CAN THE KNOWLEDGE OF ECCENTRIC TRAINING IN ACHILLES TENDINOPATHY BE USED TO TREAT SUPERFICIAL DIGITAL FLEXOR TENDINOPATHIES IN THE EQUINE? Denise Kesson MCSP MSc Veterinary Physiotherapy Student Introduction Physiotherapy has been a valued component of health care in humans for over a century. The recognition of the benefits of Veterinary Physiotherapy in the injured animal has been relatively recent. The profile of the Veterinary Physiotherapist is rising in both the Veterinary world and with the general public. To increase the credibility of the profession it is important that interventions used are evidenced based. The Equine Veterinary Journal published a review article by Buchner and Schildboeck (2006) on physiotherapy applied to the horse. This review systematically analysed published research on the effect of the various physiotherapeutic modalities used in practice applying the evidence-based medicine approach (Mair and Cohen 2003). Their findings were that there were insufficient good quality studies investigating the use of various physiotherapy treatments on horses to enable physiotherapists to work with an evidence based medicine approach to treatment. The following year, in the same journal, McGowan et al (2007) built on this review stating that Buchner and Schildboeck had limited their review of evidence to veterinary literature. The feeling was that there are good quality studies performed in human literature that has led on from previous research performed on animals that can be applied to veterinary practice. McGowan et al emphasised how physiotherapy uses a range of treatment modalities for each individual patient after a formal assessment that will have led to a functional diagnosis. They therefore
believed that it was more beneficial to discuss both the science and evidence base behind current issues in key areas of physiotherapy and to look at how they can be applied to the performance horse, rather than reviewing the research done concerning each treatment modality.
surrounding the efficacy of eccentric exercises will be explored. The author will aim to draw from the literature evidence to justify the use of eccentric exercises in the management of superficial digital flexor tendinopathy in the equine. Tendiniopathy Definition
Achilles tendon
The aim of this literature review is to follow on from McGowan et al’s article and to examine the relevance and application of eccentric exercise as an evidenced-based physiotherapeutic approach to treat superficial digital flexor tendinopathy in the equine. Currently tendon problems affect both the human and equine athletes (Williams et al (2001), Maffulli et al (1999), Horshian et al (1998) and Moller et al (1996)). Management of Achilles tendinopathy in humans is predominantly conservative and physiotherapist led whereas the equivalent tendon in equines, the superficial digital flexor tendon, is managed by more invasive methods by the veterinary surgeon (Dyson (2004)). Current literature exploring the definition of tendinopathy, its aetiology and the evidence
The term tendinopathy is used to describe tendon pathology in the sheath and or body itself arising from overuse (Benazzo and Maffulli (2000)). It has replaced the diagnosis of “tendonitis” and “tendinosis” which are only used if there is evidence of inflammation found after histopathological examination (Sharma and Maffulli, 2006). It has replaced the diagnosis of “tendonitis” and “tendinosis” which are only used if there is evidence of inflammation found after histopathological examination (Sharma and Maffulli, 2006).
Tendon structure
In both human and the equine, tendinopathies can occur from the influence of both intrinsic, for example poor foot conformation or biomechanics (Eliashar et al (2004) and Nigg (1994)), and extrinsic factors, such as excessive repetitive
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