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et_pb_bg_layout_light"> <div class="et_pb_text_inner"><h1 style="text-align: center;"><strong>La Tendinopatia Achillea nel Calcio</strong></h1></div> </div> </div> </div><div class="et_pb_row et_pb_row_3"> <div class="et_pb_column et_pb_column_4_4 et_pb_column_3 et_pb_css_mix_blend_mode_passthrough et-last-child"> <div class="et_pb_module et_pb_text et_pb_text_3 et_pb_text_align_left et_pb_bg_layout_light"> <div class="et_pb_text_inner"><h3 style="text-align: center;"><strong>CHE COSA è L’INFIAMMAZIONE DEL TENDINE D’ACHILLE E QUANTO è COMUNE NEL CALCIO?</strong></h3></div> </div> </div> </div><div class="et_pb_row et_pb_row_4"> <div class="et_pb_column et_pb_column_1_2 et_pb_column_4 et_pb_css_mix_blend_mode_passthrough"> <div class="et_pb_module et_pb_video et_pb_video_0"> <div class="et_pb_video_box"><iframe loading="lazy" title="La Tendinopatia Achillea nel Calcio" width="1080" height="608" src="https://www.youtube.com/embed/0lP5t2V64FI?feature=oembed" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share" referrerpolicy="strict-origin-when-cross-origin" allowfullscreen></iframe></div> </div> </div><div class="et_pb_column et_pb_column_1_2 et_pb_column_5 et_pb_css_mix_blend_mode_passthrough et-last-child"> <div class="et_pb_module et_pb_text et_pb_text_4 et_pb_text_align_left et_pb_bg_layout_light"> <div class="et_pb_text_inner">Dolore e infiammazione al <strong>tendine d’Achille</strong> (o tendinite Achillea) sono sensazioni molto comuni e frequenti per un calciatore: tuttavia, una patologia cronica come la tendinopatia che coinvolge il tendine d’Achille rappresenta solo il <strong>2,5 % di tutti gli infortuni nel mondo del calcio</strong>, ma ben il 20-27 % di tutti gli atleti soffre di un momentaneo dolore nella zona durante il campionato, soprattutto a seguito di una <a href="https://www.fisiocalcio.it/distorsione-della-caviglia/">distorsione di caviglia</a>.</div> </div> </div> </div><div class="et_pb_row et_pb_row_5"> <div class="et_pb_column et_pb_column_4_4 et_pb_column_6 et_pb_css_mix_blend_mode_passthrough et-last-child"> <div class="et_pb_module et_pb_text et_pb_text_5 et_pb_text_align_left et_pb_bg_layout_light"> <div class="et_pb_text_inner">La tendinopatia Achillea è <strong>più frequenze durante la preparazione atletica prima dell’inizio della stagione</strong> piuttosto che durante il campionato di calcio, questo probabilmente a causa degli improvvisi aumenti dei carichi di allenamento tipici del ritiro pre-campionato.</p> <p> </div> </div> </div> </div><div class="et_pb_row et_pb_row_6"> <div class="et_pb_column et_pb_column_4_4 et_pb_column_7 et_pb_css_mix_blend_mode_passthrough et-last-child"> <div class="et_pb_module et_pb_text et_pb_text_6 et_pb_text_align_left et_pb_bg_layout_light"> <div class="et_pb_text_inner"><h3 style="text-align: center;"><strong>COSA DEVE CONOSCERE IL CALCIATORE DEL PROPRIO TENDINE D’ACHILLE?</strong></h3></div> </div> </div> </div><div class="et_pb_row et_pb_row_7"> <div class="et_pb_column et_pb_column_1_2 et_pb_column_8 et_pb_css_mix_blend_mode_passthrough"> <div class="et_pb_module et_pb_text et_pb_text_7 et_pb_text_align_left et_pb_bg_layout_light"> <div class="et_pb_text_inner">Il tendine d’Achille rappresenta <strong>l’inserzione sul tallone, o calcagno, dei muscoli del polpaccio</strong> (gemello mediale, gemello laterale, soleo): la sua funzione è quella di esprimere la forza generata dalla contrazione del polpaccio sul calcagno, riproducendo il movimento di flessione plantare della caviglia.