Tendons are surrounded by loose areolar connective tissue called paratenon. The main components of the paratenon are the type I collogen about 95% and about 5% of type II collagen of the dry tendon weight but smaller quantities of other collagens are also present, including types V, VI, XII and type II collagen (Robi et al. 2013).
The bundles of collagen fibrils are wrapped in endotenon, which in turn is enveloped by an epitenon, forming the actual tendon. A real synovial sheath is present only in some tendons, such as tibialis posterior, peroneal, and extensor and flexor tendons of the wrist and the hand; other tendons do not have a proper sheath, with the epitenon instead surrounded by a paratenon, a layer of thin tissue(Abate et al. 2009). The space between these two layers contains fluids rich in mucopolysaccharides that provide lubrication, prevent
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friction and protect the tendon. (Abate et al. 2009) There are two types of tendons: tendons shielded with paratenon, and sheathed tendons.
They primarily differ in vascular supply. In sheathed tendons there is a vessel that supply blood to one parts of the tendon and the other section nutrition depend on the diffusion. On the other hand, paratenon-covered tendons receive their blood supply from vessels entering the tendon surface and forming a rich capillary system.(Kannus 2000) Because of the difference in blood supply paratenon-covered tendons heal better than the sheated tendons(Robi et al. 2013).
Under the paratenon, the whole tendon is covered by a fine connective tissue sheath called epitenon. On its external surface, the epitenon is touching with paratenon. To enhance connectivity, there is a high level of hydration of proteoglycan parts between the endotenon and the surface of the tendon fascicles (Rowe, 1985). Along with its important function of binding, the endotenon system permits the fiber bundle to slide on each other and transports bloods to veins, nerves, and lymphatics to the more profound part of the tendon (Elliott, 1965; Hess et al.,
1989). III. TENDON INJURIES Tendon may be injured because of intrinsic reasons which are usually considered as anatomy abnormalities or other factors specific to the person as well as because of an external stimulus or just a combination of both(Sharma & Maffulli 2006; Sharma & Maffulli 2005). The intrinsic causes of injury result from high rates of strain, similar to those in which an overuse injury or repetitive micro trauma surpasses the reparative process. The external stimulus results from high levels of stress or load such as those cases where an external violence occurs. We have a combination of both when a tendon injury occurs in contact-collision sports(Nordin 2002). Injuries can be acute or chronic and are usually painful. The main tendon injuries are tendon rupture and tendinopathy. A. TENDON RUPTURE Tendon injury occurs because of an external stimulus, although intrinsic damage may predispose tendons to rupture. Tendon rupture is usually caused by a rapid acceleration-deceleration. As much as 90% of sports related Achilles tendon ruptures are caused a rapid acceleration-deceleration mechanism(Sharma & Maffulli 2005). There exists a shock abortion mechanism made of a protective inhibitory pathway of the musculo-tendinous unit. The malfunction of this mechanism may also result in tendon rupture. Although the full set of causes behind tendon rupture still remains unclear, degenerative tendinopathy seems to be most common cause in literature (Sharma & Maffulli 2006; Sharma & Maffulli 2005). B. TENDINOPATHY Tendinopathy is usually attributed to inflammation; however the pain may originate from a combination of mechanical and biomechanical causes. Tendon deterioration with mechanical breakdown of collagen could hypothetically clarify the pain, but clinical and surgical observations also indicate that chemical irritant and neurotransmitters could also generate pain in the tendinopathy (Sharma & Maffulli 2005) “Active repair of fatigue damage must occur, or tendons would weaken and eventually rupture” (Sharma & Maffulli 2005). The repair mechanism is facilitated by resident tenocytes, which maintain a fine balance between ECM production and degradation. HEALING Studies of tendon healing process have been performed mainly on transected animal tendons or ruptured human tendons, and their relevance to healing of tendinopathy human tendons remains unclear because experiment have been performed mostly on cadaver tendons (Sharma & Maffulli 2005) Tendons and ligaments heal in the same manner as other tissues following injury with the same three phases occurring in succession: the inflammatory phase, the proliferative phase or fibroplasia, and organization or remodeling.
During the remainder of this lab, continuous drops of Ringers solution were dispensed on the frog. The first activity was isolating the gastrocnemius muscle. A cut between the thigh and hip was made so the skin could be pulled down past the lower leg. Then the tendon was cut away from the bone of the heel and one end of the nine-inch string was tied to the tendon.
... It is not completely clear how it is that a tendon becomes a ligament, although Dr. Akizuki thinks that range of motion exercises help the tendon learn that it is being used as a ligament now and that it needs to adopt. Surgeons don't go back in to biopsy the repaired elbow to see how the tissue has changed, but follow-up MRIs show that the new tissue is acting as a ligament should.
Witvrouw, E., Mahieu, N., Roosen, P., & McNair, P. (2007). The role of stretching in tendon injuries. British journal of Sports Medicine , 224-226.
A rotator cuff is simply a group of four tendons and muscles that are located right on the shoulder and on top of the humerus bone. (Source 1) The rotator cuff is what controls the shoulder and allows it to move and be mobile. The four main muscles that consist of the tendons are the supraspinatus, infraspinatus, teres minor, and subscapularis muscles. (Source 2). Too much wear and tear on these muscles (such as too many thrown fastballs) is precisely what causes the rotator cuff to begin to tear, as well as swelling in the tendons.
