Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “TENDONS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,081 records · Page 60Linked to original sources
PubMed1997

Fetal and postnatal development of the patella, patellar tendon and suprapatella in the rabbit; changes in the distribution of the fibrillar collagens.

The development of the patella, its associated tendons, and suprapatella of the rabbit knee joint is described from the 17 d fetus to the mature adult. The patellar tendon (ligament) with the patella on its posterior surface is seen in the 17 d fetus and is fully developed by 1 postnatal wk. It is composed of bundles of types I and V collagens separated by endotenons of types III and V collagens. Anteriorly there is an epitenon of types III and V collagens while synovium and a fat pad cover its posterior surface. In the 25 d fetus, the patella is cartilaginous and is separated from the femoral condyles. The cartilage contains type II collagen, but types I, III and V collagens are found along the articular surface. Ossification starts 1 postnatal wk and at 6 wk only the articular cartilage remains. In addition to type II, types III and V collagens are located around the chondrocyte lacunae. The long anterior junction between the patella and its tendon is fibrocartilaginous at 1 wk, but as ossification proceeds this is replaced by bone. Types I and V collagens are found in this region. The suprapatella on the posterior surface of the quadriceps tendon is first seen 1 wk postnatally as an area of irregularly organised fibres and chondrocyte-like cells. Types I, II, III and V collagens are present from 3 wk onwards. It is compared with the fibrocartilage of other tendons that are under compression. The arrangement of the collagens in the patellar tendon is discussed in relation to its use as a replacement for injured anterior cruciate ligaments. It is suggested that the structural differences between the patellar tendon and anterior cruciate ligament preclude the translocated tendon acquiring mechanical strength similar to that of a normal cruciate ligament. The designation 'patellar ligament' as opposed to 'patellar tendon' is questioned. It is argued that the term patellar tendon reflects its structure more accurately than patellar ligament.

Animals↗
PubMed1998

Fibrocartilage in tendons and ligaments--an adaptation to compressive load.

Where tendons and ligaments are subject to compression, they are frequently fibrocartilaginous. This occurs at 2 principal sites: where tendons (and sometimes ligaments) wrap around bony or fibrous pulleys, and in the region where they attach to bone, i.e. at their entheses. Wrap-around tendons are most characteristic of the limbs and are commonly wider at their point of bony contact so that the pressure is reduced. The most fibrocartilaginous tendons are heavily loaded and permanently bent around their pulleys. There is often pronounced interweaving of collagen fibres that prevents the tendons from splaying apart under compression. The fibrocartilage can be located within fascicles, or in endo- or epitenon (where it may protect blood vessels from compression or allow fascicles to slide). Fibrocartilage cells are commonly packed with intermediate filaments which could be involved in transducing mechanical load. The ECM often contains aggrecan which allows the tendon to imbibe water and withstand compression. Type II collagen may also be present, particularly in tendons that are heavily loaded. Fibrocartilage is a dynamic tissue that disappears when the tendons are rerouted surgically and can be maintained in vitro when discs of tendon are compressed. Finite element analyses provide a good correlation between its distribution and levels of compressive stress, but at some locations fibrocartilage is a sign of pathology. Enthesis fibrocartilage is most typical of tendons or ligaments that attach to the epiphyses of long bones where it may also be accompanied by sesamoid and periosteal fibrocartilages. It is characteristic of sites where the angle of attachment changes throughout the range of joint movement and it reduces wear and tear by dissipating stress concentration at the bony interface. There is a good correlation between the distribution of fibrocartilage within an enthesis and the levels of compressive stress. The complex interlocking between calcified fibrocartilage and bone contributes to the mechanical strength of the enthesis and cartilage-like molecules (e.g. aggrecan and type II collagen) in the ECM contribute to its ability to withstand compression. Pathological changes are common and are known as enthesopathies.

Adaptation, Physiological↗
PubMed2001

Effect of pulley integrity on excursions and work of flexion in healing flexor tendons.

