{"id":1387,"date":"2018-05-11T06:26:30","date_gmt":"2018-05-11T06:26:30","guid":{"rendered":"https:\/\/projects.techhivetechnologies.com\/lfiold\/?p=1387"},"modified":"2023-12-11T06:29:03","modified_gmt":"2023-12-11T06:29:03","slug":"skader-pa-akillessenen","status":"publish","type":"post","link":"https:\/\/projects.techhivetechnologies.com\/lfiold\/skader-pa-akillessenen\/","title":{"rendered":"Skader p\u00e5 akillessenen"},"content":{"rendered":"\t\t
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Skader p\u00e5 akillessenen<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\"Motivasjon\"\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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I mitt masterarbeid p\u00e5 Norges idrettsh\u00f8yskole arbeidet jeg i godt \u00e5 vel et \u00e5r med et smalt felt p\u00e5 akillessenerupturer (avrevet akillessene). I tillegg til dette har jeg i mange \u00e5r deltatt i et forskningsprosjekt hvor jeg har rehabilitert skadene. Dette har f\u00f8rt til en enorm interesse for feltet. Mange pasienter som kommer til meg har mange sp\u00f8rsm\u00e5l som omfatter akillesskader. Jeg vil derfor i dag ta for meg litt bakgrunnskunnskap om akillessenen. Det forskes stadig p\u00e5 forskjellige problemstillinger i forbindelse med akillessenerupturer noe som gj\u00f8r at man b\u00f8r v\u00e6re ydmyk for at b\u00e5de retningslinjer og kunnskap endrer seg med kunnskapsniv\u00e5et.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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Viser en gresk stor helt og kriger ved navn Akilles hentet fra gresk mytologi<\/em><\/p><\/div>

N\u00e5r man Googler akilles vil man som oftest m\u00f8te en gresk helt og en stor kriger, nemlig Akilles fra gresk mytologi. I anatomisk forstand kan akillessenen ogs\u00e5 ses p\u00e5 som en helt med tanke p\u00e5 at musklene som danner akillessenen er de to viktigste musklene i fra skyvet under l\u00f8p og gange. Under gange blir akillessenen utsatt for belasting tilsvarende 2-3 ganger kroppsvekten, mens ved l\u00f8p kan den bli utsatt for belastning opptil 12,5 ganger kroppsvekten (Komi, Fukashiro, & Jarvinen, 1992).<\/p>

I menneskekroppen er akillessenen den st\u00f8rste og sterkeste senen, til tross for dette er den hyppigst utsatt for rupturer \u00a0(Jiang et al., 2012). Den greske helten viste seg ogs\u00e5 \u00e5 v\u00e6re s\u00e5rbar. Sagnet forteller nemlig at ble Akilles ble drept med en pil i akilles som ble hans banes\u00e5r.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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Anatomisk bilde av m.tricpes surae og akillessenen<\/p><\/div>

Akillessenerupturer<\/h2>

Den f\u00f8rste akillessenerupturen ble rapportert i 1575 (Gulati et al., 2015). Fra 1991 til 2002 har det er blitt rapportert en \u00f8kning av akutte akillessenerupturer fra 11-32,6 per 100 000 per \u00e5r (Gulati et al., 2015). Grunnen til en st\u00f8rre forekomst av akillessenerupturer kan v\u00e6re den \u00f8kende alderen blant mosjonister (Huttunen, Kannus, Rolf, Fellander-Tsai, & Mattila, 2014; Lantto et al., 2015).<\/p>

Sportsrelaterte skader er det vanligste, men det har ogs\u00e5 blitt rapportert en \u00f8kning av ikke-sportsrelaterte akillessenerupturer, spesielt blant eldre kvinner (Lantto et al., 2015). Menn er mest utsatt for akillessenerupturer, forekomsten blant menn er tre ganger h\u00f8yere enn blant kvinner (Ganestam, Kallemose, Troelsen, & Barfod, 2015). Gjennomsnittsalderen for akillessenerupturer blant menn er 45 \u00e5r og 44 \u00e5r for kvinner (Ganestam et al., 2015).<\/p>

