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From the Trauma Department, Medical School Hannover, Hannover, Germany
* Address correspondence to Karsten Knobloch, MD, Trauma Department, Medical School Hannover, Carl-Neuberg-Str. 1, 30625 Hannover, Germany (e-mail: kknobi{at}yahoo.com).
Background: Cryotherapy and compression have been shown to decrease pain and improve function. The dosage and timing of these options remain unclear.
Purpose: To examine the effects of a standardized compression and cryotherapy device (Cryo/Cuff) on midportion Achilles tendon microcirculation during intermittent administration.
Study Design: Descriptive laboratory study.
Methods: Twenty-six subjects were included (13 men and 13 women; age, 32.3 ± 12 years; body mass index, 25.4 ± 5 kg/m2). Each underwent three 10-minute applications of the device, followed by a 10-minute recovery period. A continuous real-time assessment of parameters of Achilles tendon midportion microcirculation was performed with a laser Doppler spectrophotometry system.
Results: Superficial tendon oxygen saturation dropped significantly from 35.9 ± 21 arbitrary units (AU) to 13.5 ± 15, 15.9 ± 16, and 11.1 ± 11 AU (P = .0001) during each period of cryo-compression, respectively. There was significant increase during the recovery period (55.4 ± 29, 65.2 ± 26, and 65.7 ± 27 AU; P = .003), up to +83% of the baseline level. At 8-mm tendon depth, cryo-compression preserved local oxygen with –4% (P = .001) of the baseline level and small but significant increased oxygen saturation of up to +13% (P = .0001). Relative postcapillary venous tendon filling pressures were favorably reduced both superficially (57% ± 34%, 67% ± 27%, and 64% ± 38%, respectively; P = .0004) and deep (76% ± 13%, 79% ± 11%, and 78% ± 18%, respectively; P = .0002). Superficial capillary blood flow was reduced from 48.4 ± 48 to 5 ± 7, 4 ± 5, and 3 ± 4 AU at each period, respectively (–94%, P = .0003), with increased flow during recovery periods of up to 58 ± 64, 58 ± 79, and 47 ± 71 AU, respectively (+20%, P = .265). Deep flow was reduced from 197 ± 147 to 66.7 ± 64, 55 ± 46, and 43 ± 39 AU, respectively (–78%, P = .0002) without increase during recovery periods.
Conclusion: Cryo/Cuff exerts beneficial effects on the microcirculatory level of the midportion Achilles tendon with decreased capillary blood flow, preserved deep tendon oxygen saturation, and facilitated venous capillary outflow.
Key Words: cryotherapy • sport • ankle • microcirculation • cooling • compression
This article has been cited by other articles:
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  K. Knobloch, R. Grasemann, M. Spies, and P. M. Vogt Midportion Achilles Tendon Microcirculation After Intermittent Combined Cryotherapy and Compression Compared With Cryotherapy Alone: A Randomized Trial Am. J. Sports Med., November 1, 2008; 36(11): 2128 - 2138. [Abstract] [Full Text] [PDF]
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K. Knobloch, L. Schreibmueller, R. Meller, K. H. Busch, M. Spies, and P. M. Vogt Superior Achilles Tendon Microcirculation in Tendinopathy Among Symptomatic Female Versus Male Patients Am. J. Sports Med., March 1, 2008; 36(3): 509 - 514. [Abstract] [Full Text] [PDF]
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K. Knobloch, M. Spies, K. H. Busch, P. M. Vogt, K.-D. Schaser, A. C. Disch, and T. Mittlmeier Letter to the Editor * Authors' Response Am. J. Sports Med., September 1, 2007; 35(9): e1 - e3. [Full Text] [PDF]
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 K. Knobloch and H. Alfredson Eccentric training in Achilles tendinopathy: is it harmful to tendon microcirculation? * Commentary Br. J. Sports Med., June 1, 2007; 41(6): e2 - e2. [Abstract] [Full Text] [PDF]
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