We investigated the effect of incision of a single critical pulley on excursions and work of flexion in healing flexor tendons. Forty-two long toes from 21 white leghorn chickens were used as the experimental model. Gliding excursions of the flexor digitorum profundus tendons and work of flexion of the long toes were studied 8 weeks after tendon repair to determine the functions of the healed tendons in intact, incised, or enlarged A2 pulleys. Eleven additional chickens (22 long toes) were used to obtain tendon excursion measurements in normal chicken toes. At 8 weeks, gliding excursions were statistically smaller in the intact pulley group than in the incised or enlarged pulley groups; the excursions were 73% +/- 4% for the intact pulley group, 88% +/- 9% for the incised pulley group, and 91% +/- 8% for the enlarged sheath group compared with the normal group. Work of flexion of the toes in the intact pulley group was statistically greater than that in the incised or enlarged pulley groups. Excursion efficiency of the flexor tendons was not statistically different among the toes receiving different treatments in the pulley. The results of this study demonstrate that release of a single pulley after repair of the tendons in this area improved gliding excursions of the tendons and reduced resistance to motion of the repaired tendons, and provide support for partial A2 pulley incision after repair of the tendons in the area of the pulley.

Analysis of Variance↗
PubMed2001

Comparison of postoperative early active mobilization and immobilization in vivo utilising a four-strand flexor tendon repair.

We evaluated a technique of four-strand double-modified locking Kessler flexor tendon repair in healing tendons. Seventy-two canine flexor digitorum profundus tendons in Zone 2 were repaired and evaluated following either active mobilization or immobilization at 0, 7, 14, 28 and 42 days after surgery. Fifty-six tendons were examined for gap and ultimate strength using a tensile testing machine and 16 were evaluated with standard hematoxylin and eosin, and Masson's trichrome staining. All tendons healed without rupture or gap formation of more than 1 mm, thus demonstrating that this repair technique has enough tensile strength to withstand early active mobilization. The gap and ultimate strength of actively mobilized tendons did not decrease significantly during the first 7 days, and were significantly greater than those of immobilized tendons throughout the 42-day study period. Actively mobilized tendons healed without the extrinsic adhesions and large tendon calluses that were found in immobilized tendons.

Animals↗
PubMedDate not supplied

[Portable NMR-MOUSE: a new method and its evaluation of the Achilles tendon].

AIM: The increased demands placed on the Achilles tendon in recreational and professional sports have led to a rise in pathological changes in this anatomic region. Magnetic resonance evaluations of the tendon have proven to be a valid but expensive and stationary diagnostic tool. In this study, a new mobile NMR sensor was to be tested in the evaluation of the Achilles tendon. METHOD: The technical development of the so-called NMR-MOUSE ( Mobile Universal Surface Explorer) represents a novelty with an open and portable sensor. To appraise its diagnostic efficacy, healthy athletes (professional soccer players, track and field, as well as aquatic athletes), healthy controls and patients with Achilles tendon lesions were evaluated. As an accessible, sensitive and reproducible parameter for the study the transverse relaxation time T2 with its angular dependency was chosen. As part of the examination, the relaxation times of the skin, the tendon and the surrounding soft tissue were determined. RESULTS: During the evaluation with the NMR-MOUSE, the skin and peritendineous tissue exhibited relatively long T2 relaxation times, while the tendon itself had significantly shorter T2 times, allowing for a clear differentiation of the structures. The T2 relaxation time of the Achilles tendon in the control group averaged 5.8 ms. The MRI-MOUSE was able to demonstrate an increase in the T2 relaxation times in patients with pathological lesions of the tendon due to the increased water retention of the tissue. CONCLUSION: The novel NMR-MOUSE represents a cost efficient and portable sensor, which allows for a reliable evaluation of surface structures, such as the Achilles tendon. The anisotropic structure of the tendon and the surrounding soft tissue can be reliably differentiated with the help of the NMR-MOUSE.

Achilles Tendon↗
PubMed2004

Colour and power Doppler sonography in symptomatic Achilles tendon disease.

