NDLI: Fibril morphology and tendon mechanical properties in patellar tendinopathy: effects of heavy slow resistance training.

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Fibril morphology and tendon mechanical properties in patellar tendinopathy: effects of heavy slow resistance training.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Kongsgaard, Mads Qvortrup, Klaus Larsen, Jytte Aagaard, Per Doessing, Simon Hansen, Philip Kjaer, Michael Magnusson, S. Peter
Description	Country affiliation: Denmark Author Affiliation: Kongsgaard M ( Department of Orthopedic Surgery M, Bispebjerg Hospital and Center for Healthy Aging, University of Copenhagen, Denmark. mk11@bbh.regionh.dk)
Abstract	BACKGROUND: Patellar tendinopathy is characterized by pathologic abnormalities. Heavy slow resistance training (HSR) is effective in the management of patellar tendinopathy, but the underlying functional mechanisms remain elusive. PURPOSE: To investigate fibril morphology and mechanical properties in patellar tendinopathy and the effect of HSR on these properties. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: Eight male patients with patellar tendinopathy completed 12 weeks of HSR. Nine healthy subjects served as controls. Assessments were conducted at baseline and at 12 weeks. Patients assessed symptoms/function and maximal tendon pain during activity. Tendon biopsy samples were analyzed for fibril density, volume fraction, and mean fibril area. Tendon mechanical properties were assessed using force and ultrasonography samplings. RESULTS: Patients improved in symptoms/function (P = .02) and maximal tendon pain during activity (P = .008). Stiffness and modulus of control and tendinopathy tendons were similar at baseline. Stiffness remained unaffected in control tendons (3487 +/- 392 to 3157 +/- 327 N/mm, P = .57) but declined in tendinopathic tendons at 12 weeks (3185 +/- 187 to 2701 +/- 201 N/mm, P = .04). At baseline, fibril volume fraction was equal, fibril density smaller (P = .03), and mean fibril area tended to be higher in tendinopathy versus controls (P = .07). Fibril morphology remained unchanged in controls but fibril density increased (70% +/- 18%, P = .02) and fibril mean area decreased (-26% +/- 21%, P = .04) in tendinopathic tendons after HSR. CONCLUSION: Fibril morphology is abnormal in tendinopathy, but tendon mechanical properties are not. Clinical improvements after HSR were associated with changes in fibril morphology toward normal fibril density and mean fibril area. Heavy slow resistance training improved the clinical outcome of patellar tendinopathy, and these improvements were associated with normalization of fibril morphology, most likely due to a production of new fibrils.
File Format	HTM / HTML
ISSN	03635465
Issue Number	4
Volume Number	38
e-ISSN	15523365
Journal	The American Journal of Sports Medicine
Language	English
Publisher	SAGE Publications
Publisher Date	2010-04-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Therapy Research Support, Non-u.s. Gov't Humans Tendinopathy Male Treatment Outcome Fibrillar Collagens Journal Article Tendons Resistance Training Pathology Ultrastructure Patella Surgery Ultrasonography Adult Patellar Ligament Discipline Sports Medicine Injuries Methods
Content Type	Text
Resource Type	Article
Subject	Orthopedics and Sports Medicine Physical Therapy, Sports Therapy and Rehabilitation Sports Science

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