Håkan Alfredson

..Calf muscle strength takes a long time to recover and, furthermore, a prolonged progressive calcaneal bone loss has been shown on the operated side up to 1 year after surgical treatment...

..The mechanism that causes pain in chronic Achilles tendinosis is not known. However, high resolution colour Doppler ultrasound has shown that neovascularisation may be involved...

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..In summary, injections with the sclerosing substance Polidocanol have the potential to reduce tendon pain during activity in patients with chronic painful mid-portion Achilles tendinopathy...

..Therefore, the purpose of this study was to determine whether fat distribution was associated with asymptomatic Achilles tendon pathology...

..Furthermore, there were no signs of inflammation in the tendons with painful nodules, as indicated by the normal prostaglandin E2 levels...

..Whether the effects of polidocanol are mediated through destruction of neovessels, activity on nerves or a combination, is under evaluation...

..The importance of this finding for the pathogenesis and pain mechanisms in this chronic condition needs to be further investigated...

..Our results offer no obvious neurophysiological explanation but showed that successful treatment with eccentric training was not associated with lowered intratendinous glutamate levels...

..05). In the short-term perspective, sclerosing polidocanol injections targeting the neovessels in the supraspinatus tendon and/or bursa wall seems to have a potential to reduce the pain during shoulder loading activity...

..In conclusion, we demonstrate findings which support neovessels and accompanying nerves being the possible source of pain in chronic mid-portion Achilles tendinosis...

..In conclusion, cDNA-arrays and real-time PCR can be used to study differences in gene expression levels between tendinosis and control tendon tissue...

..Also, very recently, a new method consisting of sclerosing of neovessels in the area with painful tendinosis showed promising short-term results. Ongoing and future research will evaluate the potential of these treatment models...

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..A recent, randomized, double-blind study verified the importance of injecting the sclerosing substance Polidocanol...

..In summary, both treatment with sclerosing polidocanol injections and open surgical revision outside the ventral Achilles midportion show promising short-term clinical results...

..The findings of glutamate and it's NMDARI-receptors might have implications for treatment and be a potential target for drugs...

..The aim of this study was to investigate the occurrence of a plantaris tendon in close relation to the Achilles tendon in consecutive patients with midportion Achilles tendinosis undergoing treatment with US and Doppler-guided scraping...

..Our findings indicate involvement of the excitatory neurotransmitter glutamate, but no biochemical signs of inflammation (normal PGE2 levels) in ECRB tendons from patients with tennis elbow...

..In a randomised study on a small patient material, similar short-term clinical results were demonstrated with surgery outside the tendon and sclerosing polidocanol injections, but surgical treatment led to a faster return to activity...

..Our present finding of glutamate NMDA receptors in human Achilles tendons might have implications for pain treatment...

..A history including a sudden onset of pain and/or relative weakness in plantar flexion force is an indicator. The most loaded side of the Achilles tendon is the dorsal side (skin side)...

..These findings altogether indicate that glutamate might be involved in painful Jumper's knee, and further emphasizes that there is no chemical inflammation (normal PGE2 levels) in this chronic condition...

..This article gives an update on recently developed conservative treatment methods for the management of chronic Achilles tendinopathy...

..To characterise Achilles tendon structure and thickness a minimum of 8 years after intratendinous surgery. Material and..

..In conclusion, Achilles tendon pain seems to be relatively common among Swedish middle-aged competitive badminton players, particularly in the older ones...

..This case questions previous theories about the weak tendinosis tendon, and stresses the importance of studies evaluating tendon strength...

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..The findings are discussed in relation to aspects of vascular regulation, and to pain symptoms of tendinosis...

..It is likely that locally produced catecholamines and the occurrence of autocrine/paracrine effects of these substances are of great relevance during the process of tendinosis...

..2. Our conclusion is that treatment with eccentric calf-muscle training produced good clinical results in patients with chronic painful mid-portion Achilles tendinosis, but not in patients with chronic insertional Achilles tendon pain...

..Most likely, the findings correspond with the vasculo-neural in growth that has been demonstrated in the chronic painful Achilles tendon, and possibly have implications for treatment...

..In conclusion, treatment only focusing on sclerosing the area with neovessels showed promising short-term clinical results in this small pilot study. The findings support further studies, preferably in a randomised manner...

