Rehabilitation of Tendon Injuries in Sport

Abstract

Clinicians are faced with a growing number of athletes with injured tendons. Treatment of both acute and chronic injuries has proven to be quite complex. It is difficult to maintain the balance between resting the injured tendon and preventing atrophy of the surrounding muscles and joints. Questions also arise as to when the tendon should be strengthened and when the athlete is ready to return to full activity in sport. Through an awareness of the structural and mechanical properties of the tendon, an exercise programme for the rehabilitation of tendon injuries has been developed. It is recommended that this programme be used in combination with ice and other physical modalities. This approach will resolve most tendon injuries within 6 weeks of its implementation. The use of anti-inflammatory medications and surgery can only be recommended in select situations where more conservative measures are inadequate.

Iontophoresis with or without dexamethazone in the treatment of acute Achilles tendon pain

“…The exact time criteria that are used to classify the injury as acute or chronic are arbitrary. In the literature, definitions for the injury to be chronic range from 4 weeks to 3 months, or pain on and off for more than 6 months (el Hawary et al, 1997, Angermann and Hovgaard, 1999, Mafi et al, 2001, Roos et al, 2004. The acute phase injury consists of partial ruptures, bursitis or paratendonitis.…”

“…The basis of exercise as treatment is to address possible deficiencies in strength, range of motion, balance, proprioception and function. Since the tendon is subjected to the highest loads eccentrically, eccentric training has always been an important part of the prescribed exercise (Fyfe and Stanish, 1992, Giffin and Stanish, 1993, el Hawary et al, 1997, Stanish et al, 2000. Increased speed of movement also increases the load of the tendon during the eccentric muscle activation and, to step up the exercise loads, both the external load and the speed of movement can be increased (Stanish et al, 2000).…”

Comparison of the Effectiveness of Eccentric - Concentric Training of Wrist Extensors and Eccentric - Concentric Training Combined With Supinator Strengthening in Healthy Population

“…Eccentric exercises appear to reduce the pain and improve function, reversing the pathology of LET [18,[35][36][37][38] as supported by experimental studies on animals [39]. The way that eccentric training achieves the goals remains uncertain, as there is a lack of good quality evidence to confirm that physiological effects translate into clinically meaningful outcomes and vice versa.…”

Isocinetisme et sport de haut niveau : Applications à la traumatologie du sport

“…3). L'atteinte tendineuse micro traumatique découle d'une surcharge tensionnelle du complexe musculo-tendineux entraînant une incapacitéà la réparation tendineuse (El Hawary, Stanish, & Curwin, 1997 ;Khan, Maffuli, Coleman, Cook, & Taunton, 1998 ;Rees, Wolman, & Wilson, 2009). Les stratégies thérapeutiques anti-inflammatoires apparaissent peu efficaces mais peuventêtre utilisées en phase aigue durant un temps très court afin de diminuer la douleur et permettre une rééducation excentrique le plus rapidement possible .…”