The present trial focused on the exact role of colour and power Doppler sonography in Achilles tendinopathy and correlated these techniques with the clinical severity of the disease and with findings on grey-scale sonography. Twenty patients with in total 28 symptomatic Achilles tendons were included in this prospective trial. Additionally included were the asymptomatic tendons (n = 12) of patients and both tendons (n = 30) of fifteen controls. The pain score of Robinson - which ranges from 0 (strong severe pain) to 100 (asymptomatic) - was used to assess clinical severity of the disease. Both tendons of patients and controls were examined by a GE LOGIQ 9 trade mark scanner with a small-parts 14 MHz transducer. Grey-scale sonography detected in total 31 focal hypoechoic areas in 19 (68 %) of the 28 symptomatic tendons. Colour as well as power Doppler sonography detected blood flow in 14 (74 %) of the 19 tendons with focal hypoechoic areas. No blood flow was detected in the remaining symptomatic tendons (n = 14) and in the asymptomatic tendons of patients or in both tendons of controls. Colour and power Doppler sonography resulted in a specificity of 100 % and a sensitivity of 50 % for symptomatic Achilles tendinopathy. Patients with blood flow within the tendon had a significantly lower score according to Robinson than symptomatic patients without flow (P = 0.009). It is concluded that colour and/or power Doppler sonography are useful as an adjunct to grey-scale sonography in the examination of Achilles tendinosis, especially because the presence of blood flow is associated with stronger pain, discomfort and physical restriction.

Achilles Tendon↗
PubMed2006

Ultrasound Doppler of the Achilles tendon before and after injection of an ultrasound contrast agent--findings in asymptomatic subjects.

UNLABELLED: The sensitivity of ultrasound Doppler has now reached a level at which perfusion can be detected even in normal, resting musculoskeletal tissues. To be able to distinguish normal from abnormal flow, the resistive index (RI) determined by spectral Doppler may be of value. Inflammation is associated with low RI values and a value of 1.00 is normal. PURPOSE: In tissues with no detectable flow, it has been assumed that RI may be defined as 1.00. This study was performed to test if normal tendinous vessels could be visualised with a contrast agent, and if such vessels had normal RI. MATERIALS AND METHODS: Ultrasound (US) was performed with a 14 MHz linear transducer. 22 asymptomatic tendons in 12 subjects were scanned, and only 5 ultrasonically normal tendons in 5 subjects were identified. In these 5 normal tendons, SonoVue was used to make vessels visible. The Achilles tendons and the peritendinous tissues were evaluated clinically. RESULTS: In all 5 ultrasonically normal tendons, arteries could be detected with Doppler after contrast injection and in all cases with normal RI values. All vessels were located in the mid-portion of the tendon. 18 tendons were categorised as normal by the clinician. CONCLUSION: After administration of a contrast agent, all Achilles tendons could be demonstrated to have arteries present in the mid-portion. The flow profile of these arteries was fully normal without diastolic component and with an RI of 1.00. This finding has implications for criteria of normality of tendons, which cannot be based exclusively on the presence or absence of Doppler activity. The majority of the tendons in this study had ultrasound abnormalities both on gray-scale and colour Doppler. It can be speculated that the abnormalities may be age-related degenerative changes and that age-stratified normal materials are needed to define normality. There was no consistency between US and clinical diagnosis.

Achilles Tendon↗
PubMed2000

Quantitative assessment of intravascular volume of the human Achilles tendon.

The pathogenesis of Achilles tendon rupture remains unclear, but vascular patterns may play an important role. We determined the intravascular volume of the Achilles tendon using a new method with injection of radioisotopes. A solution of Tc-99m and gelatin-ink was injected into the lower limbs of body donors. The intravascular volume of each 1 cm section of the Achilles tendon was measured using a gamma well counter. We found that the distal part of the Achilles tendon (0-2 cm above the calcaneus) had an intravascular volume of 59-98 microL/g tendon tissue. In the middle part of the tendon (3-6 cm above the calcaneal insertion), the intravascular volume was much less: 2743 microL/g tissue. The proximal part of the tendon (7-9 cm) had an intravascular volume between 51-100 microL/g tendon tissue. The reduced vascularization in the middle part of the human Achilles tendon may play a role in degeneration and spontaneous rupture of the tendon.

