Is the chronic painful tendinosis tendon a strong tendon?: a case study involving an Olympic weightlifter with chronic painful Jumper's knee.
The chronic painful tendinosis tendon is generally considered a degenerated and weak tendon. However, this has not been scientifically verified, and is to be considered a hypothesis. We present here a case study involving a high-level Olympic weightlifter with chronic painful patellar tendinosis who started heavy-weight training very early after successful treatment with sclerosing injections. A 25-year-old super heavy-weight (+105 kg) Olympic weightlifter with 9 months duration of severe pain (prohibiting full training) in the proximal patellar tendon, where ultrasound and Doppler showed a widened tendon with structural changes and neovascularisation, was given one treatment with ultrasound and Doppler-guided injections of the sclerosing agent polidocanol. The injections targeted the neovessels posterior to the tendon. The patient was pain-free after the treatment, and already after 2-weeks he started with heavy-weight training (240 kg in deep squats) to try to qualify for the Olympics. Additional very heavy training on training camps, most often without having any discomfort or pain in the patellar tendon, resulted in Swedish records and ninth place at the European Championships 17 weeks after the treatment. Despite beating the national records, he did not qualify for the Olympics. Ultrasound and Doppler follow-ups have shown only a few remaining neovessels, and little structural tendon changes. This case questions previous theories about the weak tendinosis tendon, and stresses the importance of studies evaluating tendon strength.
Department of Surgical and Perioperative Science, Sports Medicine, Umeå University, Umea, Sweden.
Karl
K
Gisslén
Lars
L
Ohberg
Håkan
H
Alfredson
D000328:Adult; D002908:Chronic Disease; D006801:Humans; D007270:Injections, Intra-Articular; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D018919:Neovascularization, Physiologic; D010146:Pain / Q000503:physiopathology; D059408:Pain Management; D010147:Pain Measurement; D017847:Patellar Ligament / Q000098:blood supply / Q000000981:diagnostic imaging*; D000077423:Polidocanol; D011092:Polyethylene Glycols / Q000627:therapeutic use; D020127:Recovery of Function / Q000502:physiology*; D012597:Sclerosing Solutions / Q000627:therapeutic use; D052256:Tendinopathy / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D014464:Ultrasonic Therapy; D014463:Ultrasonography; D014891:Weight Lifting / Q000502:physiology*
D012597:Sclerosing Solutions; D000077423:Polidocanol; D011092:Polyethylene Glycols