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Treatment of Ligament Constructs with Exercise-conditioned Serum: A Translational Tissue Engineering Model

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Delayed exercise promotes remodeling in sub-rupture fatigue damaged tendons.

R Bell¹, M R Boniello, N R Gendron

¹Leni and Peter W. May Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1188, New York, New York.

Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society

|March 4, 2015

Summary

Timing is crucial for exercise therapy in tendon repair. Starting exercise 14 days after fatigue damage promotes tendon remodeling, unlike earlier intervention which can worsen injury.

Keywords:

ECM exercise fatigue tendinopathy tendon damage

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Area of Science:

Musculoskeletal biology
Exercise physiology
Connective tissue research

Background:

Tendinopathy is a prevalent musculoskeletal injury with limited effective treatments.
Tendons show poor repair of early fatigue damage.
Exercise promotes healthy tendon remodeling, but its therapeutic role in damaged tendons is unclear.

Purpose of the Study:

To evaluate exercise initiated 1 and 14 days post-fatigue damage for promoting structural repair in injured tendons.
To test the hypothesis that delayed exercise (14 days post-injury) enhances tendon remodeling.

Main Methods:

Rats underwent 6-week exercise protocols (30 or 60 min/day) starting 1 or 14 days after fatigue loading.
Assessment of collagen matrix damage, procollagen I, decorin, and tendinopathy markers.

Main Results:

Exercise initiated 1 day post-injury exacerbated matrix damage, especially at tendon insertions.
Exercise initiated 14 days post-injury promoted midsubstance remodeling and collagen synthesis at insertions.
Delayed exercise application counteracted negative effects of early intervention.

Conclusions:

Physiological exercise initiated after the acute inflammatory response has subsided can promote remodeling of fatigue-damaged tendons.
Exercise timing is a critical factor in therapeutic interventions for tendinopathy.