Hvordan oppdager man en akillesseneruptur?<\/h3>

Den vanligste akillessenerupturen (53%) oppst\u00e5r under fra skyvet i hopp eller l\u00f8p med kneet i full strekk (Gross & Nunley, 2016). En annen skademekanisme (17%) er en uventet b\u00f8y av ankelleddet med en umiddelbar kontraksjon av bakside leggmuskelen (Gross & Nunley, 2016). Enkelte pasienter kan fortelle om langvarig akillessenesmerter i forkant av rupturen, men som oftest oppst\u00e5r skaden uten forvarsel. De aller fleste pasientene oppdager umiddelbart at noe galt og opps\u00f8ker selv helsepersonell. Det er viktig at helsepersonellet som unders\u00f8ker pasienten har god kunnskap p\u00e5 feltet og ikke minst klinisk erfaring.<\/p>

Ved totale akillessenerupturer har nyere studier vist at det er lettere \u00e5 oppdage skaden ved kliniske unders\u00f8kelse i kombinasjon med pasient historie enn ved MR (Garras, Raikin, Bhat, Taweel, & Karanjia, 2012).<\/p>

Da det er et sterkt samspill mellom musklene som danner akilles og de andre musklene i leggen b\u00f8r helsepersonellet som utf\u00f8rer unders\u00f8kelsene b\u00f8r ha erfaring med akillessenerupturer for \u00e5 stille den riktige diagnosen. Ved LFI helse & trening har vi idrettsfysioterapeuter som har god kunnskap og erfaring med \u00e5 stille diagnoser p\u00e5 akutte skader.<\/p>

Manuellterapeutene ved LFI helse & trening har mulighetene for \u00e5 henvise til MR dersom vi mener det er n\u00f8dvendig. Vi har ogs\u00e5 et godt nettverk av offentlige sykehus og leger som vi samarbeider med ved kompliserte kasuser.<\/p>

Hvorfor f\u00e5r man akillessenerupturer?<\/h3>

\u00c5rsaksforholdene ved akillessenerupturer ser ut til \u00e5 v\u00e6re multifaktorielle og kan deles inn i indre og ytre risikofaktorer. Det er summen av hvordan de indre og ytre risikofaktorene p\u00e5virker hverandre som kan v\u00e6re predisponerende for skade (R. Bahr & Krosshaug, 2005). De indre risiko faktorene som har blitt foresl\u00e5tt i litteraturen er degenerative forandringer p\u00e5 akillessenen, anatomiske forskjeller, nedsatt sene-fibrill, genetikk, kj\u00f8nn, alder, biomekaniske faktorer. Av ytre risikofaktorer er det blitt foresl\u00e5tt sportsrelaterte faktorer som underlag og skot\u00f8y (Claessen, de Vos, Reijman, & Meuffels, 2014). Hvordan disse faktorene p\u00e5virker hverandre og videre f\u00f8rer til predisponering for en akillesseneruptur har vi fortsatt ikke nok kunnskap om.<\/p>

N\u00e5r skaden f\u00f8rst er skjedd<\/h3>

Flere studier viser at pasienten med akillessenerupturer f\u00e5r forandringer i gang funksjon og et lavere aktivitetsniv\u00e5 sammenlignet med f\u00f8r akillessenerupturen inntraff (Don et al., 2007; Olsson et al., 2011; Suydam, Buchanan, Manal, & Silbernagel, 2015). Det er derfor b\u00e5de helsemessig og samfunns\u00f8konomisk viktig \u00e5 s\u00f8rge for at pasientene blir rehabilitert slik at det blir s\u00e5 liten sideforskjell p\u00e5 skadet og uskadet side som mulig. P\u00e5 LFI helse & trening har flere av behandlerne v\u00e5re h\u00f8y kunnskap og lang erfaring i opptrening etter skade.<\/p>

Mvh<\/p>

Jannicke Fjellstad<\/strong><\/p>

Spesialist i Idrettsfysioterapi<\/p>

LFI Helse & Trening<\/p>

\u00a0<\/p>

Litteraturliste<\/strong><\/p>

Komi, P. V., Fukashiro, S., & Jarvinen, M. (1992). Biomechanical loading of Achilles tendon during normal locomotion.\u00a0Clin Sports Med, 11<\/em>(3), 521-531.<\/p>

