Achilles Tendinopathy has an Aberrant Strain Response to Eccentric Exercise

Griff · Jul 11, 2011

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Achilles Tendinopathy has an Aberrant Strain Response to Eccentric Exercise
Grigg, Nicole L; Wearing, Scott C; Smeathers, James E
Medicine & Science in Sports & Exercise
POST ACCEPTANCE, 8 June 2011

Purpose: Eccentric exercise has become the treatment of choice for Achilles tendinopathy. However, little is known about the acute response of tendon to eccentric exercise or the mechanisms underlying its clinical benefit. This research evaluated the sonographic characteristics and acute Anteroposterior(AP)strain response of control (healthy), asymptomatic and symptomatic Achilles tendons to eccentric exercise.

Methods: Eleven male adults with unilateral mid-portion Achilles tendinopathy and nine control male adults without tendinopathy participated in the research. Sagittal sonograms of the Achilles tendon were acquired immediately prior to and following completion of a common eccentric rehabilitation exercise protocol and again 24 hours later. Tendon thickness, echogenicity and AP strain were determined 40mm proximal to the calcaneal insertion.

Results: Compared to control tendon, both asymptomatic and symptomatic tendons were thicker (p<.05)and hypoechoic (p<.05) at baseline. All tendons decreased in thickness immediately following eccentric exercise (p<.05). Symptomatic tendon was characterised by a significantly lower AP strain response to eccentric exercise compared to both asymptomatic and control tendons (p < .05). AP strainsdid not differ in controland asymptomatic tendon. For all tendons, pre-exercise thickness was restored 24 hours subsequent to exercise completion.

Conclusions: These observations support the concept that Achilles tendinopathy is a bilateral or systemic process and structural changes associated with symptomatic tendinopathy alter fluid movement within the tendon matrix. Altered fluid movement may disrupt remodelling and homeostatic processes and represent a plausible mechanism underlying the progression of tendinopathy.
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