</div> </div> </div><div class="et_pb_column et_pb_column_1_2 et_pb_column_9 et_pb_css_mix_blend_mode_passthrough et-last-child"> <div class="et_pb_module et_pb_image et_pb_image_0"> <span class="et_pb_image_wrap "><img fetchpriority="high" decoding="async" width="1920" height="1080" src="https://www.fisiocalcio.it/wp-content/uploads/2020/06/1.jpg" alt="" title="1" srcset="https://www.fisiocalcio.it/wp-content/uploads/2020/06/1.jpg 1920w, https://www.fisiocalcio.it/wp-content/uploads/2020/06/1-1280x720.jpg 1280w, https://www.fisiocalcio.it/wp-content/uploads/2020/06/1-980x551.jpg 980w, https://www.fisiocalcio.it/wp-content/uploads/2020/06/1-480x270.jpg 480w" sizes="(min-width: 0px) and (max-width: 480px) 480px, (min-width: 481px) and (max-width: 980px) 980px, (min-width: 981px) and (max-width: 1280px) 1280px, (min-width: 1281px) 1920px, 100vw" class="wp-image-780" /></span> </div> </div> </div><div class="et_pb_row et_pb_row_8"> <div class="et_pb_column et_pb_column_4_4 et_pb_column_10 et_pb_css_mix_blend_mode_passthrough et-last-child"> <div class="et_pb_module et_pb_text et_pb_text_8 et_pb_text_align_left et_pb_bg_layout_light"> <div class="et_pb_text_inner">Nel calcio, gli stress continui causati da movimenti ripetitivi come i cambi di direzione e da movimenti esplosivi come <strong>accelerazioni e salti</strong> portano ad un uso eccessivo del tendine d’Achille e di conseguenza un suo <strong>prematuro deterioramento</strong>: infatti, il dolore e l’infiammazione si manifestano solitamente in una condizione di cronicità, e per questo motivo parliamo di tendinosi o tendinopatia Achillea, per cui i tempi di recupero risulteranno nettamente più lunghi rispetto ad una peri-tendinite, espressione di un sovraccarico acuto a carico del tendine risolvibile in pochi giorni.</div> </div> </div> </div><div class="et_pb_row et_pb_row_9"> <div class="et_pb_column et_pb_column_4_4 et_pb_column_11 et_pb_css_mix_blend_mode_passthrough et-last-child"> <div class="et_pb_module et_pb_text et_pb_text_9 et_pb_text_align_left et_pb_bg_layout_light"> <div class="et_pb_text_inner"><h3 style="text-align: center;"><strong>MI SONO RESO CONTO CHE MI TIRA DIETRO IL TALLONE QUANDO PIEGO LA CAVIGLIA: PUò ESSERE UN SINTOMO DELL’INFIAMMAZIONE DEL TENDINE D’ACHILLE?</strong></h3></div> </div> </div> </div><div class="et_pb_row et_pb_row_10"> <div class="et_pb_column et_pb_column_1_2 et_pb_column_12 et_pb_css_mix_blend_mode_passthrough"> <div class="et_pb_module et_pb_image et_pb_image_1"> <span class="et_pb_image_wrap "><img loading="lazy" decoding="async" width="1920" height="1080" src="https://www.fisiocalcio.it/wp-content/uploads/2020/06/5.jpg" alt="" title="5" srcset="https://www.fisiocalcio.it/wp-content/uploads/2020/06/5.jpg 1920w, https://www.fisiocalcio.it/wp-content/uploads/2020/06/5-1280x720.jpg 1280w, https://www.fisiocalcio.it/wp-content/uploads/2020/06/5-980x551.jpg 980w, https://www.fisiocalcio.it/wp-content/uploads/2020/06/5-480x270.jpg 480w" sizes="auto, (min-width: 0px) and (max-width: 480px) 480px, (min-width: 481px) and (max-width: 980px) 980px, (min-width: 981px) and (max-width: 1280px) 1280px, (min-width: 1281px) 1920px, 100vw" class="wp-image-784" /></span> </div> </div><div class="et_pb_column et_pb_column_1_2 et_pb_column_13 et_pb_css_mix_blend_mode_passthrough et-last-child"> <div class="et_pb_module et_pb_text et_pb_text_10 et_pb_text_align_left et_pb_bg_layout_light"> <div