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Intraindividual Doppler Flow Response to Exercise Differs Between Symptomatic and Asymptomatic Achilles Tendons
Lucie Risch1, Josefine Stoll1, Anne Schomöller1
1University Outpatient Clinic, Sports Medicine and Orthopedics, University of Potsdam, Potsdam, Germany.
Frontiers in Physiology
|July 23, 2021
Summary
Running exercise increases intratendinous blood flow (IBF) in Achilles tendons, particularly in symptomatic tendons with tendinopathy. This response suggests altered neovascularization associated with pain in Achilles tendinopathy.
Area of Science:
- Musculoskeletal Ultrasound
- Vascular Biology
- Sports Medicine
Background:
- Achilles tendinopathy is a common condition characterized by pain and impaired function.
- Intratendinous blood flow (IBF) changes in response to exercise are not fully understood in tendinopathy.
- Neovascularization is often implicated in tendinopathy, but its dynamic response to exercise requires further investigation.
Purpose of the Study:
- To investigate intraindividual differences in intratendinous blood flow (IBF) following running exercise in individuals with Achilles tendinopathy.
- To compare the IBF response between symptomatic and asymptomatic Achilles tendons.
- To explore the relationship between baseline IBF, exercise-induced IBF, and clinical presentation.
Main Methods:
- Cross-sectional study involving 19 participants with unilateral Achilles tendinopathy.
- IBF assessed using Doppler ultrasound (Advanced Dynamic Flow) at baseline and at 5, 30, 60, and 120 minutes post-exercise.
- IBF quantified by counting the number of intratendinous vessels.
Main Results:
- Symptomatic tendons exhibited higher baseline IBF compared to asymptomatic tendons (p < 0.01).
- A significant proportion of both symptomatic (63%) and asymptomatic (47%) tendons showed an increase in IBF post-exercise.
- IBF remained elevated longer in symptomatic tendons compared to asymptomatic tendons post-exercise (p < 0.01).
Conclusions:
- Running exercise elicits an acute physiological increase in IBF in a majority of Achilles tendons, regardless of pathology.
- Symptomatic Achilles tendons demonstrate higher baseline IBF and a more prolonged exercise-induced IBF response.
- These findings suggest an altered intratendinous neovascularization associated with pain in Achilles tendinopathy.
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