More and more studies suggest that the rehabilitation of people who suffer from musculoskeletal injuries can be hampered by irrational fear of having pain by performing certain movements (kinesiophobia) and by the propensity to imagine very negative outcome to their problem. New proof for this purpose has just been brought by a team from Laval University who published, in the journal Sports Healtha study showing that the pain felt by running enthusiasts struggling with tendonitis in Achilles tendon is associated with kinesiophobia and the propensity to catastrophism.
About 50% of people who are running will one day suffer from tendonitis in Achille tendon, recalls the study manager, Jean-Sébastien Roy, professor at the school of rehabilitation sciences and researcher at the interdisciplinary center for research in rehabilitation and social integration of Laval University. “Race is a very demanding activity for this tendon. In general, the charges he must support represent about 6 times the weight of the runner at each stride, but they can reach up to 12 times his weight in climb or downhill, “he said.
Achilles tendonitis can be tenacious. In a third of cases, it is still present a year after the appearance of symptoms. “The problem can even remain for several years and recurrences are frequent, which affects the quality of life of people,” said the researcher.
In order to identify the factors associated with the pain felt by people who suffer from tendonitis in the Achilles tendon, Professor Roy and his team recruited 84 followers of the race from which this problem had appeared for less than three months. These people first fulfilled a questionnaire frequently used in the clinic for this type of injury, the Visa-A.
“It has 8 questions based on a subjective assessment that patients make of their condition, for example, what is the intensity of the pain felt when you go down a staircase? The responses make it possible to calculate an overall pain score for each patient, ”summarizes Professor Roy.
In addition, participating people were subjected to a clinical examination of their injury, including functional tests such as jumps on a foot, and an ultrasound of the tendon. They also provided information that has made it possible to assess their degree of kinesiophobia and their propensity for catastrophism.
The analyzes revealed that the three main variables associated with the intensity of the pain estimated by the Visa-A test are the pain caused by jumps on one foot, the presence of an enlargement of the tendon detected in ultrasound and the degree of kinesiophobia and propensity to catastrophism.
The first two factors are not a surprise, observes Professor Roy. An irritated Achilles tendon is more sensitive and there is a change in composition and structure in the affected section. As for the last two factors, they show that a psychological component comes into play in the perception of pain.
— Jean-Sébastien Roy
The psychological dimension of musculoskeletal problems is sometimes neglected in the clinic, he notes. “It is important to take the time to reassure the patients, to tell them that the muscles and tendons must be asked to promote healing even if it causes a little pain, that many other runners have passed through and that the prognosis for this type of injury is good if we gradually proceed and let the body be adapted.”
The other signatories of the study published in Sports Health Are Marie-Hélène Lavallée-Bourget, Laurence Roy-Bélanger, Xavier Laurier, Arielle Tougas and Valérie Bélanger, Laval University, Blaise Dubois, of the Runner clinic, and María García-Arrabé, of the European University of Madrid.
