The diagnosis of most causes of tendinopathy is clinical – based primarily on the history and examination. In most cases, the tendon is readily palpable.
Physical exploration normally reveals a more sensitive area of the tendon with pain during load-bearing activity. Likewise, there is also a loss of muscle volume and strength caused by reflex inhibition (pain protection).
An assessment of the various biomechanical risk factors is important. As outlined earlier, the most common problem is hyper-pronation of the foot. As a result, an assessment for ligamentous laxity of the mid-foot or weakness of the calf muscle is important in Achilles tendinopathy. Other biomechanical issues which should be assessed for in this condition include lateral tibial torsion, tibial varus, pes cavus and asymmetry of the lower limbs.
Dr Mark Fulcher
Sport and Exercise Physician