Jiang, N., Wang, B., Chen, A., Dong, F., & Yu, B. (2012). Operative versus nonoperative treatment for acute Achilles tendon rupture: a meta-analysis based on current evidence.\u00a0Int Orthop, 36<\/em>(4), 765-773. doi:10.1007\/s00264-011-1431-3<\/p>

Gulati, V., Jaggard, M., Al-Nammari, S. S., Uzoigwe, C., Gulati, P., Ismail, N., . . . Gupte, C. (2015). Management of achilles tendon injury: A current concepts systematic review.\u00a0World J Orthop, 6<\/em>(4), 380-386. doi:10.5312\/wjo.v6.i4.380<\/p>

Huttunen, T. T., Kannus, P., Rolf, C., Fellander-Tsai, L., & Mattila, V. M. (2014). Acute achilles tendon ruptures: incidence of injury and surgery in Sweden between 2001 and 2012.\u00a0Am J Sports Med, 42<\/em>(10), 2419-2423. doi:10.1177\/0363546514540599<\/p>

Lantto, I., Heikkinen, J., Flinkkila, T., Ohtonen, P., & Leppilahti, J. (2015). Epidemiology of Achilles tendon ruptures: increasing incidence over a 33-year period.\u00a0Scand J Med Sci Sports, 25<\/em>(1), e133-138. doi:10.1111\/sms.12253<\/p>

Ganestam, A., Kallemose, T., Troelsen, A., & Barfod, K. W. (2015). Increasing incidence of acute Achilles tendon rupture and a noticeable decline in surgical treatment from 1994 to 2013. A nationwide registry study of 33,160 patients.\u00a0Knee Surg Sports Traumatol Arthrosc<\/em>. doi:10.1007\/s00167-015-3544-5<\/p>

Gross, C. E., & Nunley, J. A., 2nd. (2016). Acute Achilles Tendon Ruptures.\u00a0Foot Ankle Int, 37<\/em>(2), 233-239. doi:10.1177\/1071100715619606<\/p>

Garras, D. N., Raikin, S. M., Bhat, S. B., Taweel, N., & Karanjia, H. (2012). MRI is unnecessary for diagnosing acute Achilles tendon ruptures: clinical diagnostic criteria.\u00a0Clin Orthop Relat Res, 470<\/em>(8), 2268-2273. doi:10.1007\/s11999-012-2355-y<\/p>

Bahr, R., & Krosshaug, T. (2005). Understanding injury mechanisms: a key component of preventing injuries in sport.\u00a0Br J Sports Med, 39<\/em>(6), 324-329. doi:10.1136\/bjsm.2005.018341<\/p>

Bahr, R., McCrory, P., Bolic, T., & Pr\u00f8is, L.-A. (2014).\u00a0Idrettsskader : diagnostikk og behandling<\/em>. Bergen: Fagbokforl.<\/p>

Claessen, F. M., de Vos, R. J., Reijman, M., & Meuffels, D. E. (2014). Predictors of primary Achilles tendon ruptures.\u00a0Sports Med, 44<\/em>(9), 1241-1259. doi:10.1007\/s40279-014-0200-z<\/p>

Don, R., Ranavolo, A., Cacchio, A., Serrao, M., Costabile, F., Iachelli, M., . . . Santilli, V. (2007). Relationship between recovery of calf-muscle biomechanical properties and gait pattern following surgery for achilles tendon rupture.\u00a0Clin Biomech (Bristol, Avon), 22<\/em>(2), 211-220. doi:10.1016\/j.clinbiomech.2006.10.001<\/p>

Suydam, S. M., Buchanan, T. S., Manal, K., & Silbernagel, K. G. (2015). Compensatory muscle activation caused by tendon lengthening post-Achilles tendon rupture.\u00a0Knee Surg Sports Traumatol Arthrosc, 23<\/em>(3), 868-874. doi:10.1007\/s00167-013-2512-1<\/p>

Olsson, N., Nilsson-Helander, K., Karlsson, J., Eriksson, B. I., Thomee, R., Faxen, E., & Silbernagel, K. G. (2011). Major functional deficits persist 2 years after acute Achilles tendon rupture.\u00a0Knee Surg Sports Traumatol Arthrosc, 19<\/em>(8), 1385-1393. doi:10.1007\/s00167-011-1511-3<\/p>

