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OP-Journal 2016; 32(01): 44-54
DOI: 10.1055/s-0042-111250
Artikel zum Leitthema
Georg Thieme Verlag KG Stuttgart · New York

Tendinopathien der unteren Extremität im Sport – Diagnostik und Therapie

Tendinopathies of the Lower Extremities in Sport – Diagnostics and Therapy
Michael Cassel
Hochschulambulanz der Universität Potsdam, Zentrum für Freizeit-, Gesundheits- und Leistungssport
,
Josefine Stoll
Hochschulambulanz der Universität Potsdam, Zentrum für Freizeit-, Gesundheits- und Leistungssport
,
Frank Mayer
Hochschulambulanz der Universität Potsdam, Zentrum für Freizeit-, Gesundheits- und Leistungssport
› Institutsangaben
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Publikationsverlauf

Publikationsdatum:
20. September 2016 (online)

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Zusammenfassung

Tendinopathien sind häufig Ursache chronischer, belastungsabhängiger Beschwerden an der unteren Extremität. Zumeist sind die großen Sehnen an Sprung- und Kniegelenk, insbesondere die Achillessehne und die Patellarsehne, betroffen. Ätiologisch wird eine repetitive Überbeanspruchung in Sport und/oder Alltag angenommen. Neben der klinischen Untersuchung und der ausführlichen Schmerz- und Belastungsanamnese hat die Sonografie als bildgebendes Verfahren einen hohen Stellenwert in der Diagnostik von Sehnenpathologien der unteren Extremität. Als Mittel der Wahl in der Behandlung sind trainingstherapeutische Konzepte anzusehen, die mit physiotherapeutischen Maßnahmen kombiniert werden können. Bei höhergradiger Pathologie und länger bestehenden Beschwerden sollten multimodale Therapieansätze genutzt werden. Erst bei Versagen der konservativen Behandlung über zumindest mehrere Monate sollte der Einsatz eines Operationsverfahrens erwogen werden.

Abstract

Tendinopathies are frequently the cause of chronic, load-dependent complaints of the lower extremity. Commonly, the large tendons of the ankle and knee joints are affected, especially the Achilles and patellar tendons. Repeated overuse in sports and/or daily activities is assumed as the aetiology. Besides the clinical examination including a comprehensive anamnesis of pain and training/loading, sonographic imaging has a high training/loading relevance for the diagnosis of tendon pathologies of the lower extremity. Training concepts are considered in first line as the treatment of choice. A combination with physical therapy interventions can be useful. In cases of a more severe pathology and long-standing complaints multimodal therapeutic options should be employed. The use of surgical treatment procedures should only be taken into account in case of failed response to conservative treatment.

 

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