Where is your pain? achilles tendinopathy pain location on loading is different to palpation, imaging and recall location
Document Type
Journal Article
Publication Title
Journal of Orthopaedic & Sports Physical Therapy
Volume
54
Issue
1
First Page
86
Last Page
94
PubMed ID
38060345
Publisher
Movement Science Media
School
Nutrition and Health Innovation Research Institute / School of Medical and Health Sciences
Abstract
OBJECTIVE: To describe and compare pain maps reported during Achilles tendon loading exercises with recall pain location, in people with pain on palpation in their Achilles tendon and tendon pathology on imaging. t DESIGN: Cross-sectional analysis of baseline RCT. METHOD: Participants were recruited from a larger Achilles tendinopathy clinical trial. Inclusion criteria were at least 2-month self-reported history of Achilles tendinopathy, midtendon palpation pain, and pathology on ultrasound tissue characterization. Participants were asked to identify their Achilles tendon pain location on a pain map with 8 prespecified locations while at rest prior to loading (recall pain), and subsequently during tendon loading exercises (loading pain). Participants could select multiple locations or select “other” if the locations did not represent their pain. RESULTS: Ninety-three participants were included (93% of participants from a clinical trial). The locations of pain on loading were diverse; all 8 pain locations (and an “other” option) were represented within this sample. Twenty-five percent of participants did not report pain with loading (n = 23 of 93). Of the 70 participants with loading pain, recall pain location differed to loading pain location in 40% (n = 28 of 70) of the participants. CONCLUSION: Palpation pain location, recall pain location, or location of pathology on imaging were not valid proxies for load-related pain in the Achilles tendon. How different pain locations respond to treatment is unknown. Some pathologies (eg, plantaris) have clear pain locations (eg, medial tendon), and assessing pain location may assist differential diagnosis.
DOI
10.2519/jospt.2023.12131
Access Rights
subscription content
Comments
Rio, E. K., Rabusin, C. L., Munteanu, S. E., Docking, S. I., Perrott, M., Couch, J., . . . Girdwood, M. (2023). Where is your pain? achilles tendinopathy pain location on loading is different to palpation, imaging and recall location. Journal of Orthopaedic & Sports Physical Therapy, 54(1), 86-94. https://doi.org/10.2519/jospt.2023.12131