#Achilles tendon rupture; assessment of nonoperative treatment, av Barfod, K. W, 2014,\u00a0<\/i>Danish medical journal<\/strong><\/em>, 61, s.4. C<\/em>opyright 2014 Danish medical jounal. Gjengitt med tillatelse.<\/em><\/p><\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"

Skader p\u00e5 akillessenen I mitt masterarbeid p\u00e5 Norges idrettsh\u00f8yskole arbeidet jeg i godt \u00e5 vel et \u00e5r med et smalt felt p\u00e5 akillessenerupturer (avrevet akillessene). I tillegg til dette har jeg i mange \u00e5r deltatt i et forskningsprosjekt hvor jeg har rehabilitert skadene. Dette har f\u00f8rt til en enorm interesse for feltet. Mange pasienter som […]<\/p>\n","protected":false},"author":1,"featured_media":1388,"comment_status":"open","ping_status":"open","sticky":false,"template":"elementor_header_footer","format":"standard","meta":{"footnotes":""},"categories":[6],"tags":[],"class_list":["post-1387","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blogs"],"yoast_head":"\nSkader p\u00e5 akillessenen - LFI<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/projects.techhivetechnologies.com\/lfiold\/skader-pa-akillessenen\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Skader p\u00e5 akillessenen\" \/>\n<meta property=\"og:description\" content=\"Skader p\u00e5 akillessenen I mitt masterarbeid p\u00e5 Norges idrettsh\u00f8yskole arbeidet jeg i godt \u00e5 vel et \u00e5r med et smalt felt p\u00e5 akillessenerupturer (avrevet akillessene). I tillegg til dette har jeg i mange \u00e5r deltatt i et forskningsprosjekt hvor jeg har rehabilitert skadene. Dette har f\u00f8rt til en enorm interesse for feltet. 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I tillegg til dette har jeg i mange \u00e5r deltatt i et forskningsprosjekt hvor jeg har rehabilitert skadene. Dette har f\u00f8rt til en enorm interesse for feltet. Mange pasienter som […]","og_url":"https:\/\/projects.techhivetechnologies.com\/lfiold\/skader-pa-akillessenen\/","og_site_name":"LFI","article_published_time":"2018-05-11T06:26:30+00:00","article_modified_time":"2023-12-11T06:29:03+00:00","og_image":[{"width":768,"height":512,"url":"https:\/\/projects.techhivetechnologies.com\/lfiold\/wp-content\/uploads\/2023\/12\/Blogg_Nr2_Jannicke_Akilles_Bilde_Undersokelse_Akilles-768x512-1.jpg","type":"image\/jpeg"}],"author":"admin","twitter_card":"summary_large_image","twitter_misc":{"Written by":"admin","Est. reading time":"6 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/projects.techhivetechnologies.com\/lfiold\/skader-pa-akillessenen\/#article","isPartOf":{"@id":"https:\/\/projects.techhivetechnologies.com\/lfiold\/skader-pa-akillessenen\/"},"author":{"name":"admin","@id":"https:\/\/projects.techhivetechnologies.com\/lfiold\/#\/schema\/person\/5b69cb31570feb94ba91178cf62af5e6"},"headline":"Skader p\u00e5 akillessenen","datePublished":"2018-05-11T06:26:30+00:00","dateModified":"2023-12-11T06:29:03+00:00","mainEntityOfPage":{"@id":"https:\/\/projects.techhivetechnologies.com\/lfiold\/skader-pa-akillessenen\/"},"wordCount":1272,"commentCount":0,"image":{"@id":"https:\/\/projects.techhivetechnologies.com\/lfiold\/skader-pa-akillessenen\/#primaryimage"},"thumbnailUrl":"https:\/\/projects.techhivetechnologies.com\/lfiold\/wp-content\/uploads\/2023\/12\/Blogg_Nr2_Jannicke_Akilles_Bilde_Undersokelse_Akilles-768x512-1.jpg","articleSection":["Blogs"],"inLanguage":"en-US","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/projects.techhivetechnologies.com\/lfiold\/skader-pa-akillessenen\/#respond"]}]},{"@type":"WebPage","@id":"https:\/\/projects.techhivetechnologies.com\/lfiold\/skader-pa-akillessenen\/","url":"https:\/\/projects.techhivetechnologies.com\/lfiold\/skader-pa-akillessenen\/","name":"Skader p\u00e5 akillessenen - 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