..Thus, the results of this pilot study suggest that non-neuronal ACh is highly involved in the pathology of therapy-resistant patellar tendinosis...

..In conclusion, it appears as if SPergic autocrine/paracrine effects occur in tendon tissue during the processes of tendinosis, hitherto unknown effects for human tendons...

..In conclusion, the nerve-related characteristics of the area targeted by the polidicanol injection treatment for Achilles tendinosis, are shown here for the first time...

..There were no differences in age, sex, and body mass index between the players with and without painful conditions in the Achilles tendon region...

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..To determine whether there are objective findings of tendinosis in a rabbit tendinopathy model on exercised and contralateral (non-exercised) Achilles tendons...

..Decreased tendon thickness and improved structure after treatment, might indicate a remodelling potential?..

..The findings motivate further studies...

..The study showed that shoulder pain is a common and significant problem in world-class badminton players, and the consequences are most likely of importance for their training and playing capacity...

..The findings add to recent observations of the occurrence of a local production in tendons of signal substances traditionally related to neurons...

..Action on the area with neovessels during the eccentric training regimen might possibly be responsible for the good clinical results...

..These interactions may regulate tropic modulatory, and apoptotic effects. In conclusion, the observations show a new concept concerning production and function of neurotrophins, namely in the tenocytes of tendons...

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..Thus, in conclusion, there appears to be an upregulation of the cholinergic system, and an occurrence of autocrine/paracrine effects in this system, in the tendinosis patellar tendon...

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..Further, it revealed that when using the slow-flow method, a period of at least 2.0-2.5 h is needed, after probe insertion, to reach steady state for glutamate and PGE2...

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..In this study, structure, blood flow and thickness in the Achilles tendon related to tendon-loading activity were investigated...

..However, only 32% of patients with insertional Achilles tendinopathy had good clinical results with that type of eccentric training regimen...

..The nature of tendon neovascularisation associated with pain over time has not been studied...

..A recent study reported promising clinical results using eccentric quadriceps training on a decline board to treat jumper's knee (patellar tendinosis)...

..To prospectively investigate tendon thickness and tendon structure by ultrasonography in patients treated with eccentric calf muscle training for painful chronic Achilles tendinosis located at the 2-6 cm level in the tendon...

..Here we investigate the expression of the cannabinoid receptor 1 (CB₁) in human Achilles tendons from healthy volunteers and from patients with Achilles tendinosis...

..If conservative treatment is not successful, then surgery relieves pain in the majority of cases. Directing a patient through the algorithm presented here will maximise positive treatment outcomes...

..Jumper's knee patellar tendinopathy is well known to be a common and difficult injury in volleyball. Knowledge about its aetiology and pathogenesis is sparse...

..In the other five animals, fibrocartilage was the predominant tissue. In contrast to previous experimental studies using a rabbit model, we did not achieve hyaline cartilage resurfacing...

..The conditions discussed are painful and degenerative tendon disease (tendinopathy/tendinosis), rheumatoid arthritis, and osteoarthritis...

..Additionally, the production of ACh in local cells in the tissues represents an important extra supply of the transmitter. ACh effects can be obtained whether or not there is a cholinergic innervation in the tissue...

..Ultrasonography (US) and colour Doppler (CD) guided injections with polidocanol targeting the area with increased blood flow in the extensor origin have shown promising clinical results...

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..Furthermore, the results imply that a possible source of catecholamine production might be the tenocytes themselves..

..However, the percentage side-to-side difference is relatively low, and might not have any clinical relevance...

..However, it is not known whether there is local production of catecholamines and/or acetylcholine in this tissue, which is the case in patellar and Achilles tendinopathies...

..The neovascularisation found in this investigation might have implications on the pathogenesis of chronic Achilles tendinosis...

..Therefore, we suggest that female soccer players under the age of 16 years should be allowed to participate only in practice sessions but not games at a senior level...

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..All five players who suffered an anterior cruciate ligament injury during the study period had a lower hamstring-to-quadriceps ratio during concentric action on the injured side than on their noninjured side...

..Most of the injuries were of moderate severity (52%), while 34% were minor and 14% were major. Most of the major injuries were traumatic such as knee ligament injuries and ankle sprains...