Download PDF
physiopraxis 2020; 18(11/12): 38-43
DOI: 10.1055/a-1261-1494
Therapie

Gesundes Gewebe kräftigen – Tendinopathien der unteren Extremität

Christian Garlich∗
› Further Information
   Permissions and Reprints

Die Korrelation zwischen Schmerz und pathologischer Veränderung ist bei Tendinopathien nachgewiesenermaßen sehr schwach. Eine australische Studie stellte schon 2016 fest, dass pathologische Sehnen mehr gesundes Sehnengewebe als normale Sehnen aufweisen und Verbesserungen im Bild nicht darstellbar sein können. Christian Garlich fasst die therapeutische Konsequenz zusammen.



Publication History

Article published online:
26 November 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • Literaturverzeichnis

  • 1 Brinjikji W, Luetmer PH, Comstock B. et al SystematicLiterature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations. Am J Neuroradiol 2014; 36: 811-816
    CrossrefPubMedGoogle Scholar
  • 2 Girish G, Lobo LG, Jacobson JA. et al Ultrasound of the shoulder: Asymptomatic findings in men. Am J Roentgenol 2011; 197: 713-719
    CrossrefPubMedGoogle Scholar
  • 3 Frank JM, Harris JD, Erickson BJ. et al Prevalence of femoroacetabular impingement imaging findings in asymptomatic volunteers: A systematic review. Arthrosc - J Arthrosc Relat Surg 2015; 31: 1199-1204 DOI: doi:10.1016/j.arthro.2014.11.042.
    CrossrefGoogle Scholar
  • 4 Culvenor AG, Øiestad BE, Hart HF. et al Prevalence of knee osteoarthritis features on magnetic resonance imaging in asymptomatic uninjured adults: a systematic review and meta-analysis. Br J Sports Med 2019; 53: 1268-1278
    CrossrefPubMedGoogle Scholar
  • 5 O’Neil J, McDonald E, Chapman T. et al Anterior Talofibular Ligament Abnormalities on Routine Magnetic Resonance Imaging of the Ankle. Foot Ankle Orthop 2017; 2: 2473011417S0003
    CrossrefGoogle Scholar
  • 6 Nakashima H, Yukawa Y, Suda K. et al Abnormal findings on magnetic resonance images of the cervical spines in 1211 asymptomatic subjects. Spine (Phila Pa 1976) 2015; 40: 392-398
    CrossrefPubMedGoogle Scholar
  • 7 Scott A, Docking S, Vicenzino B. et al Sports and exercise-relatedtendinopathies: A review of selected topical issues by participants of the second International Scientific Tendinopathy Symposium (ISTS) Vancouver 2012. Br J Sports Med 2013; 47: 536-544
    CrossrefPubMedGoogle Scholar
  • 8 McAuliffe S, McCreesh K, Culloty F. et al Can ultrasoundimagingpredictthe development of Achilles and patellar tendinopathy? A systematic review and meta-analysis. Br J Sports Med 2016; 50: 1516-1523
    CrossrefPubMedGoogle Scholar
  • 9 Rasmussen OS. Sonography of tendons. Scand J Med Sci Sport 2000; 10: 360-364
    CrossrefPubMedGoogle Scholar
  • 10 Hirschmüller A, Frey V, Konstantinidis L. et al Prognostic value of achilles tendon doppler sonography in asymptomatic runners. Med Sci Sports Exerc 2012; 44: 199-205
    CrossrefPubMedGoogle Scholar
  • 11 Brasseur JL, Lucidarme O, Tardieu M. et al Ultrasonographic rotator-cuff changes in veteran tennis players: The effect of hand dominance and comparison with clinical findings. Eur Radiol 2004; 14: 857-864
    CrossrefPubMedGoogle Scholar
  • 12 Cook JL, Khan KM, Harcourt PR. et al Patellar tendonultrasonography in asymptomatic active athletes reveals hypoechoic regions: A study of 320 tendons. Clin J Sport Med 199873-7 DOI: doi:10.1097/00042752-199804000-00001.