Achilles Tendon↗
PubMed2001

Dose-related cellular effects of platelet-derived growth factor-BB differ in various types of rabbit tendons in vitro.

Cellular responsiveness to growth factors that can affect tendon healing may be site-specific. We have compared the dose-response effects of platelet-derived growth factor-BB (PDGF-BB) on proteoglycan, collagen, noncollagen protein and DNA synthesis between intrasynovial intermediate and proximal segments of deep flexor tendons, and extrasynovial peroneal tendons of rabbits during short-term cultures. PDGF-BB stimulated matrix and DNA synthesis of the three types of tendon segments in a dose-dependent manner in the range from 0.1 to 100 ng/mL. PDGF-BB stimulated collagen synthesis and noncollagen protein synthesis (calculated from LogED50) in proximal intrasynovial tendon segments more than in extrasynovial peroneal tendon segments, and DNA synthesis less in proximal than in intermediate intrasynovial tendons. However, the estimated maximal stimulations (Emax) by PDGF-BB were similar in the three types of tendon segments. These findings show that PDGF-BB stimulates DNA and matrix synthesis differently in various types and regions of tendons during short term explant culture and suggests that there may be differences in cellular responsiveness during tendon healing.

Animals↗
PubMed1996

Reflex inhibition following electrical stimulation over muscle tendons in man.

Electrical stimulation over selected muscle tendons in alert human subjects produced, in each muscle, a reflex inhibition of muscle activity. This inhibition, when maximal, was seen in the surface EMG as an interval of complete electrical silence during a sustained voluntary contraction. The inhibition was clearly visible in single sweeps and in averaged records. Its onset latency and duration were respectively, 56 +/- 4.9 and 46 +/- 11.8 ms in extensor digitorum communis, 71 +/- 6.1 and 46 +/- 10.5 ms in extensor pollicis brevis, 77 +/- 11.2 and 47 +/- 10.5 ms in extensor pollicis longus, 72 +/- 7.3 and 43 +/- 8.6 ms in abductor digiti minimi, and 97 +/- 3.5 and 43 +/- 2.8 ms in tibialis anterior. The inhibitory response was produced at low stimulus intensities (< 10 mA) without electrical (M wave) or mechanical (muscle twitch) signs of direct muscle stimulation. It therefore did not arise from stimulation of la afferents (muscle spindles). The response arose from tendons since it occurred at lowest threshold when stimulation was applied directly over the tendons of the five different muscles studied. At low stimulus intensities, the response declined sharply when the stimulating electrodes were moved to the skin immediately adjacent to the tendons. The response did not arise from skin afferents since it was also presented when stimuli were delivered to the tendon by subcutaneous needle electrodes and it was not reproduced by stimulation of cutaneous nerves in the region of the tendon. In another series of experiments on extensor pollicis brevis, five skin locations were stimulated while overlying the tendon and again while the skin was stretched so that they were lying 0.6-0.8 cm dorsal to the tendon. In these experiments the response was again greatly attenuated when the stimulation was not directly over the tendon, although the same cutaneous sites were stimulated. The inhibition was followed by a pronounced excitatory component (E1) of peak latency 120-140 ms. The results of the study provide evidence for a powerful autogenic inhibitory reflex in man. The evidence is consistent with the possibility that the response arises from Golgi tendon organ afferents.

Adult↗
PubMed1998

Biomechanical study of tibialis anterior tendon transfer.