class="et_pb_text_inner">Quando il calciatore presenta un sovraccarico al tendine d’Achille, solitamente dopo una distorsione di caviglia o dopo aver giocato con scarpini nuovi o campi da gioco pesanti, lamenta una <strong>sensazione di “tiraggio” dietro al tallone</strong>, soprattutto nel momento in cui si piega la caviglia: questa sensazione è dovuta all’<strong>ispessimento</strong> <strong>del tendine stesso</strong>, causato dal gonfiore che riempie le strutture intorno al tendine, limitandone lo scorrimento e comportando questa sensazione di <strong>poca fluidità durante l’allungamento</strong>.</div> </div> </div> </div><div class="et_pb_row et_pb_row_11"> <div class="et_pb_column et_pb_column_4_4 et_pb_column_14 et_pb_css_mix_blend_mode_passthrough et-last-child"> <div class="et_pb_module et_pb_text et_pb_text_11 et_pb_text_align_left et_pb_bg_layout_light"> <div class="et_pb_text_inner"><h3 style="text-align: center;"><strong></strong><strong>QUALI SONO LE CAUSE CHE POSSONO PORTARE IL CALCIATORE ALL’INFIAMMAZIONE DEL TENDINE D’ACHILLE?</strong></h3></div> </div> </div> </div><div class="et_pb_row et_pb_row_12"> <div class="et_pb_column et_pb_column_4_4 et_pb_column_15 et_pb_css_mix_blend_mode_passthrough et-last-child"> <div class="et_pb_module et_pb_text et_pb_text_12 et_pb_text_align_left et_pb_bg_layout_light"> <div class="et_pb_text_inner">Le cause che possono portare un’infiammazione del tendine d’Achille sono di due tipi:</p> <ul> <li><strong>Fattori intrinseci</strong>, ovvero tutto ciò che è caratteristico del corpo e della postura del calciatore, come <strong>problematiche biomeccaniche</strong> (piede cavo, iper-pronazione del piede, eccesiva rotazione tibiale) e <strong>debolezza dei muscoli del polpaccio</strong></li> <li><strong>Fattori estrinseci</strong>, ovvero tutto ciò che è gestibile al di fuori della componente biomeccanica, quindi <strong>scarsa pianificazione dei programmi di allenamento</strong> e progressione dei carichi troppo rapida</li> </ul></div> </div> </div> </div><div class="et_pb_row et_pb_row_13"> <div class="et_pb_column et_pb_column_1_2 et_pb_column_16 et_pb_css_mix_blend_mode_passthrough"> <div class="et_pb_module et_pb_text et_pb_text_13 et_pb_text_align_left et_pb_bg_layout_light"> <div class="et_pb_text_inner">Come già detto in precedenza, la tendinopatia Achillea è un infortunio tipico della pre-stagione e della fase di ritorno in campo dopo una lesione importante che ha richiesto tanta fisioterapia e tanti mesi lontani dagli allenamenti (come una <a href="https://www.fisiocalcio.it/lesioni-muscolari/">lesione muscolare</a> o una <a href="https://www.fisiocalcio.it/lesione-del-legamento-crociato-anteriore-occhio-al-ginocchio-2/">lesione dei legamenti del ginocchio</a>). A differenza delle lesioni, che sono degli eventi acuti con carichi ad alta intensità concentrati in un unico stimolo, l’infiammazione del tendine d’Achille è un <strong>infortunio di natura cronica causato da carichi a intensità minore applicati per numerosissimi stimoli</strong>.</div> </div> </div><div class="et_pb_column et_pb_column_1_2 et_pb_column_17 et_pb_css_mix_blend_mode_passthrough et-last-child et_pb_column_empty"> </div> </div><div class="et_pb_row et_pb_row_14"> <div class="et_pb_column et_pb_column_4_4 et_pb_column_18 et_pb_css_mix_blend_mode_passthrough et-last-child"> <div class="et_pb_module et_pb_text et_pb_text_14 et_pb_text_align_left et_pb_bg_layout_light"> <div class="et_pb_text_inner"><h3 style="text-align: center;"><strong>HO UN DOLORE DIETRO AL TENDINE CHE MI PASSA DOPO QUALCHE MINUTO DI ALLENAMENTO, MA MI TORNA IL GIORNO DOPO: COME SI EFFETTUA UNA DIAGNOSI DI INFIAMMAZIONE AL TENDINE D’ACHILLE?