As the relevance of chronic tendon injuries and orthopedic research grow, a search for the most effective means of treatment continues. The use of anti-inflammatory drugs and steroids is being replaced, and occasionally supplemented, with physical therapy and strength training. This is due to the current research pointing toward evidence that inflammation is not the cause of degeneration within the tendon. This review will attempt to introduce the basic physiological concepts relating to the development of tendinopathies and their treatments, as well as give an overview of current developments lending momentum to the idea that eccentric loading of the tendon is presently the most effective mode by which treatment of degenerating tendons …show more content…
As several have proposed in their research, there is no clear and perfectly efficient method yet known for rehabilitation of chronic degenerative tendon disorders, such as tendinosis (9, 10), however, the narrowing down of the competition among effective treatments and the relevance of this area of study to competitive and recreational athletes, as well sedentary and occupational folk, continues to push research in this area. The importance of tendons is evident in daily functioning, especially concerning activities that require demanding physical labor, as tendons are responsible for transmitting, at times, large forces from contracting muscles to bones in order to create movement and perform work (11). The standard treatment and managing of tendinopathy was directed toward the presumed inflammatory condition with the use of anti-inflammatory medication and rest, occasionally turning to corticosteroid injections for stubborn …show more content…
For example, a study conducted by Konsgaard et al. (2010) reported the changes in tendon structure after treatment with heavy resistance training, with both eccentric and concentric components, at a 3 second per half repetition rate (2). Pre-treatment unhealthy patellar tendon biopsies were examined, and were reported to have low fibril density and a large surface area (2). The same structural findings were also reported by Zhang et al. (2014) when studying patellar tendinopathy in athletes. The subjects in Kongsgaard’s study completed 12 weeks of slow repetition, high load exercises, and were examined again at the end of 12 weeks. The painful symptoms of the subjects who completed the program decreased, while the fibril density increased and the mean fibril area decreased, indicating a decrease in the number of cross links between collagen fibers (2). Both Zhang and Kongsgaard explained the stiffness in diseased tendons as a product of the cross linking between abnormal collagen fibers, such as type III collagen (2, 42). Another example that supports the self-healing ability of tendons is a study by Langberg et al. (2007), which consisted of an eccentric exercise regimen that was preceded and followed by examination of the area around the tendon by microdialysis (3). This was a 12-week eccentric