In this blog I would like to tell you something about physical therapy to support the healing of tendon injuries, but also to prevent them.
Specifically, I want to talk about electrotherapy and therapeutic ultrasound in tendon deseases.
In the last blog I wrote something about tendon injuries even without symptoms of injury and pain. Their origin and the presence of chronic changes in the tendon. Especially training (sport horses) and age lead to microlesions and supply disorders in the heavily loaded tendons. This mainly affects the so-called energy storing tendons, the superficial flexor tendon and the support ligament.
Physical therapy can have a positive effect on tendon healing, especially in the inflammatory stage, after a recent injury, and in the early stage of tendon healing.
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In electrotherapy, different forms of current and intensities can be used.
The applied form of current decides the effect in the body. And especially in the early phase of tendon injury or in subclinical cases, types of current that reduce the inflammatory edema and the pain are recommended. In addition, metabolism and blood flow to the tissues should be stimulated.
In a study, significant improvement in strain was noted after experimental tendon splitting in animals treated with stimulation current after only 28 days. Untreated control animals required 60 days of healing for the same result.
Electrotherapy is similar to magnetic field therapy in an extended form. This is because every conductor of electricity is surrounded by an electromagnetic field. In the case of electrotherapy, the muscle or tendon acts as a conductor of electricity around which an electromagnetic field is formed.
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What’s going on in tissues under current?
Inflammatory mediators such as interleukin 1ß and certain metalloproteases are inhibited. Thus the treatment alters gene expression in inflamed tissues and improves healing.
Therefore, electrotherapy can also be used to treat chronic degenerative joint disease (arthritis) and wounds with delayed healing.
In addition, ultrasound monitoring showed better organization of tendon tissue under electrotherapy.
Of course, electrotherapy can also be used prophylactically. Why wait until the tendon is damaged? In sport horses under stress, but also in older leisure horses, such physical therapy of the particularly endangered superficial flexor tendon and the supporting ligament makes perfect sense. The same applies to stressed muscular structures such as the trunk supporting apparatus and the ischial musculature, as well as the anterior neck musculature.
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Therapeutic ultrasound shows even greater efficacy than electrotherapy under study conditions.
Ultrasound above a medium intensity has a temperature-increasing effect, i.e., it promotes blood circulation, especially at the borders of tissues. This is called thermal effect.
While this is certainly desirable for chronic processes and at certain stages of healing, it also has drawbacks. For example, in acute infections and freshly bleeding wounds.
There, one uses low ultrasound intensities. They have the advantage of not having a thermal effect and of penetrating particularly deeply into the tissue. The penetration depth with the transducer of my device is up to 6.0 cm deep.
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So therapeutic ultrasound also has both pain-relieving and healing-promoting effects. Like a nonsteroidal anti-inflammatory (pain reliever), it can inhibit inflammation and pain responses (COX-2 inhibitor). Ultrasound helps with collagen synthesis in the connective tissues of tendons and joints. Thus, it makes the tendon tissue more elastic and durable and improves the prognosis of the injured tendon in terms of its durability.
And the same applies to its use in joint diseases and poorly healing wounds. It is also excellent for treating torn muscle fibers and painful muscles.