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Author Spotlight: Integrating Mechanical and Biological Analysis in Tendinopathy Research
Published on: March 1, 2024
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PAIN SENSITIVITY IN CHRONIC ACHILLES TENDINOPATHY
Brian J Eckenrode, David M Kietrys1, Scott K Stackhouse2
1Rutgers School of Health Professions, Blackwood, NJ, USA.
International Journal of Sports Physical Therapy
|December 6, 2019
Summary
Chronic Achilles tendinopathy in athletes shows signs of both peripheral and central nervous system sensitization. This suggests that physical therapy for tendinopathy should address these nervous system changes.
Area of Science:
- Sports Medicine
- Pain Research
- Neurology
Background:
- Achilles tendinopathy is a prevalent overuse injury in athletes, frequently becoming chronic.
- Chronic musculoskeletal pain conditions often display signs of nervous system sensitization.
Purpose of the Study:
- To compare pain sensitivity, including pressure pain threshold (PPT), heat pain threshold (HPT), and heat temporal summation (HTS), between athletes with and without chronic Achilles tendinopathy.
- To investigate the presence of peripheral and/or central sensitization in chronic Achilles tendinopathy.
Main Methods:
- A cohort study involving 17 participants with chronic Achilles tendinopathy (≥3 months) and 24 healthy controls.
- Pain processing was assessed using PPT, HPT, and HTS tests.
- Participants completed questionnaires including the Pain Catastrophizing Scale (PCS), Lower Extremity Functional Scale (LEFS), and Victorian Institute of Sport Assessment-Achilles (VISA-A).
Main Results:
- Participants with Achilles tendinopathy exhibited primary hyperalgesia (lower PPT and HPT) at the injury site.
- Mechanical secondary hyperalgesia, indicative of central sensitization, was observed in the affected leg and tibialis anterior muscle.
- No significant differences in PCS scores or HTS were found between the groups.
Conclusions:
- Active individuals with chronic Achilles tendinopathy demonstrate signs of both peripheral and central sensitization.
- These findings support a multifactorial model of tendinopathy involving motor, local, and pain system components.
- Physical therapy interventions for chronic Achilles tendinopathy may need to incorporate strategies to address nervous system sensitization.
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