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Rouhollah Mousavizadeh, Ludvig Backman, Robert G McCormack, Alex Scott
OBJECTIVE: Glucocorticoid injections are used by rheumatologists to treat chronic tendinopathy. Surprisingly, the mechanisms by which corticosteroids induce pain relief in this condition have not been investigated. Previous studies have shown local substance P (SP) levels to be correlated with tendon pain and tissue pathology. The objective of this study was to determine whether SP production in human tenocytes is modulated by exposure to dexamethasone. METHODS: Human tendon fibroblasts were cultured in the presence or absence of dexamethasone (1-400 nM), an inhibitor of the glucocorticoid receptor, RU486, recombinant TGF-β (2...
February 2015: Rheumatology
Stephanie G Dakin, Jayesh Dudhia, Roger K W Smith
Injuries to the superficial digital flexor tendon (SDFT) are an important cause of morbidity and mortality in equine athletes, but the healing response is poorly understood. One important drive for the healing of connective tissues is the inflammatory cascade, but the role of inflammation in tendinopathy has been contentious in the literature. This article reviews the processes involved in the healing of tendon injuries in natural disease and experimental models. The importance of inflammatory processes known to be active in tendon disease is discussed with particular focus on recent findings related specifically to the horse...
April 15, 2014: Veterinary Immunology and Immunopathology
Ebonie Rio, Dawson Kidgell, G Lorimer Moseley, Jamie Gaida, Sean Docking, Craig Purdam, Jill Cook
Tendinopathy can be resistant to treatment and often recurs, implying that current treatment approaches are suboptimal. Rehabilitation programmes that have been successful in terms of pain reduction and return to sport outcomes usually include strength training. Muscle activation can induce analgesia, improving self-efficacy associated with reducing one's own pain. Furthermore, strength training is beneficial for tendon matrix structure, muscle properties and limb biomechanics. However, current tendon rehabilitation may not adequately address the corticospinal control of the muscle, which may result in altered control of muscle recruitment and the consequent tendon load, and this may contribute to recalcitrance or symptom recurrence...
February 2016: British Journal of Sports Medicine
S I Docking, J Cook
Structural disorganization in the tendon is associated with tendinopathy, with little research investigating whether disorganization overwhelms the overall structural integrity of the tendon. This study investigated the mean cross-sectional area (CSA) of aligned fibrillar structure as detected by ultrasound tissue characterization (UTC) in the pathological and normal Achilles and patellar tendons. Ninety-one participants had their Achilles and/or patellar tendons scanned using UTC to capture a three-dimensional image of the tendon and allow a semi-quantification of the echopattern...
June 2016: Scandinavian Journal of Medicine & Science in Sports
K M Khan, A Scott
Mechanotransduction is the physiological process where cells sense and respond to mechanical loads. This paper reclaims the term "mechanotherapy" and presents the current scientific knowledge underpinning how load may be used therapeutically to stimulate tissue repair and remodelling in tendon, muscle, cartilage and bone. The purpose of this short article is to answer a frequently asked question "How precisely does exercise promote tissue healing?" This is a fundamental question for clinicians who prescribe exercise for tendinopathies, muscle tears, non-inflammatory arthropathies and even controlled loading after fractures...
April 2009: British Journal of Sports Medicine
Megan L Killian, Leonardo Cavinatto, Leesa M Galatz, Stavros Thomopoulos
Mechanical cues affect tendon healing, homeostasis, and development in a variety of settings. Alterations in the mechanical environment are known to result in changes in the expression of extracellular matrix proteins, growth factors, transcription factors, and cytokines that can alter tendon structure and cell viability. Loss of muscle force in utero or in the immediate postnatal period delays tendon and enthesis development. The response of healing tendons to mechanical load varies depending on anatomic location...
February 2012: Journal of Shoulder and Elbow Surgery
William Gibson, Lars Arendt-Nielsen, Thomas Graven-Nielsen
Delayed onset muscle soreness (DOMS) involves central and peripheral pain mechanisms. Referred pain patterns following stimulation of DOMS affected tissue have not been fully described. Referred pain may provide information on how central mechanisms are involved in DOMS, as referred pain is a central mechanism. Further, tendon tissue involvement in DOMS is not clear. This study assessed pressure pain threshold (PPT) sensitivity at the tendon, tendon-bone junction (TBJ) and muscle belly sites of tibialis anterior pre- and during DOMS in 45 subjects (34 males, 11 females)...
