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  • Title: Changes of Achilles midportion tendon microcirculation after repetitive simultaneous cryotherapy and compression using a Cryo/Cuff.
    Author: Knobloch K, Grasemann R, Jagodzinski M, Richter M, Zeichen J, Krettek C.
    Journal: Am J Sports Med; 2006 Dec; 34(12):1953-9. PubMed ID: 16998082.
    Abstract:
    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/m(2)). 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.
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