Langberg H, Ellingsgaard H, Madsen T, Jansson J, Magnusson S P, Aagaard P, Kjaer M
Institute of Sports Medicine - Copenhagen, Bispebjerg Hospital, Copenhagen, Denmark.
Scand J Med Sci Sports. 2007 Feb;17(1):61-6. doi: 10.1111/j.1600-0838.2006.00522.x. Epub 2006 Jun 19.
It has been shown that 12 weeks of eccentric heavy resistance training can reduce pain in runners suffering from chronic Achilles tendinosis, but the mechanism behind the effectiveness of this treatment is unknown. The present study investigates the local effect of an eccentric training regime on elite soccer players suffering from chronic Achilles tendinosis on the turnover of the peritendinous connective tissue. Twelve elite male soccer players, of whom six suffered from unilateral tendinosis and six were healthy controls, participated in this study. All participants performed 12 weeks of heavy-resistance eccentric training apart from their regular training and soccer activity. Before and after the training period the tissue concentration of indicators of collagen turnover was measured by the use of the microdialysis technique. After training, collagen synthesis was increased in the initially injured tendon (n=6; carboxyterminal propeptide of type I collagen (PICP): pre 3.9+/-2.5 microg/L to post 19.7+/-5.4 microg/L, P<0.05). The collagen synthesis was unchanged in healthy tendons in response to training (n=6; PICP: pre 8.3+/-5.2 microg/L to post 11.5+/-5.0 microg/L, P>0.05). Collagen degradation, measured as carboxyterminal telopeptide region of type I collagen (ICTP), was not affected by training neither in the injured nor in the healthy tendons. The clinical effect of the 12 weeks of eccentric training was determined by using a standardized loading procedure of the Achilles tendons showing a decrease in pain in all the chronic injured tendons (VAS before 44+/-9, after 13+/-9; P<0.05), and all subjects were back playing soccer following the eccentric training regime. The present study demonstrates that chronically injured Achilles tendons respond to 12 weeks of eccentric training by increasing collagen synthesis rate. In contrast, the collagen metabolism in healthy control tendons seems not to be affected by eccentric training. These findings could indicate a relation between collagen metabolism and recovery from injury in human tendons.
研究表明，12周的离心重阻力训练可以减轻患有慢性跟腱炎的跑步者的疼痛，但这种治疗效果背后的机制尚不清楚。本研究调查了离心训练方案对患有慢性跟腱炎的精英足球运动员腱周结缔组织更新的局部影响。12名精英男性足球运动员参与了本研究，其中6名患有单侧跟腱炎，6名作为健康对照。除了常规训练和足球活动外，所有参与者都进行了12周的重阻力离心训练。在训练期前后，使用微透析技术测量胶原更新指标的组织浓度。训练后，最初受伤的肌腱中胶原合成增加（n = 6；I型胶原羧基末端前肽（PICP）：训练前3.9±2.5μg/L，训练后19.7±5.4μg/L，P<0.05）。健康肌腱的胶原合成在训练后没有变化（n = 6；PICP：训练前8.3±5.2μg/L，训练后11.5±5.0μg/L，P>0.05）。以I型胶原羧基末端端肽区域（ICTP）衡量的胶原降解，在受伤和健康肌腱中均未受训练影响。通过对跟腱进行标准化负荷程序来确定12周离心训练的临床效果，结果显示所有慢性受伤肌腱的疼痛均减轻（视觉模拟评分法（VAS）：训练前44±9，训练后13±9；P<0.05），并且所有受试者在离心训练方案后都恢复了足球比赛。本研究表明，慢性受伤的跟腱对12周的离心训练有反应，胶原合成速率增加。相比之下，健康对照肌腱的胶原代谢似乎不受离心训练影响。这些发现可能表明人类肌腱中胶原代谢与损伤恢复之间存在关联。
