Preventive interventions for tendinopathy: A systematic review

Peters, Janne A; Zwerver, Johannes; Diercks, Ronald L.; Elferink‐Gemser, Marije T.; Akker‐Scheek, Inge van den

doi:10.1016/j.jsams.2015.03.008

Cited by 46 publications

(36 citation statements)

References 43 publications

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“…The prevention or reduction of musculotendinous imbalances could, in our view, have beneficial effects on (a) the risk of tendon injury and (b) athletic performance. A recent systematic review on the effects of preventive interventions for tendinopathy concluded that evidence for their efficacy is only limited (Peters et al, 2016 ). However, the exercise interventions examined were either not targeting the improvement of the mechanical properties of the tendon (e.g., balance training, stretching) or did not apply training stimuli that are in accordance with the current view on the mechanobiological basis of human tendon adaptation in vivo (e.g., Alfredson eccentric training or Silbernagel's combined concentric-eccentric exercise; Malliaras et al, 2013a for a discussion).…”

Section: Implications and Concepts For Preventionmentioning

confidence: 99%

Imbalances in the Development of Muscle and Tendon as Risk Factor for Tendinopathies in Youth Athletes: A Review of Current Evidence and Concepts of Prevention

2017

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Tendons feature the crucial role to transmit the forces exerted by the muscles to the skeleton. Thus, an increase of the force generating capacity of a muscle needs to go in line with a corresponding modulation of the mechanical properties of the associated tendon to avoid potential harm to the integrity of the tendinous tissue. However, as summarized in the present narrative review, muscle and tendon differ with regard to both the time course of adaptation to mechanical loading as well as the responsiveness to certain types of mechanical stimulation. Plyometric loading, for example, seems to be a more potent stimulus for muscle compared to tendon adaptation. In growing athletes, the increased levels of circulating sex hormones might additionally augment an imbalanced development of muscle strength and tendon mechanical properties, which could potentially relate to the increasing incidence of tendon overload injuries that has been indicated for adolescence. In fact, increased tendon stress and strain due to a non-uniform musculotendinous development has been observed recently in adolescent volleyball athletes, a high-risk group for tendinopathy. These findings highlight the importance to deepen the current understanding of the interaction of loading and maturation and demonstrate the need for the development of preventive strategies. Therefore, this review concludes with an evidence-based concept for a specific loading program for increasing tendon stiffness, which could be implemented in the training regimen of young athletes at risk for tendinopathy. This program incorporates five sets of four contractions with an intensity of 85–90% of the isometric voluntary maximum and a movement/contraction duration that provides 3 s of high magnitude tendon strain.

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Section: Implications and Concepts For Preventionmentioning

confidence: 99%

Imbalances in the Development of Muscle and Tendon as Risk Factor for Tendinopathies in Youth Athletes: A Review of Current Evidence and Concepts of Prevention

2017

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“…Although there is a wide range of tendon pathologies, it appears that the majority of overuse tendinopathies in athletes are due to tendinosis [2]. Tendinopathy has multifactorial etiology, but studies examining risk factors of tendinopathy show a lack of uniformity and statistical power [3]. Reliable, well-conducted epidemiological studies are not available for most tendinopathies [4].…”

Section: Introductionmentioning

confidence: 99%

Dry Needling as a Treatment Modality for Tendinopathy: a Narrative Review

Stoychev

Finestone

Kalichman

2020

Curr Rev Musculoskelet Med

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Purpose of Review Tendinopathy describes a combination of pain, swelling, and impaired performance of the tendon and around structures. There are various treatment options for tendinopathy with unclear efficacy. Dry needling involves inserting needles into the affected tendon, and it is thought to disrupt the chronic degenerative process and encourage localized bleeding and fibroblastic proliferation. The purpose of this review is to review the use of dry needling as a treatment modality for tendinopathy. Recent Findings The effectiveness of dry needling for treatment of tendinopathy has been evaluated in 3 systematic reviews, 7 randomized controlled trials, and 6 cohort studies. The following sites were studied: wrist common extensor origin, patellar tendon, rotator cuff, and tendons around the greater trochanter. There is considerable heterogeneity of the needling techniques, and the studies were inconsistent about the therapy used after the procedure. Most systematic reviews and randomized controlled trials support the effectiveness of tendon needling. There was a statistically significant improvement in the patient-reported symptoms in most studies. Some studies reported an objective improvement assessed by ultrasound. Two studies reported complications. Summary Current research provides initial support for the efficacy of dry needling for tendinopathy treatment. It seems that tendon needling is minimally invasive, safe, and inexpensive, carries a low risk, and represents a promising area of future research. In further high-quality studies, tendon dry needling should be used as an active intervention and compared with appropriate sham interventions. Studies that compare the different protocols of tendon dry needling are also needed.