    CrossrefGoogle Scholar
  • 13 Du Toit C, Stieler M, Saunders R. et al Diagnostic accuracy of power Doppler ultrasound in patients with chronic tennis elbow. Br J Sports Med 2008; 42: 572-576
    CrossrefPubMedGoogle Scholar
  • 14 Giombini A, Dragoni S, Di Cesare A. et al Asymptomatic Achilles, patellar, and quadriceps tendinopathy: A longitudinal clinical and ultrasonographic study in elite fencers. Scand J Med Sci Sport 2013; 23: 311-316
    CrossrefPubMedGoogle Scholar
  • 15 Khan KM, Cook JL, Kiss ZS. et al Patellar tendonultrasonography and jumper’s knee in female basketball players: A longitudinal study. Clin J Sport Med 1997: 199-206 DOI: doi:10.1097/00042752-199707000-00009.
    CrossrefGoogle Scholar
  • 16 Rio E, Moseley L, Purdam C. et al The pain of tendinopathy: Physiological or pathophysiological?. Sport Med 2014; 44: 9-23 DOI: doi:10.1007/s40279-013-0096-z..
    CrossrefPubMedGoogle Scholar
  • 17 Docking SI, Cook J. Pathological tendons maintain sufficient aligned fibrillar structure on ultrasound tissue characterization (UTC). Scand J Med Sci Sport 2016; 26: 675-683 DOI: doi:10.1111/sms.12491..
    CrossrefPubMedGoogle Scholar
  • 18 Malliaras P, Purdam C, Maffulli N. et al Temporal sequenceofgray-scaleultrasound changes and their relationship with neovascularity and pain in the patellar tendon. Br J Sports Med 2010; 44: 944-947 DOI: doi:10.1136/bjsm.2008.054916.
    CrossrefPubMedGoogle Scholar
  • 19 Drew BT, Smith TO, Littlewood C. et al Do structuralchanges (eg, collagen/matrix) explain the response to therapeutic exercises in tendinopathy: A systematic review. Br J Sports Med 2014; 48: 966-972 DOI: doi:10.1136/bjsports-2012-091285.
    CrossrefPubMedGoogle Scholar
  • 20 de Vos RJ, Heijboer MP, Weinans H. et al Tendon Structure’s Lack of Relation to Clinical Outcome After Eccentric Exercises in Chronic Midportion Achilles Tendinopathy. J Sport Rehabil 2012; 21: 34-43 DOI: doi:10.1123/jsr.21.1.34.
    CrossrefGoogle Scholar
  • 21 de Vos RJ, Weir A, Tol JL. et al Noeffectsof PRP on ultrasonographic tendon structure and neovascularisation in chronic midportion Achilles tendinopathy. Br J Sports Med 2011; 45: 387-392 DOI: doi:10.1136/bjsm.2010.076398.
    CrossrefPubMedGoogle Scholar
  • 22 Docking S, Rosengarten S, Daffy J. et al Treatthedonut, not the hole: The pathological Achilles and patellar tendon has sufficient amounts normal tendon structure. J Sci Med Sport 2014; 18: e2 DOI: doi:10.1016/j.jsams.2014.11.015.
    CrossrefGoogle Scholar
  • 23 Cook J. Lower Limb Tendinopathy. Fortbildung. Nijmegen/Niederlande 2019
    PubMedGoogle Scholar
  • 24 Janssen I, van der Worp H, Hensing S. et al Investigating achilles and patellar tendinopathy prevalence in elite athletics. Res Sport Med 2018; 26: 1-12 DOI: doi:10.1080/15438627.2017.1393748.
    CrossrefGoogle Scholar
  • 25 Rio E, Kidgell D, Purdam C. et al Isometric exercise induces analgesia and reduces inhibition in patellar tendinopathy. Br J Sports Med 2015; 49: 1277-1283 DOI: doi:10.1136/bjsports-2014-094386.
    CrossrefPubMedGoogle Scholar
  • 26 Kongsgaard M, Kovanen V, Aagaard P. et al Corticosteroid injections, eccentric decline squat training and heavy slow resistance training in patellar tendinopathy. Scand J Med Sci Sport 2009; 19: 790-802 DOI: doi:10.1111/j.1600-0838.2009.00949.x.
    CrossrefPubMedGoogle Scholar
  • 27 Comin J, Cook JL, Malliaras P. et al The prevalence and clinicalsignificance of sonographic tendon abnormalities in asymptomatic ballet dancers: A 24-month longitudinal study. Br J Sports Med 2013; 47: 89-92 DOI: doi:10.1136/bjsports-2012-091303.
