References for US and tendon healing
Chukuka Enwemeka, Physical Therapy Journal, about 1989, 1990. He also has
excellent ongoing research in this area.
Herb Silver, PT
At 06:17 PM 11/8/99 -0800, you wrote:
> 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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