Study: No inflammatory gene-expression response to acute exercise in human Achilles tendinopathy.

edited February 2014 in Running Science
Interesting study abstract, last two sentences in particular. Suggests benefit of acute exercise for tendon healing if I'm understanding it.

Eur J Appl Physiol. 2013 Aug;113(8):2101-9. doi: 10.1007/s00421-013-2638-3. Epub 2013 Apr 16.

No inflammatory gene-expression response to acute exercise in human Achilles tendinopathy.


Although histology data favour the view of a degenerative nature of tendinopathy, indirect support for inflammatory reactions to loading in affected tendons exists. The purpose of the present study was to elucidate whether inflammatory signalling responses after acute mechanical loading were more pronounced in tendinopathic versus healthy regions of human tendon and if treatment with non-steroidal anti-inflammatory medications (NSAID's) reduces this response. Twenty-seven tendinopathy patients (>6 months) were randomly assigned to a placebo (n = 14) or NSAID (Ibumetin NYCOMED GmbH Plant Oranienburg Germany (600 mg) × 3/day/1 week) group (n = 13) in a double-blinded-fashion. Tendon biopsies were taken from the painful and a healthy region of the same tendon 2 h after 1 h running. Gene-expression of several targets was analysed in the sampled Achilles tendon biopsies. The mRNA for TGF-β, collagen-I and collagen-III were significantly higher expressed, and decorin, CTGF, IL-6 and IL-10 were significantly lower expressed in the tendinopathic versus healthy tendon area. Only IL-10 was lower in expression in experiments with NSAID administration, while all other determined parameters were unaffected by NSAID. All ultrasonographic outcomes were unchanged in response to acute exercise and not influenced by NSAID. The signalling for collagen and TGF-beta was upregulated after acute loading in tendinopathic tendon. In contrast to the hypothesis, inflammatory signalling was not exaggerated in tendinopathic tendon 2 h after acute mechanical loading.


  • edited February 2014
    This may be simplistic, but might it be a good idea to figure out what caused the tendon injury in the first place? If you continue to do what made it hurt, I would think acute exercise would not help. Change your form, and exercise may indeed be helpful.
  • This study definitely follows what the current literature is saying - that tendinopathy is not an inflammatory response (any 'swelling' of the tendon is water retention not an inflammatory response) and that exercise is extremely beneficial in the rehabilitation of tendinopathy.  

    As a private practice physiotherapist (working in a sports and musculosketal practice) I think the big issue is the type of exercise that is used.  Continuing to run on an irritated achilles is probably going to make it worse, however a specific exercise program targeted to an individuals needs is likely to bring about improvements.  It is important to note that these exercises will depend on the staging of the tendinopathy (acute vs chronic/degenerate) and the specific cause (ie form, loading etc).  There is no one program that is suitable for every achilles issue (despite what some sights seem to propose - usually alfredson's eccentric achilles program)
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