The E3 Rehab Podcast 199. Achilles Tendinopathy: A Guide to Differential Diagnosis w/ Rodrigo Scattone Silva
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May 6, 2025 Rodrigo Scattone Silva, a sports physical therapist and assistant professor from Brazil, joins to unpack the intricacies of Achilles tendon pain. They discuss the critical need for thorough assessments and differentiate between various types of tendinopathy. The conversation dives into how factors like age and activity level impact treatment strategies, particularly for young athletes. They also explore modern rehabilitation techniques compared to traditional immobilization, highlighting the changing landscape of Achilles injury management.
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Achilles Tendinopathy Defined
- Achilles tendinopathy is localized tendon pain linked to mechanical loading during activities like walking or jumping.
- It can be subclassified mainly into insertional and mid-portion tendinopathies.
Primary vs Secondary Tendinopathy
- Primary tendinopathy arises from overuse, while secondary tendinopathy results from underlying conditions affecting tendon homeostasis.
- Differentiating primary and secondary tendinopathy impacts management strategies significantly.
Testing and Managing Posterior Impingement
- Use passive plantar flexion testing in prone to distinguish posterior impingement from Achilles tendinopathy.
- Avoid end-range plantar flexion exercises if posterior impingement is suspected to prevent worsening symptoms.