Tendinopathy and Sports : Understanding the Problem and Options of Management-perspectives from Physiotherapy , Sports Medicine , and Orthopedics

Tendinopathies are perhaps the leading cause of sportsrelated overuse injuries necessitating visit to an expert. Increased general public participation in sports and growing intensity of elite level sport had further warranted more attention and research into pathophysiology and management of tendeno pathies. As a result, its management has seen enormous changes in the last few decades. The newer research methodologies applied to diagnostic and therapeutic aspects have generated a plethora of literature, which has helped sports medicine experts. However, these newer modalities have also added to the confusion among many. This review aims to present current understanding of pathophysiology of tendinopathies and evidence of success or failure of several modalities in current use.

[1]  G. Moseley,et al.  Isometric Contractions Are More Analgesic Than Isotonic Contractions for Patellar Tendon Pain: An In-Season Randomized Clinical Trial , 2017, Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine.

[2]  M. Marcacci,et al.  Platelet-rich plasma in tendon-related disorders: results and indications , 2018, Knee Surgery, Sports Traumatology, Arthroscopy.

[3]  E. Rio,et al.  Do isometric and isotonic exercise programs reduce pain in athletes with patellar tendinopathy in-season? A randomised clinical trial. , 2016, Journal of science and medicine in sport.

[4]  I. Medina-Porqueres,et al.  Effectiveness of the eccentric exercise therapy in physically active adults with symptomatic shoulder impingement or lateral epicondylar tendinopathy: A systematic review. , 2016, Journal of science and medicine in sport.

[5]  L. Curtis Nutritional research may be useful in treating tendon injuries. , 2016, Nutrition.

[6]  C. Speed,et al.  Tendinopathy: Update on Pathophysiology. , 2015, The Journal of orthopaedic and sports physical therapy.

[7]  G. Moseley,et al.  Tendon neuroplastic training: changing the way we think about tendon rehabilitation: a narrative review , 2015, British Journal of Sports Medicine.

[8]  J. Roy,et al.  The efficacy of therapeutic ultrasound for rotator cuff tendinopathy: A systematic review and meta-analysis. , 2015, Physical therapy in sport : official journal of the Association of Chartered Physiotherapists in Sports Medicine.

[9]  J. Joensen,et al.  The efficacy of low-level laser therapy for shoulder tendinopathy: a systematic review and meta-analysis of randomized controlled trials. , 2015, Physiotherapy research international : the journal for researchers and clinicians in physical therapy.

[10]  M. Kjaer,et al.  Heavy Slow Resistance Versus Eccentric Training as Treatment for Achilles Tendinopathy , 2015, The American journal of sports medicine.

[11]  A. Pearce,et al.  Isometric exercise induces analgesia and reduces inhibition in patellar tendinopathy , 2015, British Journal of Sports Medicine.

[12]  J. Roy,et al.  The efficacy of manual therapy for rotator cuff tendinopathy: a systematic review and meta-analysis. , 2015, The Journal of orthopaedic and sports physical therapy.

[13]  N. Marwaha,et al.  Leukocyte-Poor Platelet-Rich Plasma versus Bupivacaine for Recalcitrant Lateral Epicondylar Tendinopathy , 2015, Journal of orthopaedic surgery.

[14]  D. Morrissey,et al.  The Effectiveness of Extracorporeal Shock Wave Therapy in Lower Limb Tendinopathy , 2015, The American journal of sports medicine.

[15]  G. Baxter,et al.  Photobiomodulation and eccentric exercise for Achilles tendinopathy: a randomized controlled trial , 2015, Lasers in Medical Science.

[16]  K. Svärdsudd,et al.  A randomized controlled trial of eccentric vs. concentric graded exercise in chronic tennis elbow (lateral elbow tendinopathy) , 2014, Clinical rehabilitation.

[17]  M. Ramsey,et al.  Efficacy of Platelet-Rich Plasma for Chronic Tennis Elbow , 2013, The American journal of sports medicine.

[18]  V. Shetty,et al.  Orthobiologics and platelet rich plasma , 2014, Indian journal of orthopaedics.

[19]  J. Cook,et al.  The challenge of managing tendinopathy in competing athletes , 2013, British Journal of Sports Medicine.

[20]  H. Langberg,et al.  Achilles and Patellar Tendinopathy Loading Programmes , 2013, Sports Medicine.

[21]  A. Scott,et al.  Tendons – time to revisit inflammation , 2013, British Journal of Sports Medicine.

[22]  Sang Chul Lee,et al.  Comparison of the therapeutic effects of ultrasound-guided platelet-rich plasma injection and dry needling in rotator cuff disease: a randomized controlled trial , 2013, Clinical rehabilitation.