</strong></h3></div> </div> </div> </div><div class="et_pb_row et_pb_row_15"> <div class="et_pb_column et_pb_column_4_4 et_pb_column_19 et_pb_css_mix_blend_mode_passthrough et-last-child"> <div class="et_pb_module et_pb_text et_pb_text_15 et_pb_text_align_left et_pb_bg_layout_light"> <div class="et_pb_text_inner">L’esame diagnostico più indicato per capire il grado di infiammazione del tendine d’Achille è l’<strong data-mce-fragment="1">ecografia</strong>, con la quale è possibile eseguire anche una valutazione in dinamica con la contrazione dei muscoli del polpaccio, così da capire come si comporta il tendine durante il movimento. Se ci trovassimo difronte alla presenza di una <strong data-mce-fragment="1">calcificazione</strong>, la radiografia o lastra è l’esame che ci permette di apprezzarne meglio i contorni e le caratteristiche. Il dolore solitamente comincia in maniera subdola, poco presente durante il riscaldamento, assente durante l’allenamento e che ritorna a fine attività fisica o il giorno dopo: se non trattato, può peggiorare sempre di più, fino ad arrivare ad intenso dolore notturno, a <strong data-mce-fragment="1">zoppia</strong> appena alzati la mattina ed a <strong data-mce-fragment="1">dolore durante la deambulazione</strong>. </div> </div> </div> </div><div class="et_pb_row et_pb_row_16"> <div class="et_pb_column et_pb_column_1_2 et_pb_column_20 et_pb_css_mix_blend_mode_passthrough et_pb_column_empty"> </div><div class="et_pb_column et_pb_column_1_2 et_pb_column_21 et_pb_css_mix_blend_mode_passthrough et-last-child"> <div class="et_pb_module et_pb_text et_pb_text_16 et_pb_text_align_left et_pb_bg_layout_light"> <div class="et_pb_text_inner">L’infiammazione del tendine d’Achille causa dolore durante la palpazione, gonfiore locale, rigidità articolare e perdita di forza dei muscoli del polpaccio, per cui una <strong>visita approfondita</strong> è di fondamentale importanza per valutare attentamente ogni componente della tendinopatia.</div> </div> </div> </div><div class="et_pb_row et_pb_row_17"> <div class="et_pb_column et_pb_column_4_4 et_pb_column_22 et_pb_css_mix_blend_mode_passthrough et-last-child"> <div class="et_pb_module et_pb_text et_pb_text_17 et_pb_text_align_left et_pb_bg_layout_light"> <div class="et_pb_text_inner"><h3 style="text-align: center;"><strong>MI è STATA DIAGNOSTICATA L’INFIAMMAZIONE DEL TENDINE D’ACHILLE: COSA DEVO FARE PER TORNARE A GIOCARE A CALCIO IN TEMPI BREVI?</strong></h3></div> </div> </div> </div><div class="et_pb_row et_pb_row_18"> <div class="et_pb_column et_pb_column_4_4 et_pb_column_23 et_pb_css_mix_blend_mode_passthrough et-last-child"> <div class="et_pb_module et_pb_text et_pb_text_18 et_pb_text_align_left et_pb_bg_layout_light"> <div class="et_pb_text_inner"><strong>Il tendine d’Achille presenta una struttura capace di sopportare centinaia di chili di carico</strong>: per questo motivo, la riabilitazione si concentrerà sul miglioramento della struttura interna e l’aumento della capacità portante del tendine. Se nelle infiammazioni acute e leggere, trattate precocemente, il riposo e la cessazione dell’attività fisica per qualche giorno possono eliminare il dolore permettendo al calciatore di tornare presto ad allenarsi, nelle infiammazioni croniche del tendine