The tibialis anterior tendon transfer has been used in the treatment of recurrent congenital clubfoot and paralytic equinovarus foot deformities in cerebral palsy. This study attempts to determine the optimal site of tibialis anterior tendon insertion for ankle and foot motion and to compare the split and whole tendon transfer. Ten fresh normal anatomic leg specimens were used. The lateral half of the tibialis anterior tendon was detached from its insertion, passed beneath the extensor retinaculum, and anchored to the appropriate tarsal bone by a barbed staple. Tension was applied, and ankle and foot motions were measured. The experiment was done by anchoring the tendon to the tarsal bones along the axis of the second metatarsal and serially through to the axis of the fifth' metatarsal. The entire experiment was repeated using the whole tibialis anterior tendon. For split tendon transfer, insertion onto the fourth metatarsal axis was the most effective route; it produced maximal dorsiflexion with minimal supination and pronation. For whole tendon transfer, the ideal site of insertion was along the third metatarsal axis. However, the difference between the average maximum dorsiflexion achieved by the split tendon transfer and that of total tendon transfer is not statistically significant.

Ankle↗
PubMed1999

Arthroscopic anterior cruciate ligament reconstruction with quadriceps tendon-patellar bone autograft.

BACKGROUND: Surgical reconstruction of the anterior cruciate ligament (ACL) is indicated in the ACL-deficient knee with symptomatic instability and multiple ligaments injuries. Bone patellar tendon-bone and the hamstring tendon generally have been used. In the present study, we describe an alternative graft, the quadriceps tendon-patellar bone autograft, by using arthroscopic ACL reconstruction. METHODS: From March of 1996 through March of 1997, a quadriceps tendon-patellar bone autograft was used in 12 patients with ACL injuries. RESULTS: After 15 to 24 months of follow-up, the clinical outcome for those patients with this graft have been encouraging. Ten patients could return to the same or a higher level of preinjury sports activity. According to the International Knee Documentation Committee rating system, 10 of the 12 patients had normal or nearly normal ratings. Recovery of quadriceps muscle strength to 80% of the normal knee was achieved in 11 patients in 1 year. CONCLUSION: The advantages of the quadriceps tendon graft include the following: the graft is larger and stronger than the patellar tendon; morbidity of harvest technique and donor site is less than that of patellar tendon graft; there is little quadriceps inhibition after quadriceps harvest; there is quicker return to sports activities with aggressive rehabilitation. A quadriceps tendon-patellar autograft is a reasonable alternative to ACL reconstruction in patients who are not suitable for either a bone-patellar tendon-bone autograft or a hamstring tendon autograft.

Adult↗
PubMed2001

Tendon healing stimulated by injected CDMP-2.

UNLABELLED: Tendon healing stimulated by injected CDMP-2. Med. Sci. Sports Exerc., Vol. 33, No. 5, 2001, pp. 685-687. INTRODUCTION: CDMP-2 is a member of the TFG-beta super-family. It is known to induce bone and cartilage formation but has also been shown under certain conditions to induce a tendon- and ligament-like tissue. The purpose of this study was to find possibilities for improvement of Achilles tendon repair during nonoperative treatment, by local injections of CDMP-2. METHODS: Fifty rats had a 3-mm segment of the Achilles tendon removed. Six hours postoperatively, CDMP-2 was injected locally into the defect at a dose of 0, 2, 10, or 50 microg. Eight days after the operation, the rats were killed and the tensile strength of the repairing tendons was measured with a materials testing machine. RESULTS: After 8 d, the CDMP-2-treated tendons were 39% stronger than the controls (P = 0.0008). CONCLUSION: One single injection CDMP-2 can augment tendon repair. Mechanical stimulation is of great importance for tissue differentiation and tendon repair. The tendons in our model were mechanically loaded during healing and this might explain why CDMP-2 injections induced a strong tendon-like tissue instead of bone or cartilage in this model.

Achilles Tendon↗
PubMed1999

Effect of injected versus iontophoretic corticosteroid on the rabbit tendon.

