Docking Sean I, Cook Jill
La Trobe Sport and Exercise Medicine Research Centre, College of Science, Health and Engineering, La Trobe University, Australia.
J Musculoskelet Neuronal Interact. 2019 Sep 1;19(3):300-310.
Understanding how tendons adapt to load is crucial to understanding how training can improve performance, minimise the risk of injury and aid rehabilitation. Adaptation is the positive response of an organism or tissue to benefit its function. In tendons, numerous tissue responses to load have been identified . Changes in tendon dimensions, structure on imaging, mechanical properties, and blood flow have been reported in response to mechanical stimuli. However, research has focused on tissue level changes with little understanding of how changes at the tissue level affect the person, their athletic performance or injury risk. Tendons can have a paradoxical response to load, load can induce positive adaptation, however it is also a major factor in the development of tendon pathology and pain. Tendon pathology is a risk factor for developing symptoms, yet the high rate of asymptomatic pathology suggests that the pathological tendon must adapt to be able to tolerate load. Similarly, there is mounting evidence to suggest that tendon remodelling or repair is not necessary for a positive clinical outcome following rehabilitation, suggesting that the tendon must adapt via other mechanisms. This narrative review synthesises evidence of how normal and pathological tendons adapts to load, and how this relates to adaptation of load capacity and function of the individual.
了解肌腱如何适应负荷对于理解训练如何提高运动表现、将受伤风险降至最低以及辅助康复至关重要。适应是生物体或组织为改善其功能而做出的积极反应。在肌腱方面，已经确定了许多组织对负荷的反应。据报道，响应机械刺激，肌腱尺寸、成像结构、力学性能和血流会发生变化。然而，研究主要集中在组织层面的变化，而对组织层面的变化如何影响个体、其运动表现或受伤风险了解甚少。肌腱对负荷可能会有矛盾的反应，负荷可诱导积极的适应，但它也是肌腱病变和疼痛发展的主要因素。肌腱病变是出现症状的一个风险因素，但无症状病变的高发生率表明，病变的肌腱必须适应才能耐受负荷。同样，越来越多的证据表明，康复后取得良好的临床结果并不一定需要肌腱重塑或修复，这表明肌腱必须通过其他机制进行适应。这篇叙述性综述综合了正常和病变肌腱如何适应负荷的证据，以及这与个体负荷能力和功能的适应有何关系。