d’Achille il percorso riabilitativo può essere suddiviso in tre fasi:</p> <p>1) Nella fase iniziale, l’obiettivo da raggiungere è quello <strong>di migliorare la sensazione di dolore e ridurre il gonfiore intorno al tendine</strong>: il primo lo possiamo ottenere grazie a sedute di <strong>onde d’urto</strong>, mentre il secondo grazie alla terapia con <strong>laser ad alta potenza</strong>. Per non tenere il calciatore troppo fermo, quando possibile, la fisioterapia in acqua da importanti risultati in termine di riduzione dei tempi di recupero. Terapia manuale e mobilizzazioni di caviglia e piede possono aiutare a migliorare la sensazione di rigidità articolare e di dolore.</p> <p>2) La seconda fase è la parte più importante della riabilitazione: per <strong>migliorare la capacità di carico del tendine d’Achille</strong> si deve affrontare un percorso di rinforzo eccentrico. Gli <strong>esercizi eccentrici</strong>, solitamente faticosi e dolorosi, se eseguite costantemente per 2-3 mesi permettono di cambiare la struttura tendinea: in caso di tendinopatie nel ventre tendineo, si utilizzano un grande numero di ripetizioni con movimento completo, mentre in caso di tendinopatie inserzionale si utilizzano esercizi a livello del terreno quasi isometrici.</p> <p>3) La terza fase è quella di ritorno in campo, dove sarà importante proseguire per almeno 3 volte a settimana per 12 settimane <strong>un programma di esercizi preventivi per evitare ricadute</strong>, basati su stretching dinamico, cyclette, massoterapia prima dell’allenamento per scaldare correttamente muscolo e tendine, massoterapia a fine allenamento per detendere la muscolatura del polpaccio e ghiaccio sul tendine d’Achille.</div> </div> </div> </div><div class="et_pb_row et_pb_row_19"> <div class="et_pb_column et_pb_column_1_2 et_pb_column_24 et_pb_css_mix_blend_mode_passthrough"> <div class="et_pb_module et_pb_text et_pb_text_19 et_pb_text_align_left et_pb_bg_layout_light"> <div class="et_pb_text_inner">In caso di tendinopatia Achillea, sono <strong>altamente sconsigliati farmaci antinfiammatori</strong>, che coprono il dolore esponendo il tendine a continua usura, e le infiltrazioni, che possono deteriorare il tendine causandone la rottura.</div> </div> </div><div class="et_pb_column et_pb_column_1_2 et_pb_column_25 et_pb_css_mix_blend_mode_passthrough et-last-child"> <div class="et_pb_module et_pb_image et_pb_image_2"> <span class="et_pb_image_wrap "><img loading="lazy" decoding="async" width="1920" height="1080" src="https://www.fisiocalcio.it/wp-content/uploads/2020/06/4.jpg" alt="" title="4" srcset="https://www.fisiocalcio.it/wp-content/uploads/2020/06/4.jpg 1920w, https://www.fisiocalcio.it/wp-content/uploads/2020/06/4-1280x720.jpg 1280w, https://www.fisiocalcio.it/wp-content/uploads/2020/06/4-980x551.jpg 980w, https://www.fisiocalcio.it/wp-content/uploads/2020/06/4-480x270.jpg 480w" sizes="auto, (min-width: 0px) and (max-width: 480px) 480px, (min-width: 481px) and (max-width: 980px) 980px, (min-width: 981px) and (max-width: 1280px) 1280px, (min-width: 1281px) 1920px, 100vw" class="wp-image-783" /></span> </div> </div> </div><div class="et_pb_row et_pb_row_20"> <div class="et_pb_column et_pb_column_4_4 et_pb_column_26 et_pb_css_mix_blend_mode_passthrough et-last-child"> <div class="et_pb_module et_pb_text et_pb_text_20 et_pb_text_align_left et_pb_bg_layout_light"> <div class="et_pb_text_inner"><h3 style="text-align: center;"><strong>IL DOLORE SUL TENDINE D’ACHILLE NON MI PASSA: IN COSA CONSISTE LA CHIRURGIA?