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Antibiotic Use and Tendon Ruptures

Tom Willemann |

I just received an  article from a special interest group of the American Physical Therapy Association.  The use of antibiotics specifically Fluoroquinolones has been identified as posing a high risk of tendon ruptures in addition to other medical complications.  Dr Hall has who authored an article titled Musculoskeletal Complications of Fluoroquinolones: Guidelines and Precautions for Usage in the Athletic Population has guidelines for the athletic population as follows:

  • Avoid fluoroquinolone use unless there is no alternative
  • Coaches and trainers should be aware of the use
  • Corticosteriods should not be utilized in conjunction with fluoroquinolones.
  • Consider concomitant use of magnesium and/or antioxidant use
  • Training routines should be reduced in intensity and volume once antibiotics are started.  A graduated return to full activity should be implemented so long as the patient remains asymptomatic after the antiobiotic course is finished.
  • All athletic activity should be stopped if any adverse reactions are experienced.
  • The patient should be monitored for one month after completion of antibiotics.
There is some evidence that  antiinflammatory medications may have negative effects on muscle, ligament, tendon and bone healing which is further compounded in the athletic population with higher physical stresses.  Click To Tweet

Too many of my athletes rely on these medications prophylactically in order to continue with running or biking without realizing the negative effects on tissue healing. Types of Fluoroquinolones are:  Cipro, Levaquin, Noroxin, Tequin, Avelox, Floxin.

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Tom Willemann

Tom Willemann

Tom Willemann is a premier physical therapist based out of Bergen County, New Jersey. He holds an MS in physical therapy from the University of Miami, is credentialed in the world-renowned McKenzie Method of Mechanical Diagnosis and Therapy (MDT), and holds an OCS (Orthopedic Clinical Specialist) certification. As of 2018, there are approximately 14,000 ABPTS certified specialists in the nation and less than 400 of them are located in the state of New Jersey. Tom is the owner and director of Apex Orthopedic Rehabilitation in Paramus. He opened the clinic, which specializes in spine and sports injury prevention, in 2004 after many years of experience in the field. Tom’s caring interest in others and his strong belief in continuity of care, combined with his clinic’s ability to find solutions for the most difficult orthopedic problems, have earned Apex Orthopedic Rehabilitation its excellent reputation with patients and medical professionals in northeastern New Jersey and beyond. A true “family man,” Tom takes pride in his clinic’s warm and welcoming environment.
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