[23]  C. Parise,et al.  Platelet-Rich Fibrin Matrix in the Management of Arthroscopic Repair of the Rotator Cuff , 2013, The American journal of sports medicine.

[24]  A. Pearce,et al.  The Pain of Tendinopathy: Physiological or Pathophysiological? , 2013, Sports Medicine.

[25]  E. Schwarz,et al.  Platelet-rich plasma therapy - future or trend? , 2012, Arthritis Research & Therapy.

[26]  O. Galasso,et al.  Short-term outcomes of extracorporeal shock wave therapy for the treatment of chronic non-calcific tendinopathy of the supraspinatus: a double-blind, randomized, placebo-controlled trial , 2012, BMC Musculoskeletal Disorders.

[27]  T. Gosens,et al.  Pain and activity levels before and after platelet-rich plasma injection treatment of patellar tendinopathy: a prospective cohort study and the influence of previous treatments , 2012, International Orthopaedics.

[28]  P. Renström,et al.  Tendinopathy in Sport , 2012, Sports health.

[29]  G. Murrell,et al.  The role of nitric oxide in tendon healing. , 2012, Journal of shoulder and elbow surgery.

[30]  K. Nilsson-Helander,et al.  Treatment of patellar tendinopathy—a systematic review of randomized controlled trials , 2012, Knee Surgery, Sports Traumatology, Arthroscopy.

[31]  J. Garrick Topical nitroglycerin decreases pain intensity in daily activities: a review. , 2011, Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine.

[32]  A. Papanikolaou,et al.  Platelet-Rich Plasma Versus Autologous Whole Blood for the Treatment of Chronic Lateral Elbow Epicondylitis , 2011, The American journal of sports medicine.

[33]  G. Baltaci,et al.  The effectiveness of manual therapy in supraspinatus tendinopathy. , 2011, Acta orthopaedica et traumatologica turcica.

[34]  P. Randelli,et al.  Platelet rich plasma in arthroscopic rotator cuff repair: a prospective RCT study, 2-year follow-up. , 2011, Journal of shoulder and elbow surgery.

[35]  M. Curtis,et al.  Growth factor-based therapies provide additional benefit beyond physical therapy in resistant elbow tendinopathy: a prospective, single-blind, randomised trial of autologous blood injections versus platelet-rich plasma injections , 2011, British Journal of Sports Medicine.

[36]  S. Fu,et al.  Deciphering the pathogenesis of tendinopathy: a three-stages process , 2010, Sports medicine, arthroscopy, rehabilitation, therapy & technology : SMARTT.

[37]  C. Gonzalez-Suarez,et al.  Evidence on the effectiveness of topical nitroglycerin in the treatment of tendinopathies: a systematic review and meta-analysis. , 2010, Archives of physical medicine and rehabilitation.

[38]  M. Marcacci,et al.  Use of platelet-rich plasma for the treatment of refractory jumper’s knee , 2010, International Orthopaedics.

[39]  N. Maffulli,et al.  Eccentric Loading versus Eccentric Loading plus Shock-Wave Treatment for Midportion Achilles Tendinopathy , 2009, The American journal of sports medicine.

[40]  J. Cook,et al.  Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy , 2008, British Journal of Sports Medicine.

[41]  N. Maffulli,et al.  Eccentric loading compared with shock wave treatment for chronic insertional achilles tendinopathy. A randomized, controlled trial. , 2008, The Journal of bone and joint surgery. American volume.

[42]  R. Newsham-West,et al.  Chronic tendinopathy: effectiveness of eccentric exercise , 2006, British Journal of Sports Medicine.

[43]  T. Pavelko,et al.  Treatment of Chronic Elbow Tendinosis with Buffered Platelet-Rich Plasma , 2006, The American journal of sports medicine.

[44]  Harpreet S Gill,et al.  Sports injuries: what is new today? , 2010, The Ceylon medical journal.

[45]  H. Alfredson The chronic painful Achilles and patellar tendon: research on basic biology and treatment , 2005, Scandinavian journal of medicine & science in sports.

[46]  J. Taunton,et al.  The VISA-A questionnaire: a valid and reliable index of the clinical severity of Achilles tendinopathy , 2001, British journal of sports medicine.

[47]  H. Langberg,et al.  Time Pattern of Exercise-Induced Changes in Type I Collagen Turnover after Prolonged Endurance Exercise in Humans. , 2000, Calcified tissue international.

[48]  J. Wark,et al.  The VISA score: an index of severity of symptoms in patients with jumper's knee (patellar tendinosis). Victorian Institute of Sport Tendon Study Group. , 1998, Journal of science and medicine in sport.