Patellar and Achilles tendinopathies are predominantly peripheral pain states: a blinded case control study of somatosensory and psychological profiles

Melanie L Plinsinga, Cornelis P Van Wilgen, Michel S Brink, Viana Vuvan, Aoife Stephenson, Luke J Heales, Rebecca Mellor, Brooke K Coombes, Bill T Vicenzino

    Research output: Contribution to journalArticle

    15 Citations (Scopus)

    Abstract

    Study design Case–control design.

    Background Tendinopathy is characterised by pain on tendon loading. In persistent cases of upper limb tendinopathy, it is frequently associated with central nervous system sensitisation, whereas less commonly linked in the case of persistent lower limb tendinopathies.

    Objectives Compare somatosensory and psychological profiles of participants with persistent patellar (PT) and Achilles tendinopathies (AT) with pain-free controls.

    Methods A comprehensive battery of Quantitative Sensory Testing (QST) was assessed at standardised sites of the affected tendon and remotely (lateral elbow) by a blinded assessor. Participants completed the Victorian Institute of Sports Assessment, a health-related quality of life questionnaire, the Hospital Anxiety and Depression Scale and the Active Australia Questionnaire. Independent t-test and analysis of covariance (sex-adjusted and age-adjusted) were performed to compare groups.

    Results Participants with PT and AT did not exhibit differences from controls for the QST at the remote site, but there were differences at the affected tendon site. Compared with controls, participants with PT displayed significantly lower pressure pain threshold locally at the tendon (p=0.012) and fewer single limb decline squats before pain onset, whereas participants with AT only displayed fewer single heel raises before pain onset, but this pain was of a higher intensity.

    Conclusion PT and AT appear to be predominantly local not widespread pain states related to loading of tendons without significant features of central sensitisation.
    LanguageEnglish
    Pages284-291
    JournalBritish Journal of Sports Medicine
    Volume52
    Issue number5
    DOIs
    Publication statusPublished - 11 Jul 2017

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    Tendinopathy
    Case-Control Studies
    Psychology
    Tendons
    Pain
    Central Nervous System Sensitization
    Pain Threshold
    Heel
    Elbow
    Upper Extremity
    Sports
    Lower Extremity
    Extremities
    Anxiety
    Quality of Life
    Depression
    Pressure

    Cite this

    Plinsinga, Melanie L ; Van Wilgen, Cornelis P ; Brink, Michel S ; Vuvan, Viana ; Stephenson, Aoife ; Heales, Luke J ; Mellor, Rebecca ; Coombes, Brooke K ; Vicenzino, Bill T. / Patellar and Achilles tendinopathies are predominantly peripheral pain states: a blinded case control study of somatosensory and psychological profiles. In: British Journal of Sports Medicine. 2017 ; Vol. 52, No. 5. pp. 284-291.
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    abstract = "Study design Case–control design.Background Tendinopathy is characterised by pain on tendon loading. In persistent cases of upper limb tendinopathy, it is frequently associated with central nervous system sensitisation, whereas less commonly linked in the case of persistent lower limb tendinopathies.Objectives Compare somatosensory and psychological profiles of participants with persistent patellar (PT) and Achilles tendinopathies (AT) with pain-free controls.Methods A comprehensive battery of Quantitative Sensory Testing (QST) was assessed at standardised sites of the affected tendon and remotely (lateral elbow) by a blinded assessor. Participants completed the Victorian Institute of Sports Assessment, a health-related quality of life questionnaire, the Hospital Anxiety and Depression Scale and the Active Australia Questionnaire. Independent t-test and analysis of covariance (sex-adjusted and age-adjusted) were performed to compare groups.Results Participants with PT and AT did not exhibit differences from controls for the QST at the remote site, but there were differences at the affected tendon site. Compared with controls, participants with PT displayed significantly lower pressure pain threshold locally at the tendon (p=0.012) and fewer single limb decline squats before pain onset, whereas participants with AT only displayed fewer single heel raises before pain onset, but this pain was of a higher intensity.Conclusion PT and AT appear to be predominantly local not widespread pain states related to loading of tendons without significant features of central sensitisation.",
    author = "Plinsinga, {Melanie L} and {Van Wilgen}, {Cornelis P} and Brink, {Michel S} and Viana Vuvan and Aoife Stephenson and Heales, {Luke J} and Rebecca Mellor and Coombes, {Brooke K} and Vicenzino, {Bill T}",
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    Patellar and Achilles tendinopathies are predominantly peripheral pain states: a blinded case control study of somatosensory and psychological profiles. / Plinsinga, Melanie L; Van Wilgen, Cornelis P; Brink, Michel S; Vuvan, Viana; Stephenson, Aoife; Heales, Luke J; Mellor, Rebecca; Coombes, Brooke K; Vicenzino, Bill T.

