Abstract
Achilles paratenonitis and medial tibial syndrome are the most common specific overuse injuries among athletes in Finland, and they are a problem especially in endurance sports, such as long-distance running and jogging. Conservative treatment is often successful, but if it fails operative treatment is necessary. The surgical methods developed in Finland, which are widely used in the treatment of Achilles paratenonitis and medial tibial syndrome, are presented with clinical follow-up results in this paper. The patients operated on for Achilles paratenonitis were some years older than the patients operated on for retrocalcaneal bursitis (mean 38.4 versus 32.3 years). Results after operation were excellent or good in 92.4% of 291 patients operated on for Achilles paratenonitis, 84.2% of the 63 operated on for retrocalcaneal bursitis and 79% of the 47 operated on for medial tibial syndrome. All the patients treated operatively were patients in whom conservative treatment had failed. In conclusion, operative treatment of Achilles paratenonitis or medial tibial syndrome in athletes is indicated when these complaints do not respond to any type of conservative treatment.
Similar content being viewed by others
References
Allen MJ, Barnes MR (1986) Exercise pain in the lower leg chronic compartment syndrome and medial tibial syndrome. J Bone Joint Surg [Br] 68: 818–823
Clement DB, Taunton JE, Smart GW (1984) Achilles tendinitis dinitis and peritendinitis. Etiology and treatment. Am J Sprots Med 12: 179–184
Hess GP, Cappiello WL, Poole RM, Hunter SC (1989) Prevention and treatment of overuse injuries. Sports Med 8: 371–384
James SL, Bates BT, Osterning LR (1978) Injuries to runners. Am J Sports Med 6: 40–50
Jones DC, James SL (1984) Partial calcaneal osteotomy for retrocalcaneal bursitis. Am J Sports Med 12: 72–73
Järvinen M (1992) Epidemiology of tendon injuries in sports. Clin Sports Med 11: 493–504
Järvinen M, Aho H, Niittymäki S (1989) Results of the surgical treatment of the medial tibial syndrome in athletes. Int J Sports Med 10: 55–57
Järvinen M, Kvist H, Jozsa L (1990) The intratendineal ossification with fracture in the Achilles tendon of the top-level athlete. Clin Sports Med 2: 47–51
Kannus P, Jozsa L (1991) Histopathological changes preceding spontaneous rupture of a tendon. J Bone Joint Surg [Am] 72: 1507–1525
Kujala UM, Kvist M, Österman K (1986) Knee injuries in athletes. Review of exertion injuries and retrospective study of outpatient sports clinic material Sports Med 3: 447–460
Kvist H, Kvist M (1980) The operative treatment of chronic ealcaneal paratenonitis. J Bone Joint Surg [Br] 62: 353–357
Kvist M (1991) Achilles tendon overuse injuries. A clinical and pathophysiological study in athletes with special reference to Achilles paratenonitis. Academic dissertation, University of Turku. Turku. Finland, pp 1–122
Kvist M (1991) Achilles tendon injuries in athletes. Ann Chir Gynaecol 80: 188–201
Kvist M, Järvinen M (1980) Zur Epidemiologie von Sportver-letzungen und Fehlbelastungen. Patienten-Analyse einer Sportmedizinischen Poliklinik. Med. Sport 20: 375–378
Kvist M, Jozsa L, Järvinen M, Kvist H (1985) Fine structural alterations in chronic Achilles paratenonitis in athletes. Pathol Res Pract 180: 416–423
Kvist M, Jozsa L, Järvinen MJ, Kvist H (1987) Chronic Achilles paratenonitis in athletes: a histological and histochemical study. Pathology 19: 1–11
Kvist MJ, Lehto MUK, Jozsa L, Järvinen M, Kvist H (1988) Chronic Achilles paratenonitis. An immunohistologic study of fibronectin and fibrinogen. Am J Sports Med 16: 616–623
Leadbetter WB, Mooar PA, Lane GJ, Lee SJ (1992) The surgical treatment of tendinitis. Clinical rationale and biologic basis. Clin Sports Med 11: 679–712
Lehto MUK, Järvinen M, Suominen P (1992) Results of surgical treatment of Achilles peritendinitis and retrocalcanear bursitis. First World Congress of Sports Trauma, Fifth Congress of the European Society of Knee Surgery and Arthroscopy, Palma de Mallorca. 25–29 May 1992, abstract book p. 10
Leppilahti J, Orava S, Karpakka J, Takala T (1991) Overuse injuries of the Achilles tendon. Ann Chir Gynaecol 80: 202–207
Orava S (1980) Exertion injuries due to sports and physical exercise. Academic dissertation, University of Oulu, Oulu, Finland, pp. 1–59
Orava S, Puranen J (1978) Athletes' exertion injuries. Ann Chir Gynaecol 67: 58–65
Orava S, Leppilahti J, Karpakka J (1991) Operative treatment of typical overuse injuries in sport. Ann Chir Gynaecol 80: 208–211
Puranen J (1974) The medial tibial syndrome. Exercise ischemia in the medial fascial compartment. J Bone Joint Surg [Br] 56: 7112–7115
Puranen J (1991) The medial tibial syndrome. Ann Chir Gynaecol 80: 215–218
Puranen J, Alavaikko A (1981) Intracompartmental pressure increase on exertion in patients with chronic compartment syndrome in the leg. J Bone Joint Surg [Am] 63: 1304–1309
Renström P, Johnson RJ (1985) Overuse injuries. Sports Med 2: 316–323
Rorabeck CH, Bourne RB, Fowler PJ (1983) The surgical treatment of exertional compartment syndrome in athletes. J Bone Joint Surg [Am] 65: 1245–1231
Subotnick SI, Sisley P (1986) Treatment of Achilles tendinopathy in athletes. J Am Podiatr Assoc 10: 552–557
Viitasalo J, Kvist M (1983) Some biomechanical aspects of the foot and ankle in athletes with and without shin splints. Am J Sports Med 11: 125–130
Wallensten R (1983) The medial tibial and chronic anterior compartment syndromes. Academic dissertation, Karolinska Institutet, Stockholm, Sweden, pp 1–45
Wallensten R (1983) Results of fasciotomy in patients with medial tibial syndrome or chronic anterior compartment syndrome. J Bone Joint Surg [Am] 65: 1252–1255
Wallensten R, Eriksson E (1984) Intramuscular pressures in exercise-induced lower leg pain. Int J Sports Med 5: 31–34
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Järvinen, M. Lower leg overuse injuries in athletes. Knee Surg, Sports traumatol, Arthroscopy 1, 126–130 (1993). https://doi.org/10.1007/BF01565467
Issue Date:
DOI: https://doi.org/10.1007/BF01565467