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DOES SENSITISATION PLAY A ROLE IN THE PAIN OF PATIENTS WITH CHRONIC PATELLAR TENDINOPATHY?
  1. J Zwerver1,
  2. K H Konopka2,
  3. D Keizer3,
  4. R Dekker4,
  5. C P van Wilgen5
  1. 1Centre for Sports Medicine, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
  2. 2Department of Anesthesiology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
  3. 3GP Surgery Het Homeer Harkema, The Netherlands
  4. 4Department of Rehabilitation, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
  5. 5Centre for Human Movement Sciences, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands

    Abstract

    Introduction The aetiology and pain mechanisms of tendinopathies are not completely understood. Currently, little is known regarding whether, or to which degree, somatosensory changes within the nervous system may contribute to the pain in tendinopathies.

    The aim of this study was to investigate whether somatosensory changes represent a plausible explanation for pain in patients with chronic patellar tendinopathy.

    Methods A patient controlled study in which the standardised QST protocol developed by the German Research Network on Neuropathic Pain was used. This protocol consists of seven different tests that measure 13 somatosensory parameters and can be seen as the gold standard to measure somatosensory function.

    Results Twelve athletes with clinically diagnosed chronic patellar tendinopathy (PT) with a mean duration of 30 months (range 6–120) and 20 controls were included in the study. In two of the 13 QST parameters, namely Mechanical Pain Threshold (p<0.05) and Vibration Disappearance Threshold (p<0.5), injured athletes were significantly more sensitive for the applied stimuli. None of the athletes had signs of Dynamic Mechanical Allodynia.

    Discussion Reduced mechanical pain thresholds or pinprick allodynia reflects the involvement of central sensitisation upon the myelinated (Ad-fibre) nociceptive input. From this explorative study, we conclude that sensitisation may play a prominent role in the pain experienced during and after sports activity, by patellar tendinopathy patients.

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