What is the best clinical test for Achilles tendinopathy?

Differential diagnosis of Achilles pathology is challenging. This study was intended to examine the diagnostic accuracy of clinical tests identified for a chronic mid body Achilles tendinopathy. Ultrasound scanning provides the reference standard. Twenty-one participants with, and without, an Achilles tendinopathy, had an ultrasound scan followed immediately by the application of ten clinical tests. The accuracy and reproducibility of each test was determined. The most valid tests are; pain on palpation of the tendon (sensitivity 84%, specificity 73%, kappa 0.74-0.96) and the subjective reporting of pain 2-6 cm above the insertion into the calcaneum (sensitivity 78%, specificity 77%, kappa 0.75-0.81).

The study found that only location of pain and pain on palpation were adequately dependable and accurate, to be suggested for use.

Neck Pain

Out of all 291 conditions studied in the Global Burden of Disease 2010 Study, neck pain ranked 4th highest in terms of disability and 21st in terms of overall burden.

Comments

Rob van Gelderen

Hello Rachael,
I would propose a Test Cluster
1 At first a thorough palpation of the whole painfull Area, including the musscles going to the achilles Region tibialis posterior, Flexor hallucis, flexor digitorum such ad palpation of the soleus and the parts of the gastrocnemiis
2 with normsl(not sporting) patients stance control of the foot arcs and walking, with sporting patients checking the running and letting them do threir specific moves or jumps
3 Musscle strenght in one legged calf raising on the stair, in high activity sports this has to be accomplished untill 30 rps without faillure and with proper symmetrie, everything under this level can be used as a goal(I found some evidence for this in recently found(poor evidence) ballet artickels))
What I also use in my work with gymnastics is to check the extension chain e.g the step up and the 1 legged squat
4 a threath would be, as a fourth assesement is how the patient reacts on kinesiotape support
This is my routine

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