deeago ha scritto:Domanda provocatoria: allungare il tendine dovrebbe disinfiammare?
Nel maggiore parte dei casi il problema non è "Tendinitis" (infiammazione) ma "Tendinosis" (micro ferite).
"Achilles tendinopathy. This includes one of two conditions:
Tendinitis. This actually means "inflammation of the tendon." But inflammation is rarely the cause of tendon pain.
Tendinosis. This refers to tiny tears (microtears) in the tissue in and around the tendon. These tears are caused by overuse. In most cases, Achilles tendon pain is the result of tendinosis, not tendinitis."
Dato questo fatto di sopra possiamo immaginare che queste micro-ferite tendono a ripararsi (perché il corpo umano è una macchina meraviglioso) ma come sappiamo una qualsiasi riparazione del corpo tende a formare dei cicatrici. E sono questi cicatrici nel collagene del tendine a creare il classico dolore del Tendine d'Achille.
L'esercizio (eccentric heel drop) allunga le fibre di collagene e tende a rompere questi piccoli cicatrici, come descritto sotto. Nel tempo il tendine ricostruisce le varie fibre che adesso sono allineati nella direzione giusta e senza cicatrici.
"While the term “tendonitis” implies that inflammation (-itis) is the root cause of the problem, in fact, the true cause is real, physical damage to the fibers of the Achilles tendon itself.
Much like a bungee cord is made up of tiny strands of rubber aligned together, tendons are comprised of small fiber-like proteins called collagen. Pain in the Achilles tendon is a result of damage to the collagen. Because of this, treatment options should start with ways to address this.
Unfortunately, it seems that the thick tendons of the body do not heal as rapidly or completely as we’d like.
The cause of this seems to be the collagen fibers:
When a tendon is damaged, collagen fibers are ruptured. The body is able to lay down new fibers to replace the damaged ones, but it does so in a rather disorganized way. The new collagen fibers look much like a mess of spaghetti when viewed on a microscope, in contrast to the smooth, aligned appearance that healthy tendon fibers have.
The exercise of choice is the eccentric heel drop, which has an impressive research pedigree backing its use.
The strength protocol consists of two exercises: a straight-kneed and a bent-kneed eccentric heel drop.
The protocol calls for three sets of fifteen heel drops, both bent-kneed and straight-kneed, twice a day for twelve weeks.
Standing on a step with your ankles plantarflexed (at the top of a “calf raise”), shift all of your weight onto the injured leg.
Slowly use your calf muscles to lower your body down, dropping your heel beneath your forefoot. Use your uninjured leg to return to the “up” position. Do not use the injured side to get back to the “up” position!
The exercise is designed to cause some pain, and you are encouraged to continue doing it even with moderate discomfort. You should stop if the pain is excruciating, however.
Once you are able to do the heel drops without any pain, progressively add weight using a backpack. If you are unlucky enough to have Achilles tendon problems on both sides, use a step to help you get back to the “up” position, using your quads instead of your calves to return up.
What’s the bottom line?
The eccentric exercises are thought to selectively damage the Achilles tendon, stripping away the misaligned tendon fibers and allowing the body to lay down new fibers that are closer in alignment to the healthy collagen in the tendon.
This is why moderate pain during the exercises is a good thing, and why adding weight over time is necessary to progressively strengthen the tendon."