Tendon is a tough band of fibrous connective tissue that usually connects muscle to bone Tendons are highly organized connective tissues that transmit muscle force to the bone. Tendons are resilient during the development of tension, but flexible enough to carry on its function. In the resting state, the collagen fibrils exhibit a wavy conformation. As a tendon is stretched, collagen fibrils begin to straighten out, and, as a result, the tendon becomes stiffer with increasing application of mechanical strain. The transition from tendon to bone and from tendon to muscle is progressive to allow an efficient load transfer minimizing stress concentrations.
A healthy tendon is up to twice as strong as the muscle, making the body of the tendon unlikely to tear before the muscle unless the tendon has already been weakened by degenerative changes. The effects of ageing, wear and tear, genetic pre-disposition and inflammation are known factors contributing to tendon injuries. Tendons consist of collagens, proteoglycans, glycoproteins, water and cells. In case of injury, repair will take place only through scar tissue. This leads to decreased functional properties of these injured regions and to a greater risk of recurrent injury. Injured tendon can cause pain, loss of limb function and prevent exercise and activities of daily living.
There are ∼2 million Achilles tendon sports-related injuries each year worldwide. Of these, over 250 000 require surgical intervention and prolonged rehabilitation. However, patients with these injuries seldom regain full pre-injury function. These ailments are difficult to manage, frequently resulting in long-term pain and discomfort. The poor repair of tendons is a direct consequence of their limited vascularity and relatively acellular nature. Most frequently injured are the rotator cuff, the patellar and the Achilles tendons, with pathology ranging from tendinopathy and calcific tendinopathy, to partial tears, to complete ruptures. The poor tendon self-repair makes recovery difficult.
Calcification is the accumulation of calcium salt in the tissue. Bone is the common place to occur, but calcification can happen in the soft tissue, such as fascia and tendon causing hardening of the tissue. Soft tissue calcifications happens anytime and any location of the body. The most common place is in the damaged tissue, such as injured tendon causing calcific tendinitis. Calcium phosphate is accumulated in the tendon causing pain and inflammation. Chronic pain is the most common symptom of tendon calcification. Other symptoms include stiffness, snapping, catching or weakness on related tendon and joints. It is involved in abnormal repairment of damaged tissue. Acupuncture can help to reduce the pain, improve stiffness and improve circulation to help reabsorbing the calcium.
Pain and burning in the affected area, decreased strength and flexibility, and pain caused by everyday activities are very common. This is often caused by tendinopathy-tendon injury.
The healing time for injured tendon varies depending on whether treatment starts with early presentation or chronic presentation. Healing time for acute injury can be a few days to 6 weeks. Treatment at an early stage can be as brief as 6–10 weeks. Once it becomes chronic the treatment can take 3–6 months. The effective treatment might take up to 9 months to 36 months when it is chronic. Knowing these timelines is part of creating an effective treatment plan.
Acupuncture helps with tendon injury
Acupuncture is used to treat tendon injury and it improves pain and functional activity in patients with tendinopathy. This is suggested that acupuncture can modulate both anti-inflammatory and mechanotransduction molecular pathways which can increase type I collagen synthesis. Collagen synthesis is the main factor that influences tendon biomechanical properties. Therefore one reason of acupuncture for tendon healing is that acupuncture increases synthesis and subsequent reorganisation of type I collagen during tendon healing process.
MacPherson H et al (2016) Pain Oct 17 Epub ahead of print
Welcome to my blog, discover acupuncture with Dr Maggie Ju
Qualified as a medical doctor in Western medicine in China with a Medical degree from Beijing, China and a PhD degree from the UK. Many year research and clinical experiences. This blog is for information only.
Saturday, 28 April 2018
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