    In: British Journal of Sports Medicine, Vol. 52, No. 5, 11.07.2017, p. 284-291.

    Research output: Contribution to journalArticle

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    T1 - Patellar and Achilles tendinopathies are predominantly peripheral pain states: a blinded case control study of somatosensory and psychological profiles

    AU - Plinsinga, Melanie L

    AU - Van Wilgen, Cornelis P

    AU - Brink, Michel S

    AU - Vuvan, Viana

    AU - Stephenson, Aoife

    AU - Heales, Luke J

    AU - Mellor, Rebecca

    AU - Coombes, Brooke K

    AU - Vicenzino, Bill T

    PY - 2017/7/11

    Y1 - 2017/7/11

    N2 - Study design Case–control design.Background Tendinopathy is characterised by pain on tendon loading. In persistent cases of upper limb tendinopathy, it is frequently associated with central nervous system sensitisation, whereas less commonly linked in the case of persistent lower limb tendinopathies.Objectives Compare somatosensory and psychological profiles of participants with persistent patellar (PT) and Achilles tendinopathies (AT) with pain-free controls.Methods A comprehensive battery of Quantitative Sensory Testing (QST) was assessed at standardised sites of the affected tendon and remotely (lateral elbow) by a blinded assessor. Participants completed the Victorian Institute of Sports Assessment, a health-related quality of life questionnaire, the Hospital Anxiety and Depression Scale and the Active Australia Questionnaire. Independent t-test and analysis of covariance (sex-adjusted and age-adjusted) were performed to compare groups.Results Participants with PT and AT did not exhibit differences from controls for the QST at the remote site, but there were differences at the affected tendon site. Compared with controls, participants with PT displayed significantly lower pressure pain threshold locally at the tendon (p=0.012) and fewer single limb decline squats before pain onset, whereas participants with AT only displayed fewer single heel raises before pain onset, but this pain was of a higher intensity.Conclusion PT and AT appear to be predominantly local not widespread pain states related to loading of tendons without significant features of central sensitisation.

    AB - Study design Case–control design.Background Tendinopathy is characterised by pain on tendon loading. In persistent cases of upper limb tendinopathy, it is frequently associated with central nervous system sensitisation, whereas less commonly linked in the case of persistent lower limb tendinopathies.Objectives Compare somatosensory and psychological profiles of participants with persistent patellar (PT) and Achilles tendinopathies (AT) with pain-free controls.Methods A comprehensive battery of Quantitative Sensory Testing (QST) was assessed at standardised sites of the affected tendon and remotely (lateral elbow) by a blinded assessor. Participants completed the Victorian Institute of Sports Assessment, a health-related quality of life questionnaire, the Hospital Anxiety and Depression Scale and the Active Australia Questionnaire. Independent t-test and analysis of covariance (sex-adjusted and age-adjusted) were performed to compare groups.Results Participants with PT and AT did not exhibit differences from controls for the QST at the remote site, but there were differences at the affected tendon site. Compared with controls, participants with PT displayed significantly lower pressure pain threshold locally at the tendon (p=0.012) and fewer single limb decline squats before pain onset, whereas participants with AT only displayed fewer single heel raises before pain onset, but this pain was of a higher intensity.Conclusion PT and AT appear to be predominantly local not widespread pain states related to loading of tendons without significant features of central sensitisation.

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    JF - British Journal of Sports Medicine

    SN - 0306-3674

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