Tendinopathy: Pathophysiology, Therapeutic Options, and Role of Nutraceutics. A Narrative Literature Review

Loiacono, Carlo; Palermi, Stefano; Massa, Bruno Sérgio Ferreira; Belviso, Immacolata; Romano, Veronica; Gregorio, Ada Di; Sirico, Felice; Sacco, Anna Maria

doi:10.3390/medicina55080447

Cited by 75 publications

(66 citation statements)

References 96 publications

(99 reference statements)

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“…Some antiepileptic drugs, like pregabalin and gabapentin [ 85 ], have shown positive effects in post-traumatic neuropathic pain relief, although some side effects are reported (i.e., dizziness) and discontinuation of treatment is frequent. As in other musculoskeletal conditions [ 86 ], some multivitamin supplements and neurotrophic agents are commonly adopted, especially in neuroapraxia and axonotmesis, even if their effectiveness is debated and even if they are commonly used in sports population behind nerve injuries [ 87 ]. Perineural steroid and anesthetic injections at the site of nerve injury, commonly adopted for short relief of the pain in other several musculoskeletal conditions [ 88 ], are not routinely performed in the management of neuropathic pain but they have shown some positive results [ 89 ].…”

Section: Therapeutic Optionsmentioning

confidence: 99%

Brachial Plexus Injuries in Sport Medicine: Clinical Evaluation, Diagnostic Approaches, Treatment Options, and Rehabilitative Interventions

Belviso

Palermi

Sacco

et al. 2020

JFMK

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The brachial plexus represents a complex anatomical structure in the upper limb. This “network” of peripheral nerves permits the rearrangement of motor efferent fibers, coming from different spinal nerves, in several terminal branches directed to upper limb muscles. Moreover, afferent information coming from different cutaneous regions in upper limb are sorted in different spinal nerves through the brachial plexus. Severe brachial plexus injuries are a rare clinical condition in the general population and in sport medicine, but with dramatic consequences on the motor and sensory functions of the upper limb. In some sports, like martial arts, milder injuries of the brachial plexus can occur, with transient symptoms and with a full recovery. Clinical evaluation represents the cornerstone in the assessment of the athletes with brachial plexus injuries. Electrodiagnostic studies and imaging techniques, like magnetic resonance and high-frequency ultrasound, could be useful to localize the lesion and to define an appropriate treatment and a functional prognosis. Several conservative and surgical techniques could be applied, and multidisciplinary rehabilitative programs could be performed to guide the athlete toward the recovery of the highest functional level, according to the type of injury.

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Section: Therapeutic Optionsmentioning

confidence: 99%

Brachial Plexus Injuries in Sport Medicine: Clinical Evaluation, Diagnostic Approaches, Treatment Options, and Rehabilitative Interventions

Belviso

Palermi

Sacco

et al. 2020

JFMK

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“…It is the case of eccentric exercise for the treatment of tendinopathy (O'Neill, Watson, & Barry, 2015) (Loiacono et al, 2019), or the use of isokinetic dynamometer in the prevention of sport injuries (Croisier & Crielaard, 2001). In the last years, a novel modality of muscle contraction, iso-inertial (Tesch, Fernandez-Gonzalo, & Lundberg, 2017), is gaining more scientific interest for its potential applications.…”

Section: Practical Application To Sport Medicine and Rehabilitation Smentioning

confidence: 99%

“…These differences have impact on several functions of skeletal muscles, determining different level of tension. Recent evidences (Naugle, Naugle, Fillingim, & Riley, 2014) showed that isometric contraction could modulate pain perception (Rio et al, 2015), while eccentric contractions could have a role in the rehabilitation of muscle injuries and tendinopathies (Loiacono et al, 2019). Isometric contractions are useful to contrast hypotrophy.…”

Section: Introductionmentioning

confidence: 99%

From “sliding” to “winding” filaments theory: A narrative review of mechanisms behind skeletal muscle contraction

Montesano¹,

Palermi²,

Massa³

et al. 2020

Journal of Human Sport and Exercise - 2020 - Spring Conferences of Sports Science

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The physiological mechanisms behind muscle contraction are a main concept in sport medicine and rehabilitation. The sarcomere is the functional unit of skeletal muscle and several proteins definite its complex structure. The most common theory to explain muscle contraction was proposed in the last 50's and has become widely popular and accepted: the "sliding filaments" theory. Even if this hypothesis was able to justify some form of muscle contraction, other processes are not fully described by it. Eccentric contraction and some phenomena, like the "force enhancement during stretch" concept described in the 2002, are not explicable according to the sliding filament theory. Therefore, several hypotheses have been suggested over the years, such as the "popping sarcomeres" theory and the "winding filament" theory. Some other proteins, like titin, have gained a main role in the physiology of the sarcomere and should be relevant to explain mechanisms of eccentric contraction, where the sarcomere generates highest level of tension while it is lengthening. The aim of this review is to summarize the physiological theories of muscle contraction and to define concepts applicable in sport medicine and in rehabilitation areas.

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“…Tendon disorders are very common in sports and any anatomical district may be interested depending on the type of sport practiced (Loiacono et al, 2019). For position and role, hip and the surrounding tendons are overstressed and often overloaded, especially in athletes (Schilders et al, 2013): this could lead to the developing of several tendinopathies, among which the differential diagnosis is often complicated (Frizziero et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

Tendinopathies of the hip and pelvis in athletes: A narrative review

Sirico¹,

Palermi²,

Massa³

et al. 2020

Journal of Human Sport and Exercise - 2020 - Spring Conferences of Sports Science

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Tendon disorders represent some of the most frequent musculoskeletal complaints worldwide. In the athletic population, tendinopathy could affect different anatomical districts. Tendons surrounding hip and pelvis are frequently involved due to overuse and high functional demands in the athletes. These disorders negatively impact on sport performance, since they are a long-lasting clinical condition requiring a multimodal management. Great trochanter pain syndrome, proximal hamstring tendinopathy, insertional adductor tendinopathy and ileopsoas tendinopathy are the most common clinical conditions involving tendon structures of the hip and pelvis. Due to the anatomical complexity of the region, the relationship with pelvic organs, the demographic and anthropometric characteristics of the athletes, the differential diagnosis between these musculoskeletal disorders and other diseases is often difficult to conduct and some therapeutic options are challenging. Modification of risk factors, changes in training protocols, some specific therapeutic exercise programs and rehabilitation procedures have been proposed as an efficient conservative management strategy, guarantying a complete recovery of athletic function. Surgical approaches are required in a specific subset of patients. This narrative literature review aims to summarize current understanding and areas of ongoing research about the clinical features, diagnostic keys and therapeutic options of the main clinical tendinopathies surrounding hip and pelvis.

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Tendinopathy: Pathophysiology, Therapeutic Options, and Role of Nutraceutics. A Narrative Literature Review

Cited by 75 publications

References 96 publications

Brachial Plexus Injuries in Sport Medicine: Clinical Evaluation, Diagnostic Approaches, Treatment Options, and Rehabilitative Interventions

Brachial Plexus Injuries in Sport Medicine: Clinical Evaluation, Diagnostic Approaches, Treatment Options, and Rehabilitative Interventions

From “sliding” to “winding” filaments theory: A narrative review of mechanisms behind skeletal muscle contraction

Tendinopathies of the hip and pelvis in athletes: A narrative review

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