Abstract
Extracorporeal shockwave (ESW) therapy is popular in the treatment of musculoskeletal injuries, but the mechanism by which ESW therapy might have an effect on a tendon injury is unknown. Therefore, this study examined the effects of ESW therapy on the progressive changes in the nanostructure and adhesion force of collagen fibrils of a rat Achilles tendinitis model induced by collagenase, using atomic force microscopy. The nanostructural progressive changes in morphology including the fibril diameter and D-periodicity, and properties such as the fibril adhesion force in each healing phase, were investigated over a 9-week period after injecting collagenase. The injured collagen network structures with the physical ESW therapy were returned to a well-aligned normal collagen network nanostructure. These results suggest that physical ESW therapy may promote the healing response to Achilles tendinitis.
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