Análise das intervenções fisioterapêuticas que alteram as anormalidades teciduais presentes nas tendinopatias patelar e de aquiles: uma revisão da literatura

Abstract

The patellar and Achilles tendinopathy are highly prevalent in athletes and are characterized by pathophysiological changes in the tendon. Initial treatment is conservative and largely performed by physiotherapy techniques, which restore the injured tendon, and thus improve permanently the symptomatology of the patient. The aim of this study was to make a literature review to identify which physical therapy interventions modify the abnormalities present on Achilles and patellar tendinopathy and what are the possible mechanisms responsible for this change. A search of the literature was performed in Medline / PubMed, SciELO, PEDro, and LILACS Google Scholar from the first record until October 2012. From this search ten articles were selected for this review. Exercise eccentric, Heavy Slow Resistance, cryotherapy associated with rest and ankle bracing were the interventions analyzed. The results showed that only ankle bracing did not alter the injured tendon. The other therapies modified the histology and morfology of the affected tendon. Abnormalities influenced by therapies were responsible for clinical improvement, among those are neovascularization, tendon thickness, hypoechoic areas in ultrasound, disorganization of collagen fibers and abnormalities in this. There are few studies that assess changes in the tendon as an outcome, even though these changes are decisive in the presence of tendinopathy, and those who do, have different protocols for intervention and measurement of results. Further studies with better methodological quality and to assess the described outcome is needed to determine the most effective techniques to modify the abnormalities in the patellar and Achilles tendon with tendinopathy, and what are the mechanisms responsible for the normalization.