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Knobloch 2006
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Knobloch K, Grasemann R, Jagodzinski M, Richter M, Zeichen J, Krettek C. Changes of Achilles midportion tendon microcirculation after repetitive simultaneous cryotherapy and compression using a Cryo/Cuff. Am J Sports Med. 2006 Dec;34(12):1953-9.
Design: In-vivo laboratorystudy Subjects: 26 healthy participants were included.
34 • Oxygen saturation: Superficial tendon oxygen saturation dropped significantly up to -70%. There was significant increase during the recovery period up to +83% of the baseline level. At 8-mm tendon depth, cryo-compression preserved local oxygen with -4% of the baseline level and small but significant increased oxygen saturation of up to +13% during the recovery period. • Complications: None of the subjects had any skin burns or nerve palsies caused by the Cryo/Cuff. • Postcapillary venous filling pressures are diminished during Cryo/Cuff application favoring capillary venous outflow: up to 67% pressure reduction at 2mm and up to 79% pressure reduction at 8mm. • Increased postcapillary filling pressure indicates venous congestion with decreased clearance of local capillary metabolic end products. Facilitation of the postcapillary venous clearance is therefore beneficial in a microcirculatory view. Methods: Each subject underwent 3 10-minute applications of the Cryo/Cuff , 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: • Capillary blood flow: Superficial (2mm) capillary blood flow was significantly reduced by 94%, with increased flow during recovery periods of up to 20%. Deep flow (8mm) was significantly reduced by 78% without increase during recovery periods. • To speculate on tendinopathic or injured patients, one could think that cryo-compression might decrease the pathologically increased capillary flow at the point of pain in Achilles tendinopathy and limit bleeding on the capillary level in injured patients.
Key message: Cryo/Cuff exerts beneficial effects on the microcirculatory level of the midportion of the Achilles tendon with decreased capillary blood flow, preserved deep tendon oxygen saturation, and facilitated venous capillary outflow.
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