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  • 1.
    Alfredson, Håkan
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Lorentzon, Ronny
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Chronic Achilles tendinosis: recommendations for treatment and prevention.2000In: Sports Medicine, ISSN 0112-1642, E-ISSN 1179-2035, Vol. 29, no 2, p. 135-146Article in journal (Refereed)
    Abstract [en]

    Chronic Achilles tendinosis is a condition with an unknown aetiology and pathogenesis that is often, but not always, associated with pain during loading of the Achilles tendon. Histologically, there are no inflammatory cells, but increased amounts of interfibrillar glycosaminoglycans and changes in the collagen fibre structure and arrangement are seen. In situ microdialysis has confirmed the absence of inflammation. It is a condition that is most often seen among recreational male runners aged between 35 and 45 years, and it is most often considered to be associated with overuse. However, this condition is also seen in patients with a sedentary lifestyle. Chronic Achilles tendinosis is considered a troublesome injury to treat. Nonsurgical treatment most often includes a combination of rest, NSAIDs, correction of malalignments, and stretching and strengthening exercises, but there is sparse scientific evidence supporting the use of most proposed treatment regimens. It has been stated that, in general, nonsurgical treatment is not successful and surgical treatment is required in about 25% of patients. However, in a recent prospective study, treatment with heavy load eccentric calf muscle training showed very promising results and may possibly reduce the need for surgical treatment of tendinosis located in the midportion of the Achilles tendon. The short term results after surgical treatment are frequently very good, but in the few studies with long term follow-up there are signs of a possible deterioration with time. Calf muscle strength takes a long time to recover and, furthermore, a prolonged progressive calcaneal bone loss has been shown on the operated side up to 1 year after surgical treatment.

  • 2. Ivarsson, Andreas
    et al.
    Johnson, Urban
    Andersen, Mark B.
    Tranaeus, Ulrika
    Stenling, Andreas
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Lindwall, Magnus
    Psychosocial Factors and Sport Injuries: Meta-analyses for Prediction and Prevention2017In: Sports Medicine, ISSN 0112-1642, E-ISSN 1179-2035, Vol. 47, no 2, p. 353-365Article, review/survey (Refereed)
    Abstract [en]

    Background Several studies have suggested that psychosocial variables can increase the risk of becoming injured during sport participation. Objectives The main objectives of these meta-analyses were to examine (i) the effect sizes of relationships between the psychosocial variables (suggested as injury predictors in the model of stress and athletic injury) and injury rates, and (ii) the effects of psychological interventions aimed at reducing injury occurrence (prevention). Methods Electronic databases as well as specific sport and exercise psychology journals were searched. The literature review resulted in 48 published studies containing 161 effect sizes for injury prediction and seven effect sizes for injury prevention. Results The results showed that stress responses (r = 0.27, 80 % CI [0.20, 0.33]) and history of stressors (r = 0.13, 80 % CI [0.11, 0.15]) had the strongest associations with injury rates. Also, the results from the path analysis showed that the stress response mediated the relationship between history of stressors and injury rates. For injury prevention studies, all studies included (N = 7) showed decreased injury rates in the treatment groups compared to control groups. Conclusion The results support the model's suggestion that psychosocial variables, as well as psychologically, based interventions, can influence injury risk among athletes.

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