Discussion
swelling, inflammation, tendon stiffness, pain, chronic tendon pain, tendinopathy
NEOVASCULARITY, INFLAMMATION, DEGENERATIVE, CLINICAL SYNDROME, PATHOGENESIS
AT is a clinical syndrome characterised by pain, swelling, and functional impairment, indicating a degenerative inflammatory process in the Achilles tendon. The overall incidence rate of AT was 2.45 per 1000 in the adult population between 21 and 60 years in their lifetime. It can affect athletes and non-athletes. Patients with AT commonly refer to persistent pain that may result in loss of function and activity cessation. The pathogenesis of tendinopathy can be described as failed healing of the diseased tendon. Failed recovery mainly refers to prolonged inflammation and failed resolution of the normal healing process. Furthermore, increased focal vascularity contributes to the clinical presentations of chronic tendon pain, stiffness, and weakness.An increase in tendon thickness is often found in patients with AT. It could happen in either midportion or insertion of the Achilles tendon, which is caused by swelling of the affected area. Moreover, the ingrowth of new blood vessels into tendinopathic regions is often seen in ultrasound imaging. PEMF may reduce tendon inflammation, thus reducing tendon thickness and neovascularity. Tendon elasticity is measured by shear wave elastography (SWE). SWE could quantify soft tissue stiffness and provide an absolute value of the stiffness of the soft tissue. There may be an increase in tendon stiffness in patients with AT. This is because patients may reduce the level of activities because of pain associated with AT. PEMF may minimise tendon pain and facilitate the performance of the eccentric exercise. Thus, there may be a reduction in tendon elasticity.This trial may demonstrate the effectiveness of PEMF in relieving pain, improving function, and restoring mechanical changes of the tendon in patients with AT. AT is a common clinical condition affecting both athletes and sedentary populations. Exercise prescription is used as a non-invasive therapy for patients with AT. However, some participants do not respond well to exercise therapy and conventional treatments. It is essential to investigate treatment adjuncts to improve rehabilitation outcomes for this group of patients.