</strong></h3></div> </div> </div> </div><div class="et_pb_row et_pb_row_21"> <div class="et_pb_column et_pb_column_4_4 et_pb_column_27 et_pb_css_mix_blend_mode_passthrough et-last-child"> <div class="et_pb_module et_pb_text et_pb_text_21 et_pb_text_align_left et_pb_bg_layout_light"> <div class="et_pb_text_inner">Se dopo 6 mesi di trattamento conservativo non si ottiene nessun tipo di risultato, può essere presa in considerazione la chirurgia: l’operazione chirurgica per risolvere una tendinopatia Achillea riporta ottimi risultati in circa il <strong>70% </strong>dei casi. Le tecniche maggiormente utilizzate sono la <strong>tenotomia</strong>, l’asportazione di aderenze fibrotiche, la rimozione di noduli danneggiati, il rilascio del tendine plantare se crea conflitto meccanico con il tendine d’Achille.</div> </div> </div> </div><div class="et_pb_row et_pb_row_22"> <div class="et_pb_column et_pb_column_4_4 et_pb_column_28 et_pb_css_mix_blend_mode_passthrough et-last-child"> <div class="et_pb_module et_pb_text et_pb_text_22 et_pb_text_align_left et_pb_bg_layout_light"> <div class="et_pb_text_inner"><p><strong>Bibliografia:</strong></p> <ol> <li>Cook JL, Khan KM, Purdam C. Achilles tendinopathy. <em>Man Ther</em>. 2002;7(3):121-130. <a href="https://www.ncbi.nlm.nih.gov/pubmed/12372309">https://www.ncbi.nlm.nih.gov/pubmed/12372309</a></li> <li>Alfredson H. The chronic painful achilles and patellar tendon: Research on basic biology and treatment. <em>Scand J Med Sci Sports</em>. 2005;15(4):252-259. <a href="https://www.ncbi.nlm.nih.gov/pubmed/15998342">https://www.ncbi.nlm.nih.gov/pubmed/15998342</a></li> <li>Alfredson H, Pietila T, Jonsson P, Lorentzon R. Heavy-load eccentric calf muscle training for the treatment of chronic achilles tendinosis. <em>Am J Sports Med</em>. 1998;26(3):360-366. <a href="https://www.ncbi.nlm.nih.gov/pubmed/9617396">https://www.ncbi.nlm.nih.gov/pubmed/9617396</a></li> <li>Bell KJ, Fulcher ML, Rowlands DS, Kerse N. Impact of autologous blood injections in treatment of mid-portion achilles tendinopathy: Double blind randomised controlled trial. <em>BMJ</em>. 2013;346:f2310. <a href="https://www.ncbi.nlm.nih.gov/pubmed/23599320">https://www.ncbi.nlm.nih.gov/pubmed/23599320</a></li> <li>de Vos RJ, Weir A, van Schie HT, et al. Platelet-rich plasma injection for chronic achilles tendinopathy: A randomized controlled trial. <em>JAMA</em>. 2010;303(2):144-149. <a href="https://www.ncbi.nlm.nih.gov/pubmed/20068208">https://www.ncbi.nlm.nih.gov/pubmed/20068208</a></li> <li>Humphrey J, Chan O, Crisp T, et al. The short-term effects of high volume image guided injections in resistant non-insertional achilles tendinopathy. <em>J Sci Med Sport</em>. 2010;13(3):295-298. <a href="https://www.ncbi.nlm.nih.gov/pubmed/19944642">https://www.ncbi.nlm.nih.gov/pubmed/19944642</a></li> <li>Chan O, O’Dowd D, Padhiar N, et al. High volume image guided injections in chronic achilles tendinopathy. <em>Disabil Rehabil</em>. 2008;30(20-22):1697-1708. <a href="https://www.ncbi.nlm.nih.gov/pubmed/18608362">https://www.ncbi.nlm.nih.gov/pubmed/18608362</a></li> <li>Maffulli N, Spiezia F, Longo UG, Denaro V, Maffulli GD. High volume image guided injections for the management of chronic tendinopathy of the main body of the achilles tendon. <em>Phys Ther Sport</em>. 2013;14(3):163-167. <a href="https://www.ncbi.nlm.nih.gov/pubmed/23131435">https://www.ncbi.nlm.nih.gov/pubmed/23131435</a></li> <li>Rees JD, Maffulli N, Cook J. Management of tendinopathy. <em>Am J Sports Med</em>. 