Welcome to the last edition of the tendinopathy research blog for 2012. It is a brief but interesting one…here is a brief overview:
Fong et al. & Dunkerman et al. investigate acetylcholine induced tenocyte proliferation and altered proteoglycan function, respectively – both may have a role in tendon pathology.
Couppe et al. suggest that volleyball players with patellar tendinopathy may have a smaller patellar tendon cross-sectional area than matched controls – tendinopathy may therefore develop due to greater peak tendon load in these smaller tendons. Incidentally, the Achilles usually breaks down in the midportion, which is the part of the tendon with the smallest cross-sectional area.
Saithna et al performed an interesting systematic review focused on whether patients with patellar tendinopathy should be withdrawn from sport during rehabilitation. Their suggestion is not necessarily, but clinically factors such as sport played, irritability of symptoms after sport and base level of strength/function are important individual considerations.
Scibek et al. report a case study showing a good outcome from oral pain meds and exercise for acute calcific supraspinatus tendinopathy (i.e. constant pain, trouble sleeping). The true clinical syndrome of calcific tendinopathy (ie acute/constant pain along with calcific tendon deposits on imaging) is rare – as apposed to calcific tendon deposits on imaging with mechanical impingement or no symptoms.
Joseph et al. review deep transverse frictions in tendinopathy and the concluded that there is some evidence of benefit at the elbow and shoulder in comparison with other modalities, although there are studies that show it is inferior to exercise based intervention (e.g. Stasinopoulos et al 2006) so if used it should be an adjunct to load. The authors also suggest reducing molecular cross links and applying mechanical load are ‘plausible’ explanations of observed benefit, but given the often short term effect on pain neurophysiological effects are likely.
Here is a link to the abstracts: Tendon research update Dec 2012
Stasinopoulos, D. and I. Stasinopoulos (2006). “Comparison of effects of Cyriax physiotherapy, a supervised exercise programme and polarized polychromatic non-coherent light (Bioptron light) for the treatment of lateral epicondylitis.” Clinical rehabilitation 20(1): 12.
I hope you enjoy