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Is compressive load a factor in the development of tendinopathy?

PainSci » bibliography » Cook et al 2012
Tags: etiology, treatment, tendinosis, pro, pain problems, overuse injury, injury

One article on PainSci cites Cook 2012: Deep Friction Massage Therapy for Tendinitis

PainSci notes on Cook 2012:

From the paper’s conclusion: “Although the science is incomplete in substantiating a role for compression in the typical tendinopathies encountered in clinical practice, we have endeavoured to provide a cellular, biomechanical and clinical level for such a hypothesis to improve understanding and management of tendinopathy.”

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

Tendons are designed to take tensile load, but excessive load can cause overuse tendinopathy. Overuse tendinopathy results in extensive changes to the cells and extracellular matrix, resulting in activated cells, increase in large proteoglycans and a breakdown of the collagen structure. Within these pathological changes, there are areas of fibrocartilaginous metaplasia, and mechanotransduction models suggest that this response could be due to compressive load. As load management is a cornerstone of treating overuse tendinopathy, defining the effect of tensile and compressive loads is important in optimising the clinical management of tendinopathy. This paper examines the potential role of compressive loads in the onset and perpetuation of tendinopathy, and reviews the anatomical, epidemiological and clinical evidence that supports consideration of compressive loads in overuse tendinopathy.

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