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Achilles Tendon Disorder: Free MSRA Podcast

Achilles Tendon Disorder: Free MSRA Podcast

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 🎧 MSRA Deep Dive: Achilles Tendinopathy — Persistent Heel Pain ExplainedA common overuse injury, Achilles tendinopathy causes pain at the back of the heel — especially in runners and active individuals. This episode simplifies what you need to know for exams and clinics.🦶 DefinitionChronic injury to the Achilles tendon (connects calf muscles to the heel). Can affect:• Mid-portion (more common)• Insertional (at the heel bone)🔥 Causes• Repetitive overloading• Sudden increases in activity• Poor biomechanics• Tight calves• Inflammatory/enthesitis-linked conditions📌 Risk Factors – Mnemonic: A MAN POOR SHIFTERAgeMale sexActivity (running, jumping)Non-compliance with warm-upPoor biomechanicsObesityOveruseRepeated injurySystemic disease (e.g. diabetes, AS)Heel wear/footwearInflammatory diseaseFamily historyToxic meds (fluoroquinolones)🔬 Pathophysiology• Degeneration > inflammation• Disorganised collagen, tendon thickening• Mid-portion: poor vascularity = poor healing🩺 Differentials• Retrocalcaneal bursitis• Posterior ankle impingement• Plantaris tear• Sural nerve entrapment• DVT (always rule out)📊 Epidemiology• Affects ~52% of long-distance runners• Common in men >40• Linked to BMI, training volume, footwear👣 Clinical Features• Gradual posterior heel pain• Worse with activity, mornings• Tender, thickened tendon• Pain with resisted plantarflexion• Thompson’s Test – exclude rupture!🔎 Investigations• Clinical diagnosis• Ultrasound → tendon thickening, neovascularity• MRI if unclear or pre-surgery💊 Management1st Line: Conservative• Activity modification• Ice, short NSAID course• Heel lifts, orthotics• Eccentric exercises (Alfredson protocol): – 3×15 reps, knee bent/straight, twice daily, 12 weeksAvoid: Steroid injections → ↑ rupture riskAdjuncts:• Shockwave therapy (ESWT)• Topical GTN• PRP (limited evidence)Surgery• For >6 months refractory cases• Options: debridement, tenotomy + rehab📈 Prognosis• ~85% regain full function over time• Long rehab, but excellent outcomes if compliant• Recurrence possible without proper management⚠️ Complications• Rupture• Chronic pain• Functional impairment• Recurrent tendinopathy🧠 MSRA Tips• Risk factors = A MAN POOR SHIFTER• Prioritise eccentric loading in treatment• Use Thompson’s test to exclude rupture• Don’t inject steroids into tendon• Differentiate from bursitis, DVT, impingement📚 Achilles Tendon MSRA Resources📝 Revision Notes🃏 Flashcards📖 Accordion Q&A🎯 Rapid Quiz🧠 Practice Quiz🌐 More:www.passthemsra.comwww.freemsra.com🏁 Key TakeawayAchilles tendinopathy is common, chronic, and highly manageable. Recognise it early, manage it properly — and avoid unnecessary injections!#MSRA #AchillesTendinopathy #PosteriorHeelPain #ThompsonsTest #AlfredsonProtocol #TendonDisorders #MSRAMSK #PassTheMSRA #FreeMSRA #MSRAQuiz #MSRAFlashcards #GPRevision #MedicalEducation

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