September 2006: Experimental Brain Research. Experimentelle Hirnforschung. Expérimentation Cérébrale
Paul W Ackermann, Sarah L Franklin, Benjamin J F Dean, Andrew J Carr, Paul T Salo, David A Hart
The regulatory mechanisms involved in tendon homeostasis and repair are not fully understood. Accumulating data, however, demonstrate that the nervous system, in addition to afferent (sensory) functions, through efferent pathways plays an active role in regulating pain, inflammation, and tissue repair. In normal-, healing- and tendinopathic tendons three neurosignalling pathways consisting of autonomic, sensory and glutamatergic neuromediators have been established. In healthy tendons, neuromediators are found in the paratenon, whereas the proper tendon is practically devoid of nerves, reflecting that normal tendon homeostasis is regulated by pro- and anti-inflammatory mediators from the tendon surroundings...
June 1, 2014: Frontiers in Bioscience (Landmark Edition)
M Cassel, J Stoll, F Mayer
Tendinopathies are frequently the cause of chronic, load-dependent complaints of the lower extremity. Commonly, the large tendons of the ankle and knee joints are affected, especially the Achilles and patellar tendons. Repeated overuse in sports and/or daily activities is assumed as the aetiology. Besides the clinical examination including a comprehensive anamnesis of pain and training/loading, sonographic imaging has a high training/loading relevance for the diagnosis of tendon pathologies of the lower extremity...
June 2015: Sportverletzung Sportschaden: Organ der Gesellschaft Für Orthopädisch-Traumatologische Sportmedizin
Michael F Joseph, Craig R Denegar
Tendinopathy is a common and complex disorder. Once viewed as an inflammatory condition labeled tendinitis, it is now viewed along a continuum that can lead to tissue necrosis and risk of tendon rupture. Anti-inflammatory medications can alter symptoms but may also promote tissue degeneration. Loading of the tendon through exercise, especially exercise involving eccentric muscle contraction, has been shown to promote symptom resolution and functional recovery in many patients. This article reviews the pathoetiology of tendinopathy and the role anti-inflammatory interventions and therapeutic exercise in treatment of active patients...
April 2015: Clinics in Sports Medicine
C T Thorpe, S Chaudhry, I I Lei, A Varone, G P Riley, H L Birch, P D Clegg, H R C Screen
Tendon injury is thought to involve both damage accumulation within the matrix and an accompanying cell response. While several studies have characterized cell and matrix response in chronically injured tendons, few have assessed the initial response of tendon to overload-induced damage. In this study, we assessed cell response to cyclic loading. Fascicle bundles from the equine superficial digital flexor tendon were exposed to cyclic loading in vitro, designed to mimic a bout of high-intensity exercise. Changes in cell morphology and protein-level alterations in markers of matrix inflammation and degradation were investigated...
August 2015: Scandinavian Journal of Medicine & Science in Sports
Alex Scott, Sean Docking, Bill Vicenzino, Håkan Alfredson, Richard J Murphy, Andrew J Carr, Johannes Zwerver, Kirsten Lundgreen, Oliver Finlay, Noel Pollock, Jill L Cook, Angela Fearon, Craig R Purdam, Alison Hoens, Jonathan D Rees, Thomas J Goetz, Patrik Danielson
In September 2010, the first International Scientific Tendinopathy Symposium (ISTS) was held in Umeå, Sweden, to establish a forum for original scientific and clinical insights in this growing field of clinical research and practice. The second ISTS was organised by the same group and held in Vancouver, Canada, in September 2012. This symposium was preceded by a round-table meeting in which the participants engaged in focused discussions, resulting in the following overview of tendinopathy clinical and research issues...
June 2013: British Journal of Sports Medicine
Lauren K Wood, Susan V Brooks
Increased tendon stiffness in response to mechanical loading is well established in young animals. Given that tendons stiffen with aging, we aimed to determine the effect of increased loading on tendons of old animals. We subjected 28-month-old mice to 10 weeks of uphill treadmill running; sedentary 8- and 28-month-old mice served as controls. Following training, plantaris tendon stiffness and modulus were reduced by approximately half, such that the values were not different from those of tendons from adult sedentary animals...
