Dear vanessa,
I haven't read the article, but it's funny you should mention this
because it is something that I have long considered. I guess
you need to look at what you are doing with the US, and that is
breaking down mast cells to create a contolled inflammatory
process (as I'm sure you know). Then you need to look at how
tendons heal. Firstly we know that they have a poor blood
supply. Tendons heal via the "common wound concept". ie
proliferation of fibroblasts to creat a scar (extrinsic healing). We
now know that they also heal via "intrinsic healing", ie. tenocytes
can produce collagen. In light of these facts, US is good at
encouraging fibroblastic activity, but the question is what does
it do to new collagen? Does it decrease the cross links and thus
deteriorate its tensile strength? My feeling is that this is quite
possibly the case. My tendon repair post op management notes
state that you shouldn't use US in the first 6 weeks as this can
have a detrimental effect on healing. And having said all of this I
have just found the reference I think you are looking for:
van Strein G. (1990). Postoperative Management of Flexor Tendon
Injuries. In Rehabilitation of the Hand, Hunter, Schneider, Mackin,
Callahan (Eds), Ch, 30, 3rd edit. Mosby Co, StLouis, Baltimore
Philidelphia, Toronto.
I also know of a study that looked at using US in horses for
tendonitis, and found that it actually made the problem worse when
used daily for ? number of weeks as opposed to imtermitent use.
Thus, I would be wary of US in know tendon damage and would
prefer to use digital ischaemic pressure, grI frictions and gentle
stretches.
Hope this helps,
Scott Epsley
Physiotherapist
Brisbane, QLD. Australia.
--
On Mon, 8 Nov 1999 19:11:05 fizzy wrote:
>Hi colleagues,
>
>I recently heard there's been some research suggesting that ultrasound may be harmful when treating tendinitis. I think the general idea was that it is not possible to distinguish if tendon degeneration/ to what degree degeneration is present, and that ultrasound could be harmful if degeneration of the tendon is present as opposed to inflammation without tendon degeneration. As you can tell I haven't read the article and wondered if anyone had heard of this and had any references or comments on the matter?
>
>look forward to hearing your ideas
>
>Vanessa MCSP
>
>
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