The analgesic effect of joint mobilization and manipulation in tendinopathy: a narrative review

Savva, Christos; Karagiannis, Christos; Korakakis, Vasileios; Efstathiou, Michalis

doi:10.1080/10669817.2021.1904348

Cited by 9 publications

(2 citation statements)

References 112 publications

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“…In our trial, we found that in all groups a significant reduction in pain (NRS) went parallel with a significant improvement in the VISA-A score without differences between groups. The applied passive therapy, which was available for all groups due to ethical reasons, consisted of > 90% of manual therapy treatment which is known to have hypoalgesic effects [74][75][76][77][78]. It may thus have affected both NRS and VISA-A outcomes in all groups.…”

Section: Discussionmentioning

confidence: 99%

Evidence-Based High-Loading Tendon Exercise for 12 Weeks Leads to Increased Tendon Stiffness and Cross-Sectional Area in Achilles Tendinopathy: A Controlled Clinical Trial

et al. 2022

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Background Assuming that the mechanisms inducing adaptation in healthy tendons yield similar responses in tendinopathic tendons, we hypothesized that a high-loading exercise protocol that increases tendon stiffness and cross-sectional area in male healthy Achilles tendons may also induce comparable beneficial adaptations in male tendinopathic Achilles tendons in addition to improving pain and function. Objectives We investigated the effectiveness of high-loading exercise in Achilles tendinopathy in terms of inducing mechanical (tendon stiffness, maximum strain), material (Young’s modulus), morphological (tendon cross-sectional area (CSA)), maximum voluntary isometric plantar flexor strength (MVC) as well as clinical adaptations (Victorian Institute of Sports Assessment—Achilles (VISA-A) score and pain (numerical rating scale (NRS))) as the primary outcomes. As secondary outcomes, drop (DJ) and counter-movement jump (CMJ) height and intratendinous vascularity were assessed. Methods We conducted a controlled clinical trial with a 3-month intervention phase. Eligibility criteria were assessed by researchers and medical doctors. Inclusion criteria were male sex, aged between 20 and 55 years, chronic Achilles tendinopathy confirmed by a medical doctor via ultrasound-assisted assessment, and a severity level of less than 80 points on the VISA-A score. Thirty-nine patients were assigned by sequential allocation to one of three parallel arms: a high-loading intervention (training at ~ 90% of the MVC) (n = 15), eccentric exercise (according to the Alfredson protocol) as the standard therapy (n = 15) and passive therapy (n = 14). Parameters were assessed pre- and-post-intervention. Data analysis was blinded. Results Primary outcomes: Plantar flexor MVC, tendon stiffness, mean CSA and maximum tendon strain improved only in the high-loading intervention group by 7.2 ± 9.9% (p = 0.045), 20.1 ± 20.5% (p = 0.049), 8.98 ± 5.8% (p < 0.001) and −12.4 ± 10.3% (p = 0.001), respectively. Stiffness decreased in the passive therapy group (−7.7 ± 21.2%; p = 0.042). There was no change in Young’s modulus in either group (p > 0.05). The VISA-A score increased in all groups on average by 19.8 ± 15.3 points (p < 0.001), while pain (NRS) dropped by −0.55 ± 0.9 points (p < 0.001). Secondary outcomes: CMJ height decreased for all groups (−0.63 ± 4.07 cm; p = 0.005). There was no change in DJ height and vascularity (p > 0.05) in either group. Conclusion Despite an overall clinical improvement, it was exclusively the high-loading intervention that induced significant mechanical and morphological adaptations of the plantar flexor muscle–tendon unit. This might contribute to protecting the tendon from strain-induced injury. Thus, we recommend the high-loading intervention as an effective (alternative) therapeutic protocol in Achilles tendinopathy rehabilitation management in males. Clinical Trials Registration Number: NCT02732782.

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Section: Discussionmentioning

confidence: 99%

Evidence-Based High-Loading Tendon Exercise for 12 Weeks Leads to Increased Tendon Stiffness and Cross-Sectional Area in Achilles Tendinopathy: A Controlled Clinical Trial

et al. 2022

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“…The use of joint mobilisation and manipulation close to or locally on the afflicted joint may lessen tendon pain, according to limited evidence, suggesting that these techniques could be used as analgesic interventions for the treatment of tendinopathy. 11 Joints in the shoulder complex (acromioclavicular joint, glenohumeral joint, scapulothoracic joint and sternoclavicular joint), as well as the cervical or thoracic spine, may be subjected to joint mobilisations. Grades I, II, III, IV, and Vthe most popular grading systemare used to categorise passive joint mobilisations based on the joint resistance which is influenced by the movement's amplitude and the view in its range where it occurs.…”

Section: Introductionmentioning

confidence: 99%

Effect of Maitland and Mulligan mobilization on pain, range of motion and disability in patients with rotator cuff syndrome: a randomized clinical trial protocol

Sonone,

Patil

2023

F1000Res

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Background: Rotator cuff syndrome (RCS) comprises partial or whole-thickness rotator cuff tears, rotator cuff tendonitis, subacromial impingement syndrome, and bursitis. Expansion of rotator cuff arthropathy and glenohumeral degenerative disease are both made more likely by chronic rotator cuff syndrome. The maximum well-supported nonsurgical treatment for individual with rotator cuff (RC) injury appears to be musculoskeletal physiotherapy, including manual treatments and exercises. Scapular stabilisation exercises, proprioceptive neuromuscular facilitation (PNF), range of motion (ROM), rotator cuff strengthening exercises, and stretching exercises are some of the therapeutic exercises that have been shown to be useful in recovering shoulder function. The passive, expert movements known as joint mobilisation and manipulation are used by clinicians to increase joint mobility and to reduce pain. Methods: In this study we aim to find out the effect of Maitland and Mulligan mobilization on improving ROM, functional disability and pain in individuals with rotator cuff syndrome through a randomized clinical trial. 80 individuals in total will be allocated equally into two groups, and both groups will be receiving treatment for six weeks with five sessions per week. After six weeks of therapy the results will be assessed for follow-up. By mobilization there will be increased range of motion, reduction in pain and functional disability, this technique may be used to patient with rotator cuff syndrome if our study's premise is found to be significant. Conclusions: In this study, we expect that the Maitland and Mulligan mobilization on pain, range of motion and disability in patients with rotator cuff syndrome will have significant effects. CTRI Registration: CTRI/2023/05/052643.

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Physiotherapeutische Möglichkeiten bei lateraler Epikondylopathie

Reuter

2023

Orthopädie

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The analgesic effect of joint mobilization and manipulation in tendinopathy: a narrative review

Cited by 9 publications

References 112 publications

Evidence-Based High-Loading Tendon Exercise for 12 Weeks Leads to Increased Tendon Stiffness and Cross-Sectional Area in Achilles Tendinopathy: A Controlled Clinical Trial

Evidence-Based High-Loading Tendon Exercise for 12 Weeks Leads to Increased Tendon Stiffness and Cross-Sectional Area in Achilles Tendinopathy: A Controlled Clinical Trial

Effect of Maitland and Mulligan mobilization on pain, range of motion and disability in patients with rotator cuff syndrome: a randomized clinical trial protocol

Physiotherapeutische Möglichkeiten bei lateraler Epikondylopathie

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