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Logo of brjsmedBritish Journal of Sports MedicineVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
 
Br J Sports Med. 2007 April; 41(4): 280.
PMCID: PMC2658966

Commentary

When is it safe to return to sport? This simple, yet often vexing question, applies particularly to cases of tendinopathy. Recurrence is a hallmark of the condition.1,2 Although expert clinicians have long argued that patients need to continue their rehabilitation exercises even after pain has abated, research has been unable to point to factors that may explain recurrences (other than tissue healing); nor has there been a test battery that could be used as a functional test for full recovery.

To deal with this clinically relevant issue, the authors of this paper investigated the recovery of muscular strength, power, endurance, flexibility and motor control in patients recovering from Achilles tendinopathy. They have previously developed a test battery that evaluates lower leg muscle–tendon function comprehensively3—this instrument detected impaired function in patients with painful Achilles tendons. This study—an assessment of muscle tendon function in the now pain‐free tendon—aimed at determining whether this was due to pain or due to a true functional deficit.

Importantly, the present paper showed that functional deficits remained even when symptoms improved. This provides important evidence that further rehabilitation is indicated even after the pain has disappeared. What was previously a clinical hunch can now be added to the more evidence‐based textbooks. Thus, the authors' conclusions would make an excellent poster (choose your image of choice to go with the text) to be framed and hung up on the walls of physiotherapy clinics and the locker rooms of high‐level teams… “patients should be encouraged to continue their rehabilitation protocol even when symptoms subside in order to achieve full recovery…”.

References

1. Alfredson H, Lorentzon R. Chronic Achilles tendinosis: recommendations for treatment and prevention. Sports Med 2000. 29135–146.146 [PubMed]
2. Paavola M, Kannus P, Paakkala T. et al Long‐term prognosis of patients with Achilles tendinopathy. An observational 8‐year follow‐up study. Am J Sports Med 2000. 28634–642.642 [PubMed]
3. Silbernagel K G, Gustavsson A, Thomee R. et al Evaluation of lower leg function in patients with Achilles tendinopathy. Knee Surg Sports Traumatol Arthrosc 2006. 141207–1217.1217 [PubMed]

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