    CrossrefPubMedGoogle Scholar
  • 28 Riel H, Lindstrøm CF, Rathleff MS. et al Prevalence and incidence rate of lower-extremity tendinopathies in a Danish general practice: A registry-based study. BMC Musculoskelet Disord 2019; 20: 4-9 DOI: doi:10.1186/s12891-019-2629-6.
    CrossrefPubMedGoogle Scholar
  • 29 Fearon AM, Cook JL, Scarvell JM. et al Greatertrochantericpainsyndrome negatively affects work, physical activity and quality of life: A case control study. J Arthroplasty 2014; 29: 383-386 DOI: doi:10.1016/j.arth.2012.10.016.
    CrossrefPubMedGoogle Scholar
  • 30 Goom TSH, Malliaras P, Reiman MP. et al Proximal hamstringtendinopathy: Clinical aspects of assessment and management. J Orthop Sports Phys Ther 2016; 46: 483-493 DOI: doi:10.2519/jospt.2016.5986.
    CrossrefPubMedGoogle Scholar
  • 31 Malliaras P, Cook J, Purdam C. et al Patellar tendinopathy: Clinical diagnosis, load management, and advice for challenging case presentations. J Orthop Sports Phys Ther 2015; 45: 887-898 DOI: doi:10.2519/jospt.2015.5987.
    CrossrefPubMedGoogle Scholar
  • 32 Bakkegaard M, Johannsen FE, Højgaard B. et al Ultrasonography as a prognostic and objective parameter in Achilles tendinopathy: A prospective observational study. Eur J Radiol 2015; 84: 458-462 DOI: doi:10.1016/j.ejrad.2014.11.028.
    CrossrefPubMedGoogle Scholar
  • 33 Petersen W, Welp R, Rosenbaum D. Chronic Achilles tendinopathy: A prospective randomized study comparing the therapeutic effect of eccentric training, the AirHeel brace, and a combination of both. Am J Sports Med 2007; 35: 1659-1667
    CrossrefPubMedGoogle Scholar
  • 34 Nørregaard J, Larsen CC, Bieler T. et al Eccentric exercise in treatment of Achilles tendinopathy. Scand J Med Sci Sport 2007; 17: 133-138
    CrossrefPubMedGoogle Scholar
  • 35 Lieberthal K, Paterson KL, Cook J. et al Prevalence and factors associated with asymptomatic Achilles tendon pathology in male distance runners. Phys Ther Sport 2019; 39: 64-68 DOI: doi:10.1016/j.ptsp.2019.06.006.
    CrossrefPubMedGoogle Scholar
  • 36 Couppe C, Kongsgaard M, Aagaard P. et al Habitual loading results in tendon hypertrophy and increased stiffness of the human patellar tendon. J Appl Physiol 2008; 105: 805-810 Im Internet http://jap.physiology.org/cgi/doi/10.1152/japplphysiol.90361.2008
    CrossrefPubMedGoogle Scholar
  • 37 Schneider M, Erhard R, Brach J. et al Spinal Palpation for Lumbar Segmental Mobility and Pain Provocation: An Interexaminer Reliability Study. J Manipulative Physiol Ther 2008; 31: 465-473
    CrossrefPubMedGoogle Scholar
  • 38 May S, Littlewood C, Bishop A. Reliability of procedures used in the physical examination of non-specific low back pain: A systematic review. Aust J Physiother 2006; 52: 91-102 Im Internet http://dx.doi.org/10.1016/S0004-9514(06)70044-7
    CrossrefPubMedGoogle Scholar
  • 39 Martin RL, Chimenti R, Cuddeford T. et al Achilles pain, stiffness, and muscle power deficits: Midportion achilles tendinopathy revision 2018. J Orthop Sports Phys Ther 2018; 48: A1-A38
    CrossrefPubMedGoogle Scholar
  • 40 Crossley KM, Thancanamootoo K, Metcalf BR. et al Clinical featuresof patellar tendinopathy and their implications for rehabilitation. J Orthop Res 2007
    PubMedGoogle Scholar
  • 41 Kountouris A, Cook J. Rehabilitation of Achilles and patellar tendinopathies. Best Pract Res Clin Rheumatol 2007; 21: 295-316
    CrossrefPubMedGoogle Scholar
  • 42 Purdam CR, Cook JL, Hopper DM. et al Discriminativeabilityoffunctional loading tests for adolescent jumper’s knee. Phys Ther Sport 2003; 4: 3-9
    CrossrefGoogle Scholar