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“…Tendinopathy is a common condition that affects a large portion of the population, making up 30% of all musculoskeletal injuries 1 and being the most prevalent tendon disorder 2 . It is generally defined as an overuse injury resulting in tendon degeneration after a failed early inflammatory healing response 3 , leading to collagen disorientation and disorganization in the absence of classic inflammatory changes, accompanied by pain and dysfunction 4,5 .…”

mentioning

confidence: 99%

Influence of genetic factors in elbow tendon pathology: a case-control study

Alakhdar

Cook

Benítez-Martínez

et al. 2020

Sci Rep

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Elbow tendinopathy is a common pathology of the upper extremity that impacts both athletes and workers. Some research has examined the genetic component as a risk factor for tendinopathy, mainly in the lower limbs. A case-control study was designed to test for a relationship between certain collagen gene single nucleotide polymorphisms (SNPs) and elbow tendon pathology. A sample of 137 young adult athletes whose sports participation involves loading of the upper limb were examined for the presence of structural abnormalities indicative of pathology in the tendons of the lateral and medial elbow using ultrasound imaging and genotyped for the following SNPs: COL5A1 rs12722, COL11A1 rs3753841, COL11A1 rs1676486, and COL11A2 rs1799907. Anthropometric measurements and data on participants' elbow pain and dysfunction were collected using the Disabilities of the Arm, Shoulder and Hand and the Mayo Clinic Performance Index for the Elbow questionnaires. Results showed that participants in the structural abnormality group had significantly higher scores in pain and dysfunction. A significant relationship between COL11A1 rs3753841 genotype and elbow tendon pathology was found (p = 0.024), with the CT variant associated with increased risk of pathology.Tendinopathy is a common condition that affects a large portion of the population, making up 30% of all musculoskeletal injuries 1 and being the most prevalent tendon disorder 2 . It is generally defined as an overuse injury resulting in tendon degeneration after a failed early inflammatory healing response 3 , leading to collagen disorientation and disorganization in the absence of classic inflammatory changes, accompanied by pain and dysfunction 4,5 . Tendon homeostasis relies on a dynamic remodeling process influenced by tendon loading and cytokines, among other things. Evidence support the expression and functional involment of pro-inflammatory cytokines such as interleukin-1ß in tissues surrounding mechanically injured tendon 6 . Tendon inflammation and tendinopathy are possible manifestations of a disturbance of this homeostasis. The role of inflammation in tendon healing or failure to heal is complex and not fully understood, but it is known that an initial inflammatory response is required to begin the healing process. On the other hand, cytokines appear to be capable of inducing a failed healing response in several diseases of connective tissue (cartilage, bone, synovial joint) possibly by altering the expression of matrix metalloproteinases 7 . Probably the tendon is no exception, although there are no conclusive data at present on the role of these cytokines in the tendinopathy development 6,7 .The exact incidence of elbow tendinopathy is unknown, but it is estimated to affect 1-3% of adults each year in the lateral elbow 8 and 0.1-0.75% in the medial elbow 9 . It has been reported that the pathogenesis of the medial pathology parallels that of the lateral pathology, with similar patterns of angiofibroblastic degeneration 10 . In athletes, individuals who practice s...

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Preventive interventions for tendinopathy: A systematic review

Cited by 46 publications

References 43 publications

Imbalances in the Development of Muscle and Tendon as Risk Factor for Tendinopathies in Youth Athletes: A Review of Current Evidence and Concepts of Prevention

Imbalances in the Development of Muscle and Tendon as Risk Factor for Tendinopathies in Youth Athletes: A Review of Current Evidence and Concepts of Prevention

Dry Needling as a Treatment Modality for Tendinopathy: a Narrative Review

Influence of genetic factors in elbow tendon pathology: a case-control study

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