BACKGROUND: The etiologic role of corticosteroid therapy in tendon rupture is controversial. This study compared the effects of injected versus iontophoretically delivered corticosteroid on the normal rabbit Achilles tendon. METHODS: Rabbits were divided into three treatment groups: (1) corticosteroid injections, (2) iontophoretically delivered corticosteroid, and (3) no treatment. One tendon of each rabbit in the treatment groups was treated with either drug injection or iontophoresis; the tendon of the other leg served as a control. Some tendons were used for testing elastic modulus, ultimate load, and ultimate stress, while the remaining tendons were evaluated histologically. RESULTS: Injections of either corticosteroid or saline into the tendon sheath resulted in short-term changes in tendon biomechanical characteristics and somewhat higher histologic severity scores; however, iontophoretic delivery of corticosteroid or saline did not affect either significantly. CONCLUSIONS: Iontophoresis using sterile water or corticosteroid resulted in minimal or no biochemical and histologic changes in the tendon compared with injection of either substance. The method of corticosteroid delivery may be as important as the actual drug effects on the biomechanical and histologic properties of tendons.

Achilles Tendon↗
PubMed1993

Sonography of the Achilles tendon in hypercholesterolaemia.

OBJECTIVES: Tendon xanthomas cause thickening of the tendon and are an important sign in monogenic familial hypercholesterolaemia (FH). The aim of our study was to investigate the usefulness of achilles tendon sonography in detecting FH patients. Special attention was paid to structural abnormalities of the achilles tendon. DESIGN: A clinical study with methodological testing. SETTING: Patients suspected of having FH were sent to the out-patient Department of Medicine from other departments of Turku University Central Hospital and from primary care units. The patients were studied by high-frequency ultrasound before more exact typing of the lipid disorder. An additional study of normolipidaemic volunteers and a phantom study were also carried out. SUBJECTS: Forty FH patients, 51 non-FH hypercholesterolaemia patients and 41 normolipidaemic volunteers were included in the study. MAIN OUTCOME OF MEASURES: The thickness of the tendon was measured and the tendon structure and its echogenicity were recorded. RESULTS: Twenty-five out of 40 (63%) FH patients had distinctly thickened tendons (men more than 10 mm, women more than 9 mm). Thirty-six (90%) had a typical structural alteration of low or mixed echogenicity of the tendon. Three non-FH patients were found to have xanthomas on sonography. CONCLUSIONS: We conclude that ultrasonography is a sensitive method of detecting xanthomas that reveals the altered tendon structure even in xanthomatous tendons of normal thickness.

Achilles Tendon↗
PubMed1999

The tendons of Todaro and the "triangle of Koch": lessons from eponymous hagiolatry.

INTRODUCTION: There is growing use of the Todaro tendon and triangle of Koch as anatomic icons for invasive cardiac electrophysiologists. Reasons exist to doubt this validity. METHODS AND RESULTS: Histologic sections were prepared from 96 anatomically normal human hearts. The study area extended from the crista supraventricularis to the eustachian valve and included the AV node and His bundle. This encompasses any tendon of Todaro. Because the purported triangle of Koch includes the tendon of Todaro, all of Koch's available publications were examined. The tendon of Todaro is absent in only one fourth of infant hearts, but in two thirds of adult hearts. Tendons present were less often single than double or more, rarely exceeded 4 mm in length, and were seldom > 1 mm in diameter. Tendons usually originated from the central fibrous body and ended in the eustachian valve. Their origin most often was over the His bundle or its junction with the AV node, rather than the AV node. Tendons were primarily composed of collagen. Koch never described any triangle or acknowledged existence of tendons of Todaro. CONCLUSION: Todaro tendons are too often absent (or multiple) to warrant use as anatomic landmarks. Without this side of the supposed triangle of Koch, the entire tendon and triangle concept collapses and should be abandoned. There are numerous far more constant anatomic landmarks available to orient one to the human AV node and His bundle; these are briefly reviewed.

Adolescent↗
PubMed2006

Eccentric training in Achilles tendinopathy: is it harmful to tendon microcirculation?

