and public health · 2022Article
- Radiofrequency Microtenotomy or Physical Therapy for Achilles Tendinopathy: Results of a Randomized Clinical Trial.Orthopaedic journal of sports medicine · 2021Article
- Long Term Clinical-Functional and Ultrasound Outcomes in Recreational Athletes after Achilles Tendon Rupture: Ma and Griffith versus Tenolig.Medicina (Kaunas, Lithuania) · 2021Article
- Clinical and Radiological Outcomes of Operative Therapy in Insertional Achilles Tendinopathy With Debridement and Double-Row Refixation.Foot & ankle international · 2021Article
- Dry Needling as a Treatment Modality for Tendinopathy: a Narrative Review.Current reviews in musculoskeletal medicine · 2020Review
- Prevalence of Coexistent Plantaris Tendon Pathology in Patients with Mid-Portion Achilles Pathology: A Retrospective MRI Study.Sports (Basel, Switzerland) · 2019Article
- Results of minimally invasive Achilles tendon scraping and plantaris tendon removal in patients with chronic midportion Achilles tendinopathy: A longer-term follow-up study.SAGE open medicine · 2019Article
- Partial mid-portion Achilles tear resulting in substantial improvement in pain and function in an amateur long-distance runner.BMJ case reports · 2018Article
- Surgical plantaris tendon removal for patients with plantaris tendon-related pain only and a normal Achilles tendon: a case series.BMJ open sport & exercise medicine · 2018Article
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Chronic mid-portion Achilles tendinopathy is generally difficult to treat as the background to the pain mechanisms has not yet been clarified. A wide range of conservative and surgical treatment options are available. Most address intratendinous degenerative changes when present, as it is believed that these changes are responsible for the symptoms. Since up to 34% of asymptomatic tendons show histopathological changes, we believe that the tendon proper is not the cause of pain in the majority of patients. Chronic painful tendons show the ingrowth of sensory and sympathetic nerves from the paratenon with release of nociceptive substances. Denervating the Achilles tendon by release of the paratenon is sufficient to cause pain relief in the majority of patients. This type of treatment has the additional advantage that it is associated with a shorter recovery time when compared with treatment options that address the tendon itself. An evidence-based philosophy on the cause of pain in chronic mid-portion Achilles tendinopathy is presented. Level of evidence V.
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