Clinical reasoning in patients with lower limb tendinopathy a rehabilitation framework

Abstract

Tendinopathy is an “umbrella” term that indicates a load-related, non-rupture injury of the tendon. The etiology of tendinopathy can be considered as multifactorial, and its identification and management have proved to be difficult. Numerous studies have concluded that in the majority of patients with tendinopathy, there is a failure of the healing process, and as a result, the limbs remain dysfunctional. The purpose of this study was to explore the scientific evidence related to the main theories, in order to provide a clinical framework for rehabilitation in patients with lower limb tendinopathy. The proposed model involves two different routes. The first route is based mainly on a structural concept, clearly related to the stage of pathology, biomechanics and function of the tendon, and the healing process. The second route focuses on the kinetic system as a whole, following the functional concept of a kinetic chain. The resulting proposed algorithm is based on both structural and functional features, according to current evidence, providing a clinical reasoning framework that aims to bridge the gap between research and clinical practice and to empower the patient-centered approach. © Athens Medical Society.