2009;37(9):1855-1867. <a href="https://www.ncbi.nlm.nih.gov/pubmed/19188560">https://www.ncbi.nlm.nih.gov/pubmed/19188560</a></li> <li>Tallon C, Coleman BD, Khan KM, Maffulli N. Outcome of surgery for chronic achilles tendinopathy. A critical review. <em>Am J Sports Med</em>. 2001;29(3):315-320. <a href="https://www.ncbi.nlm.nih.gov/pubmed/11394602">https://www.ncbi.nlm.nih.gov/pubmed/11394602</a></li> <li>Alfredson H. Midportion achilles tendinosis and the plantaris tendon. <em>Br J Sports Med</em>. 2011;45(13):1023-1025. <a href="https://www.ncbi.nlm.nih.gov/pubmed/21628352">https://www.ncbi.nlm.nih.gov/pubmed/21628352</a></li> <li>Maffulli N, Longo UG, Spiezia F, Denaro V. Minimally invasive surgery for achilles tendon pathologies. <em>Open Access J Sports Med</em>. 2010;1:95-103. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3781859/">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3781859/</a></li> <li>Alfredson H. Chronic midportion achilles tendinopathy: an update on research and treatment. <em>Clin Sports Med</em>. 2003;22(4):727-741. <a href="https://www.ncbi.nlm.nih.gov/pubmed/14560544">https://www.ncbi.nlm.nih.gov/pubmed/14560544</a></li> <li>Kujala UM, Sarna S, Kaprio J. Cumulative incidence of Achilles tendon rupture and tendinopathy in male former elite athletes. <em>Clin J Sport Med</em>. 2005;15(3):133-135. <a href="https://www.ncbi.nlm.nih.gov/pubmed/15867554">https://www.ncbi.nlm.nih.gov/pubmed/15867554</a></li> <li>Raikin SM, Garras DN, Krapchev PV. Achilles tendon injuries in a United States population. <em>Foot Ankle Int</em>. 2013;34(4):475-480. <a href="https://www.ncbi.nlm.nih.gov/pubmed/23386750">https://www.ncbi.nlm.nih.gov/pubmed/23386750</a></li> <li>Krolo I, Viskovic K, Ikic D, Klaric-Custovic R, Marotti M, Cicvara T. The risk of sports activities – the injuries of the Achilles tendon in sportsmen. <em>Coll Antropol</em>. 2007;31(1):275-278. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6259075/">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6259075/</a></li> <li>Metzl JA, Ahmad CS, Levine WN. The ruptured Achilles tendon: operative and non-operative treatment options. <em>Curr Rev Musculoskelet Med</em>. 2008;1(2):161-164. <a href="https://www.ncbi.nlm.nih.gov/pubmed/19468891">https://www.ncbi.nlm.nih.gov/pubmed/19468891</a></li> <li>Kocher MS, Bishop J, Marshall R, Briggs KK, Hawkins RJ. Operative versus nonoperative management of acute Achilles tendon rupture: Expected-value decision analysis. <em>Am J Sports Med</em>. 2002;30(6):783-790. <a href="https://www.ncbi.nlm.nih.gov/pubmed/12435641">https://www.ncbi.nlm.nih.gov/pubmed/12435641</a></li> <li>Tendinopatia Achillea <a href="https://www.fisioterapiaitalia.com/blog/tendinopatia-tendine-dachille/">https://www.fisioterapiaitalia.com/blog/tendinopatia-tendine-dachille/</a></li> <li>Dolore Tendine d’Achille <a href="https://www.fisioterapiaitalia.com/blog/cosa-fare-dolore-tendine-achille/">https://www.fisioterapiaitalia.com/blog/cosa-fare-dolore-tendine-achille/</a></li> </ol></div> </div> </div> </div> </div><div class="et_pb_section et_pb_section_3 et_hover_enabled et_pb_with_background et_section_regular" > <div class="et_pb_row et_pb_row_23 et_hover_enabled"> <div class="et_pb_column et_pb_column_4_4 et_pb_column_29 et_pb_css_mix_blend_mode_passthrough et-last-child"> <div class="et_pb_module et_pb_text 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