The Importance of Controlled Passive Mobilization on Flexor Tendon Healing:<i>A Biomechanical Study</i>

Woo, Savio L‐Y.; Gelberman, Richard H.; Cobb, Norman G.; Amiel, David; Lothringer, Kimberly; Akeson, Wayne H.

doi:10.3109/17453678108992156

Cited by 224 publications

(111 citation statements)

References 12 publications

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“…Appropriate tendon mobilization accelerates the healing of an injured tendon, and immobilization prevents healing (Woo et al 1981, Gelberman et al 1982, Murrell et al 1994. The reasons for these effects may be as follows.…”

Section: Discussionmentioning

confidence: 99%

Unfavorable effect of knee immobilization on Achilles tendon healing in rabbits

Yasuda

Koshi

Abe

et al. 2000

Acta Orthopaedica Scandinavica

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Section: Discussionmentioning

confidence: 99%

Unfavorable effect of knee immobilization on Achilles tendon healing in rabbits

Yasuda

Koshi

Abe

et al. 2000

Acta Orthopaedica Scandinavica

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“…Throughout weeks 2-4, that is, the proliferative phase, the amount of newly organized collagen at the rupture site increased up to 130%, while the tendon diameter was unchanged. During the remaining weeks (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16), that is, the remodeling phase, the amount of newly organized collagen slowly increased to almost reach the total diameter of the tendon. of the wheel-running group (RUN) compared to that of the plaster-treated group (IMMOB) (Fig.…”

Section: Nerve Fiber Occurrencementioning

confidence: 99%

“…[1][2][3][4][5] During the past decade early mobilization and exercise have been shown to promote tissue repair after injury to the locomotor apparatus. [6][7][8][9] The underlying mechanisms have been studied extensively, but still remain largely unknown.…”

Section: Introductionmentioning

confidence: 99%

Physical activity modulates nerve plasticity and stimulates repair after achilles tendon rupture

Bring

Kreicbergs

Renström

et al. 2006

Journal Orthopaedic Research

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In a rat model of tendon rupture using semiquantitative methodology, healing was assessed according to the diameter of newly organized collagen and the occurrence of the sensory neuropeptides (SP, CGRP) in relation to different levels of physical activity. Normally, innervation of the Achilles tendon is confined to the paratenon. After rupture new nerve fibers grow into the tendon proper, but disappear after healing. In a first experiment to establish peak tissue and nerve regeneration after rupture, tendon tissues from freely moving rats were collected consecutively over 16 weeks. A peak increase in organized collagen and nerve ingrowth was observed between week 2 to 4 post rupture. Therefore, in a second experiment week 4 was chosen to assess the effect of physical activity on tendon healing in three groups of rats, that is, wheel running, plaster treated, and freely moving (controls). In the wheel-running group, the diameter of newly organized collagen was 94% ( p ¼ 0.001) greater than that in the plaster-treated group and 48% ( p ¼ 0.02) greater than that in the controls. Inversely, the neuronal occurrence of CGRP in the tendon proper was 57% ( p ¼ 0.02) lower in the wheel-running group than that in the plaster-treated group and 53% ( p ¼ 0.02) lower than that in the controls, suggesting an earlier neuronal in-growth and disappearance in the more active group. Physical activity speeds up tendon healing, which may prove to be linked to accelerated neuronal plasticity. ß

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“…The most important reason for this was to assess friction after trauma (Lane et al, 1976) and friction of different suture techniques and tendon grafts (Peterson et al, 1986;Woo et al, 1981;Uchiyama et al, 1997;Coert et al, 1995;Williams and Amis, 1995;Nishida et al, 1998). Therefore, various indirect measurement techniques and models (Fowler and Nicol, 2000) and measurements in animals have been described (Lane et al, 1976).…”

Section: Friction In the Tendon-pulley Interfacementioning

confidence: 99%

Friction between human finger flexor tendons and pulleys at high loads

Schweizer

Frank

Ochsner

et al. 2003

Journal of Biomechanics

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A method was developed to indirectly measure friction between the flexor tendons and pulleys of the middle and ring finger in vivo. An isokinetic movement device to determine maximum force of wrist flexion, interphalangeal joint flexion (rolling in and out) and isolated proximal interphalangeal (PIP) joint flexion was built. Eccentric and concentric maximum force of these three different movements where gliding of the flexor tendon sheath was involved differently (least in wrist flexion) was measured and compared. Fifty-one hands in 26 male subjects were evaluated. The greatest difference between eccentric and concentric maximum force (29.9%) was found in flexion of the PIP joint. Differences in the rolling in and out movement (26.8%) and in wrist flexion (14.5%) were significantly smaller. The force of friction between flexor tendons and pulleys can be determined by the greater difference between eccentric and concentric maximum force provided by the same muscles in overcoming an external force during flexion of the interphalangeal joints and suggests the presence of a non-muscular force, such as friction. It constitutes of 9% of the eccentric flexion force in the PIP joint and therefore questions the low friction hypothesis at high loads. r

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The Importance of Controlled Passive Mobilization on Flexor Tendon Healing:A Biomechanical Study

Cited by 224 publications

References 12 publications

Unfavorable effect of knee immobilization on Achilles tendon healing in rabbits

Unfavorable effect of knee immobilization on Achilles tendon healing in rabbits

Physical activity modulates nerve plasticity and stimulates repair after achilles tendon rupture

Friction between human finger flexor tendons and pulleys at high loads

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