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Increased supraspinatus tendon thickness following fatigue loading in rotator cuff tendinopathy: potential implications for exercise therapy
McCreesh, Karen; Purtill, Helen; Donnelly, Alan Edward; Lewis, Jeremy S.
Background/aim Exercise imparts a load on tendon tissue that leads to changes in tendon properties. Studies suggest that loading immediately reduces tendon thickness, with a loss of this response in symptomatic tendinopathy. No studies investigating the response of tendon dimensions to load for the rotator cuff tendons exist. This study aimed to examine the short-term effect of loading on the thickness of the supraspinatus tendon and acromiohumeral distance those with and without rotator cuff tendinopathy. Methods Participants were 20 painfree controls, and 23 people with painful rotator cuff tendinopathy. Supraspinatus tendon thickness and acromiohumeral distance were measured using ultrasound scans before, and at three time points after loading (1, 6 and 24 hours). Loading involved isokinetic eccentric and concentric external rotation and abduction. Results There was a significant increase in supraspinatus tendon thickness in the pain group at 1 (7%, Δ=0.38, 95% CI 0.19 to 0.57) and 6 hours (11%, Δ=0.53, 95% CI 0.34 to 0.71), although only the 6 hours difference exceeded minimal detectable difference. In contrast, there was a small non-significant reduction in thickness in controls. The acromiohumeral distance reduced significantly in both groups at 1 hour (controls: Δ=0.64, 95% CI 0.38 to 0.90; pain: Δ=1.1, 95% CI 0.85 to 1.33), with a larger change from baseline in the pain group. Conclusion Those diagnosed with painful supraspinatus tendinopathy demonstrated increased thickening with delayed return to baseline following loading. Rehabilitation professionals may need to take into account the impact of loading to fatigue when planning rehabilitation programmes.
Keyword(s): increased; supraspinatus; tendon; thickness; fatigue; rotator; cuff tendinopathy; potential implications; exercise therapy
Publication Date:
Type: Journal article
Peer-Reviewed: Yes
Language(s): English
Institution: University of Limerick
Funder(s): Health Research Board
Citation(s): BMJ;3:e000279
Publisher(s): BMJ Publishing Group
First Indexed: 2018-01-05 06:33:47 Last Updated: 2018-01-05 06:33:47