Treatment with HVI or PRP in combination with eccentric training in chronic AT seems more effective in reducing pain, improving activity level, and reducing tendon thickness and intratendinous vascularity than eccentric training alone. HVI may be more effective in improving outcomes of chronic AT than PRP in the short term. Registration: NCT02417987 ( ClinicalTrials.gov identifier).

This file was dowloaded from the institutional repository Brage NIH -brage.bibsys.no/nih Bloomquist, K. L., Langberg, H. C., Karlsen, S., Madsgaard, S., Boesen, M., Raastad, T. (2013 AbstractPurpose Manipulating joint range of motion during squat training may have differential effects on adaptations to strength training with implications for sports and rehabilitation. Consequently, the purpose of this study was to compare the effects of squat training with a short vs. a long range of motion.Methods Male students (n=17) were randomly assigned to 12 weeks of progressive squat training (repetition matched, repetition maximum sets) performed as either a) deep squat (0-120˚ of knee flexion); n=8 (DS) or (b) shallow squat (0-60˚ of knee flexion); n=9 (SS). Strength (1 RM and isometric strength), jump performance, muscle architecture and cross-sectional area (CSA) of the thigh muscles, as well as CSA and collagen synthesis in the patellar tendon, were assessed before and after the intervention. ResultsThe DS group increased 1RM in both the SS and DS with ~20±3%, while the SS group achieved a 36±4% increase in the SS, and 9±2% in the DS (P<0.05). However, the main finding was that DS training resulted in superior increases in front thigh muscle CSA (4-7%) compared to SS training, whereas no differences were observed in patellar tendon CSA. In parallel with the larger increase in front thigh muscle CSA, a superior increase in isometric knee extension strength at 75˚(6±2%) and 105˚(8±1%) knee flexion, and squat-jump performance (15±3%), were observed in the DS group compared to the SS group. ConclusionTraining deep squats elicited favourable adaptations on knee extensor muscle size and function compared to training shallow squats.Running title: Squat range of motion and musculotendinous adaptations 3

Background: Intratendinous Doppler activity has been interpreted as an equivalent of neovessels in the Achilles tendon and as a sign of tendinosis (AT). Aim: To evaluate the vascular response as indicated by color Doppler activity after repeated loading of both symptomatic and non‐symptomatic Achilles tendons. Material and methods: Ten non‐trained, healthy subjects ran 5 km. Ultrasound (US) Doppler activity was determined before and after the exercise. Eleven patients with chronic AT performed 3 × 15 heavy‐load eccentric exercise. The Achilles tendons were scanned before and immediately after the exercise. Results: Non‐symptomatic: six Achilles tendons in five subjects had intratendinous Doppler activity before the exercise. All but two subjects (80%) had intratendinous Doppler activity after running. Symptomatic: all patients had Doppler activity in the tendons, with a median color fraction before eccentric exercise of 0.05 (range 0.01–0.33). The Doppler activity did not disappear after exercise. Tendons with a color fraction below the median at baseline increased significantly after the exercise (P=0.02). Conclusion: The mere presence of Doppler in the Achilles tendon does not per se indicate disease. Eccentric exercise does not extinguish the flow during or after one training session in patients with chronic AT.

It was not possible to verify any association between intratendinous flow and pain at the start of the season or at the follow-up (end of the season). Intratendinous flow at the start of the season could not predict symptomatic outcome at the end of the season. The decrease in Doppler flow during the season might suggest that intratendinous flow could be part of a physiological adaptive response to loading and that intratendinous flow as previously believed is not always a sign of pathological changes.