The pathogenesis of Achilles tendinopathy (AT) concerns physical activities which entail pushing off and “stop and go” strains mainly in runners and in jumpers. Overuse induces changes in the architecture of the collagen ultrastructure which results in the weakening of tendon matrix that alters, in turn, the mechanical properties and increases the risk of rupture. Genetic, hormonal, metabolic causes, such as structural and functional features of the foot and of the gastrocnemius-soleus functional complex, also post-traumatic causes, are frequently associated with AT. Conservative treatments include eccentric muscle training, drugs and substances which affect the pathological angiogenesis that distinguishes tendinopathies. Promising experimental results derive from biophysical stimulation with ultrasound, radiofrequencies and pulsed magnetic fields (PEMF), while extracorporeal shock waves (ESW) are successfully employed in the treatment of tendinopathies such as AT. Their mechanism of action involves the aptitude of the cells to recognize and activate definite pathways of identification, transmission and arrangement of the mechanical impulse in biological units of information addressed to the nucleus (mechanotransduction) whose response is expressed in the production of pro-angiogenic substances, cytokines, and growth factors which are normally involved in the tendon healing process.
Onde d’urto extracorporee e tendinopatia dell’achilleo nello sportivo: evidenze cliniche e razionale terapeutico
FRAIRIA, Roberto
2014-01-01
Abstract
The pathogenesis of Achilles tendinopathy (AT) concerns physical activities which entail pushing off and “stop and go” strains mainly in runners and in jumpers. Overuse induces changes in the architecture of the collagen ultrastructure which results in the weakening of tendon matrix that alters, in turn, the mechanical properties and increases the risk of rupture. Genetic, hormonal, metabolic causes, such as structural and functional features of the foot and of the gastrocnemius-soleus functional complex, also post-traumatic causes, are frequently associated with AT. Conservative treatments include eccentric muscle training, drugs and substances which affect the pathological angiogenesis that distinguishes tendinopathies. Promising experimental results derive from biophysical stimulation with ultrasound, radiofrequencies and pulsed magnetic fields (PEMF), while extracorporeal shock waves (ESW) are successfully employed in the treatment of tendinopathies such as AT. Their mechanism of action involves the aptitude of the cells to recognize and activate definite pathways of identification, transmission and arrangement of the mechanical impulse in biological units of information addressed to the nucleus (mechanotransduction) whose response is expressed in the production of pro-angiogenic substances, cytokines, and growth factors which are normally involved in the tendon healing process.
I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