February 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Jeffrey A Housner, Jon A Jacobson, Yoav Morag, George Guntar A Pujalte, Rebecca M Northway, Tracy A Boon
OBJECTIVE: To report the retrospective results of ultrasound-guided needle fenestration for the treatment of recalcitrant patellar tendinopathy. DESIGN: Retrospective follow-up study. SETTING: University outpatient sports medicine clinic. PATIENTS: Forty-seven patellar tendons in 32 patients (26 men and 6 women; mean age, 26 years) with recalcitrant patellar tendinopathy. Diagnosis made via history, physical examination, and sonographic examination...
November 2010: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
Alexander Scott, Roald Bahr
Overuse tendinopathy remains a major clinical burden for sports medicine and general practitioners. Recent studies have highlighted the role of sensory and autonomic nerves in generating or perpetuating the symptoms and tissue abnormalities associated with tendinopathy. We outline the neuroanatomy and potential roles of nerves and associated neuropeptides in tendinopathy. In addition, intriguing new data is reviewed which suggests that there may be a substantial intrinsic source of neuropeptides within tendons - namely, the tenocytes themselves...
January 1, 2009: Frontiers in Bioscience (Landmark Edition)
Hayedeh Behzad, Shu-Huei Tsai, Paulina Nassab, Rouhollah Mousavizadeh, Robert G McCormack, Alex Scott
Mast cells and fibroblasts are two key players involved in many fibrotic and degenerative disorders. In the present study we examined the nature of binding interactions between human mast cells and tendon fibroblasts (tenocytes). In the mast cell-fibroblast co-culture model, mast cells were shown to spontaneously bind to tenocytes, in a process that was partially mediated by α5β1 integrin receptors. The same receptors on mast cells significantly mediated binding of these cells to tissue culture plates in the presence of tenocyte-conditioned media; the tenocyte-derived fibronectin in the media was shown to also play a major role in these binding activities...
January 2015: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Jens Christensen, Håkan Alfredson, Gustav Andersson
BACKGROUND/AIM: Tendinopathies are pathological conditions of tissue remodelling occurring in the major tendons of the body, accompanied by excessive nociceptive signalling. Tendinopathies have been shown to exhibit an increase in the number of mast cells, which are capable of releasing histamine, tryptase and other substances upon activation, which may play a role in the development of tendinopathies. This study set out to describe the distribution patterns of a family of receptors called protease-activated receptors (PARs) within the Achilles tendon...
2015: Molecular Pain
Benjamin John Floyd Dean, Peter Gettings, Stephanie Georgina Dakin, Andrew Jonathan Carr
BACKGROUND: The role of inflammation in tendinopathy has historically been a subject of significant controversy. Our primary aim was to determine whether inflammatory cell numbers were increased in painful human tendinopathy versus healthy control tendons. Our secondary aim was to assess whether the inflammatory cells had been linked with symptoms or disease stage. METHODS: We conducted a systematic review of the scientific literature using the PRISMA and Cochrane guidelines of the Medline database using specific search criteria...
February 2016: British Journal of Sports Medicine
Hayedeh Behzad, Aishwariya Sharma, Rouhollah Mousavizadeh, Alex Lu, Alex Scott
INTRODUCTION: We have previously found an increased mast cell density in tendon biopsies from patients with patellar tendinopathy compared to controls. This study examined the influence of mast cells on basic tenocyte functions, including production of the inflammatory mediator prostaglandin E2 (PGE2), extracellular matrix remodeling and matrix metalloproteinase (MMP) gene transcription, and collagen synthesis. METHODS: Primary human tenocytes were stimulated with an established human mast cell line (HMC-1)...
2013: Arthritis Research & Therapy
Robert J de Vos, Marinus P Heijboer, Harrie Weinans, A N Verhaar J, T M van Schie J
CONTEXT: Chronic midportion Achilles tendinopathy is a common and hard-to-treat disorder characterized by degenerative changes of the tendon matrix. Ultrasonographic tissue characterization (UTC) was successfully used to quantify structural human Achilles tendon changes. This novel and reliable technique could be used in follow-up studies to relate tendon structure to symptoms. OBJECTIVE: To quantify structural tendon changes and assess clinical change in patients with tendinopathy...
February 2012: Journal of Sport Rehabilitation
2015-08-03 14:45:40
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