  • 43 Jesus JF de, Bryk FF, Moreira VC. et al Gluteus Maximus inhibition in proximal hamstring tendinopathy. Med Express 2015; 2: 1-5
    Google Scholar
  • 44 Ganderton C, Pizzari T, Harle T. et al A comparison of gluteus medius, gluteus minimus and tensor facia latae muscle activation during gait in post-menopausal women with and without greater trochanteric pain syndrome. J Electromyogr Kinesiol 2017; 33: 39-47 Im Internet http://dx.doi.org/10.1016/j.jelekin.2017.01.004
    CrossrefPubMedGoogle Scholar
  • 45 Beyer R, Kongsgaard M, Hougs Kjær B. et al Heavy slow resistance versus eccentric training as treatment for achilles tendinopathy: A randomized controlled trial. Am J Sports Med 2015; 43: 1704-1711
    CrossrefPubMedGoogle Scholar
  • 46 Alfredson H, Pietilä T, Jonsson P. et al Heavy-loadeccentriccalfmuscle training for the treatment of chronic achilles tendinosis. Am J Sports Med 1998; 26: 360-366
    CrossrefPubMedGoogle Scholar
  • 47 Camargo PR, Alburquerque-Sendín F, Salvini TF. Eccentrictrainingas a new approach for rotator cufftendinopathy: Review and perspectives. World J Orthop 2014; 5: 634-644
    CrossrefPubMedGoogle Scholar
  • 48 Douglas J, Pearson S, Ross A. et al ChronicAdaptationstoEccentric Training: A Systematic Review. Sport Med 2017; 47: 917-941
    CrossrefPubMedGoogle Scholar
  • 49 Silbernagel KG, Thomeé R, Eriksson BI. et al Continued sports activity, using a pain-monitoring model, during rehabilitation in patients with achilles tendinopathy: A randomized controlled study. Am J Sports Med 2007; 35: 897-906
    CrossrefPubMedGoogle Scholar
  • 50 Mascaró A, Cos MÀ, Morral A. et al Load management in tendinopathy: Clinical progression for Achilles and patellar tendinopathy. Apunt Med l’Esport 2018; 53: 19-27
    CrossrefGoogle Scholar
  • 51 O’Neill S, Radia J, Bird K. et al Acutesensory and motorresponse to 45-s heavy isometric holds for the plantar flexors in patients with Achilles tendinopathy. Knee Surgery, Sport TraumatolArthrosc 2019; 27: 2765-2773 DOI: doi:10.1007/s00167-018-5050-z.
    CrossrefGoogle Scholar
  • 52 van der Vlist AC, van Veldhoven PLJ, van Oosterom RF. et al Isometric exercises do not provide immediate pain relief in Achilles tendinopathy: A quasi-randomized clinical trial. Scand J MedSci Sport 2020: 1712-1721 DOI: doi:10.1111/sms.13728
    CrossrefGoogle Scholar
  • 53 Clifford C, Paul L, Syme G. et al Isometric versus isotonicexercise for greater trochanteric pain syndrome: A randomised controlled pilot study. BMJ Open Sport ExercMed 2019; 5: e000558 DOI: doi:10.1136/bmjsem-2019-000558.
    CrossrefGoogle Scholar
  • 54 Rio E, Kidgell D, Lorimer Moseley G. et al Tendon neuroplastic training: Changing the way we think about tendon rehabilitation: A narrative review. Br J Sports Med 2016; 50: 209-215
    CrossrefPubMedGoogle Scholar
  • 55 Kongsgaard M, Qvortrup K, Larsen J. et al Fibril Morphology and Tendon Mechanical Properties in Patellar Tendinopathy. Am J Sports Med 2010; 38: 749-756
    CrossrefPubMedGoogle Scholar
  • 56 Lim HY, Wong SH. Effects of isometric, eccentric, or heavy slow resistance exercises on pain and function in individuals with patellar tendinopathy: A systematic review. Physiother Res Int 2018; 23: e1721 DOI: doi:10.1002/pri.1721.
    CrossrefPubMedGoogle Scholar
  • 57 Stasinopoulos D, Stasinopoulos I. Comparison of effects of eccentric training, eccentric-concentric training, and eccentric-concentric training combined with isometric contraction in the treatment of lateral elbow tendinopathy. J Hand Ther 2017; 30: 13-19 DOI: doi:10.1016/j.jht.2016.09.001.
    CrossrefPubMedGoogle Scholar