... This patient, after treatment, had completed ROM and was able to get back to daily activities (Papa 2012). GISTM has been shown to work on all types of injuries, whether the patient had surgery or not. GISTM is becoming a well-known tool in the clinical world and is a reason for faster recovery periods (Black 2010). Works Cited Black D. Treatment of knee arthrofibrosis and quadriceps insufficiency after patellar tendon repair: a case report including use of the graston technique.
The arteries have a thick inner layer of muscle and elastic fibres. This means that they can stretch a lot more than the veins that have a thin inner layer, this means that they are more compact.
Repair after a muscle is damaged happens through the division of certain cells who then fuse to existing, undamaged muscle fibers to correct the damage. Different muscle types take different amounts of time to heal and regenerate after it has been damaged. Smooth muscle cells can regenerate with the greatest capacity due to their ability to divide and create many more cells to help out. While cardiac muscle cells hardly regenerate at all due to the lack of specialized cells that aid in repair and regeneration. In skeletal muscle, satellite cells aid in helping restoration after injury. Along with muscles, tendons are very important structures within the human body, and they to can be damaged. However, tendon repair involves fibroblast cells cross-linking collagen fibers that aid in not only reinforcing structural support, but also mechanical support as well (“Understanding Tendon Injury,” 2005). While quite different from muscle repair, tendon repair involves the similarity of reestablishing d...
The musculoskeletal system is made up of bones, muscles, cartilage, tendons, ligaments, joints and other connective tissue that supports and binds tissue and other organs together. Each muscle is a discreet organ constructed of skeletal muscle tissue, blood vessels, and nerves. Did you know there are roughly 600 organs that make up the muscular system? They include the cardiac muscles, smooth muscles, and skeletal muscles to name a few. The heart is the cardiac muscle. Smooth muscle are the tissues that line blood vessels and organs, such as the stomach and intestines. The skeletal muscles, which are the most well known and familiar of the muscle organ system, helps hold the skeletal frame work together. They make up bout 40 percent of the
There are three types of muscle tissue in the human body. These muscle tissues are skeletal muscles, smooth muscles and cardiac muscles. Each of these muscle tissues has it very own anatomical makeup, which vary from muscle to muscle. The muscle cells in a muscle are referred to as muscle fibers, these fibers are skeletal muscle fibers, smooth muscle fibers and cardiac muscle fibers.
When observing both cell types under a microscope several differences are obvious. Firstly, skeletal muscles are larger than smooth muscle cells (one muscle cell can be up to 100µm in length). They are also multinucleated whilst smooth muscle cells are uninucleate (Alberts et al, 2002: 961). Additionally, skeletal muscle cells appear to be striated, whereas smooth muscle cells do not show this banding pattern; but are instead smooth and tapered. The absence of this patterning in smooth muscle cells suggests that they consist of a less organised collection of contractile fibres (Silverthorn, 2007: 397). This banding pattern in skeletal muscles is known as the sarcomere.
The solution to this problem is located in the lab. Researchers across the country are working day in and day out to come up with a solution to accelerate the healing of soft tissues. They have come up with many solutions, from vibration therapy, to personalized rehab plans, but none of these are yielding truly significant results. I believe the solution lies at the molecular level. I believe that we can observe the healing of these soft connective tissues and learn from it. Then we can design a method from the observations to accelerate the production of the fibrils and collagen that will go on to make up the soft connective tissue. I have begun to take the beginning steps in solving this problem through my mentorship with Dr. Weinhold. Our research goals go hand in hand, which has led us to beginning research on the release of an angiogenic growth factor through a gelatin that will coat sutures. In theory, this angiogenic growth factor, once released from the crosslinking with the gelatin will stimulate the development of blood vessels around the recently repaired collagenous tissue. This, in turn, will allow the tendon/ligament to have a better oxygen supply and allow for quicker
Tendonitis- Repetitive strain on a tendon can aggravate the tendon causing pain, inflammation, and complications with movement involving the muscle. Unfortunately, tendons have an insufficient blood supply; consequently, it takes an extensive time to heal, usually six weeks or more.
Wang PhD, James, and Jianying Zhang PhD. "Platelet-Rich Plasma Releasate Promotes Differentiation of Tendon Stem Cells Into Active Tenocytes." The American Journal of Sports Medicine 88.12 (2010): 2477-486. Print.
The cytoskeleton is made up of three different types of filaments, actin filaments, intermediate filaments and microtubules. Actin filaments are the thinnest, they are also known as microfilaments. They create a band under the plasma membrane, this gives strength to the cell and links transmembrane proteins such as cell surface receptors to cytoplasmic proteins. Intermediate filaments include keratins, lamins, neurofilaments and vimentins. Keratins form hooves, horns and hair and are found in epithelial cells. Lamins form a type of mesh that ‘stabilizes the inner membrane of the nuclear envelope’ (Biology Pages). Neurofilaments bring strength to the axons of neurons and vimentins provide mechanical support to cells – particularly muscles. The cytoskeleton is also involved in cell
The muscular system is the set of all the muscles that make up the human body. It is an extensive system of muscles and nervous tissue, which is distributed all through the body. In total, the human body consists of approximately 650 muscles (Shier, Butler, Lewis, 2009). The muscular system is divided into three types of muscle: cardiac muscle, smooth muscle, and skeletal muscle (p.212).