BACKGROUND: Eccentric training has been shown to reduce pain and gain function in patients with chronic Achilles tendinopathy. However, currently no data are available regarding any potential adverse effects of an eccentric training intervention on Achilles tendon microcirculation. METHODS: 59 patients (49 (12) years; body mass index 27 (5); 49 mid-portion, 10 chronic insertional tendinopathy) with 64 symptomatic (54 mid-portion, 10 insertional) Achilles tendons were prospectively enrolled. Baseline tendon microcirculation at four distinct tendon positions from the insertion to the proximal mid-portion area was assessed using a laser Doppler system for capillary blood flow, tissue oxygen saturation and postcapillary venous filling pressure. A 12-week daily painful home-based eccentric training regimen was initiated (3x15 repetitions per tendon and day). RESULTS: Achilles tendon capillary blood flow was significantly reduced at the insertion (by 35%, p = 0.008) and the distal mid-portion area (by 45%, p = 0.015) at 2 mm and by 22% (p = 0.007) and 13% (p = 0.122) at 8 mm tissue depths, respectively. Achilles tendon oxygen saturation was not decreased after the 12-week eccentric training regimen throughout the insertion to the proximal mid-portion area (insertion 72 (13) vs 73 (10), proximal mid-portion 63 (13) vs 62 (11), both NS). Achilles tendon postcapillary venous filling pressures were significantly reduced at the insertion (51 (16) vs 41 (19), p = 0.001) and the distal mid-portion (36 (13) vs 32 (12), p = 0.037) at 2 mm and at the insertion at 8 mm (63 (19) vs 51 (13), p = 0.0001). Pain was reduced from 5.4 (2.1) to 3.6 (2.4; p = 0.001) in the mid-portion and from 6 (2.5) to 3.2 (2.7; p = 0.002) in the insertional tendinopathy group. No Achilles tendon rupture or any interruption during the eccentric training was noted among the 59 patients. CONCLUSION: Daily eccentric training for Achilles tendinopathy is a safe and easy measure, with beneficial effects on the microcirculatory tendon levels without any evident adverse effects in both mid-portion and insertional Achilles tendinopathy.

Achilles Tendon↗
PubMed2006

Intermittent KoldBlue cryotherapy of 3x10 min changes mid-portion Achilles tendon microcirculation.

BACKGROUND: Neovascularisation and microcirculatory changes have been reported in Achilles tendinopathy. Cryotherapy and compression, as part of a rest, ice, compression and elevation regimen, are shown to decrease pain and improve function. However, the microcirculatory changes following a given dosage of cryotherapy on mid-portion Achilles tendon remain unclear. STUDY DESIGN: Prospective clinical cohort study, level of evidence 2. METHODS: 30 people (12 males, 33 (SD 12) years, body mass index 25.6 (5.3) kg/m2) were included in the cohort. 3x10 min KoldBlue ankle-cooling bandages were applied and microcirculation of Achilles tendon mid-portion was real-time and continuously assessed using a laser-Doppler-spectrophotometry system (O2C, Germany). RESULTS: Superficial capillary blood flow was reduced from 42 to 6, 5 and 3 relative units (rU) in the first, second and third cryotherapy periods, respectively (-65%, p = 0.001), with no significant capillary hyperaemia. Deep capillary tendon blood flow was reduced from 180 to 82, 53 and 52 rU (-71%, p = 0.001) within 6-9 min of application without hyperaemia. Superficial tendon oxygen saturation dropped significantly from 43% to 26%, 18% and 11% (p = 0.001) after repetitive cryotherapy, with persisting increase of tendon oxygenation during rewarming (51%, 49% and 54%, p = 0.077) up to 27% of the baseline level. At 8 mm tendon depth, cryotherapy preserved local oxygenation. Relative postcapillary venous tendon filling pressures were favourably reduced from 41 (11) to 31, 28 and 26 rU (-36%, p = 0.001) superficially and from 56 (11) to 45, 46 and 48 rU (-18%, p = 0.001) in deep capillary blood flow during cryotherapy, facilitating capillary venous clearance. CONCLUSION: Intermittent cryotherapy of 3x10 min significantly decreases local Achilles tendon mid-portion capillary blood flow by 71%. Within 2 min of rewarming, tendon oxygen saturation is re-established following cryotherapy. Postcapillary venous filling pressures are reduced during cryotherapy, favouring capillary venous outflow of the healthy Achilles tendon.

Achilles Tendon↗